Glibomet
Glibomet: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. With impaired renal function
- 10. Drug interactions
- 11. Analogs
- 12. Terms and conditions of storage
- 13. Terms of dispensing from pharmacies
- 14. Reviews
- 15. Price in pharmacies
Latin name: Glibomet
ATX code: A10BD02
Active ingredient: Glibenclamide + Metformin (Glibenclamide + Metformin)
Producer: Berlin-Chemie AG / Menarini Group (Germany)
Description and photo update: 2019-12-08
Prices in pharmacies: from 290 rubles.
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Glibomet is an oral hypoglycemic drug.
Release form and composition
Dosage form of Glibomet: tablets of a round biconvex shape with a dividing line on one side, coated white, odorless (20 pieces in blisters, in a cardboard box of 2, 3 or 5 blisters).
Content of active ingredients in 1 tablet:
- Glibenclamide - 2.5 mg;
- Metformin hydrochloride - 400 mg
Excipients: colloidal silicon dioxide, microcrystalline cellulose, glycerol, corn starch, magnesium stearate, gelatin, talc.
Shell composition: diethyl phthalate, acetyl phthalyl cellulose, talc.
Pharmacological properties
Pharmacodynamics
Glibomet is an oral combined hypoglycemic drug belonging to the second generation biguanide and sulfonylurea derivatives. It is characterized by pancreatic and extra-pancreatic action.
Glibenclamide is a member of the group of II generation sulfonylurea derivatives and stimulates the synthesis of insulin by lowering the threshold of glucose irritation of the beta cells of the pancreas. The substance increases insulin sensitivity and the degree of its binding to target cells, activates the release of insulin, increases its effect on the absorption of glucose by the liver and muscles, and inhibits lipolysis in adipose tissue. Its action is observed at the second stage of insulin secretion.
Metformin belongs to the biguanide category. It stimulates the peripheral sensitivity of tissues to the effects of insulin (increases the degree of binding of insulin to receptors, intensifies the effects of insulin at the post-receptor level), inhibits the absorption of glucose in the intestine, inhibits gluconeogenesis and has a beneficial effect on lipid metabolism, helps to reduce excess body weight in patients with diabetes mellitus, and also has a fibrinolytic effect due to inhibition of tissue-type plasminogen activator inhibitor.
The hypoglycemic effect of Glibomet is observed 2 hours after administration and lasts for 12 hours. The synergistic combination of two active substances of the drug, which consists in the stimulation of endogenous insulin synthesis by sulfonylurea derivatives (pancreatic effect) and the direct effect of biguanide on adipose and muscle tissues (a significant increase in glucose uptake - extra-pancreatic effect), as well as liver tissue (decrease in gluconeogenesis), makes it possible a certain dose ratio to reduce the concentration of each of the components. This prevents overstimulation of the beta cells of the pancreas and reduces the risk of dysfunction of this organ, as well as contributes to the safety of taking hypoglycemic drugs and reduces the incidence of side effects.
Pharmacokinetics
Glibenclamide is absorbed in the gastrointestinal tract at a high rate and quite completely (by 84%). The maximum concentration is reached 1-2 hours after ingestion. The substance binds to plasma proteins by 97% and is almost completely metabolized in the liver, forming inactive metabolites. Glibenclamide is excreted 50% through the kidneys and 50% through the bile. The half-life is 5-10 hours.
The degree of absorption of metformin in the gastrointestinal tract is quite high. The compound is rapidly distributed throughout the tissues and practically does not bind to blood plasma proteins. Metformin is practically not metabolized in the body and is excreted through the kidneys and partly the intestines. The half-life is approximately 7 hours.
Indications for use
The use of Glibomet is indicated in the treatment of type 2 diabetes mellitus, in case of ineffectiveness of previous therapy with biguanides, sulfonylurea derivatives or other oral hypoglycemic agents and diet therapy.
Contraindications
- Lactic acidosis, including history;
- Type 1 diabetes mellitus;
- Conditions accompanied by impaired absorption of food and the development of hypoglycemia;
- Diabetic ketoacidosis, diabetic precoma and coma;
- Gestational diabetes mellitus;
- Conditions requiring the use of insulin therapy, including gangrene, extensive burns, major surgical interventions, volumetric acute blood loss, infectious diseases, trauma;
- Functional disorders of the liver;
- Renal failure or functional impairment of the kidneys;
- Acute conditions that cause changes in renal function - severe infection, dehydration, intravascular administration of iodine-containing contrast media, shock;
- Hypoxia against the background of pathological conditions - recent myocardial infarction, heart or respiratory failure, severe respiratory tract diseases, shock;
- Leukopenia;
- Dystrophic diseases, including myotonic dystrophy, lipodystrophy;
- Porphyria;
- The period of 48 hours before and 48 hours after: surgery under general anesthesia with spinal or epidural anesthesia; radioisotope or X-ray studies requiring the administration of an iodine-containing contrast agent;
- Strict hypocaloric diet (up to 1000 kcal per day);
- Acute alcohol intoxication, chronic alcoholism;
- Age under 18;
- Age over 60 years, in case of heavy physical exertion (increased risk of lactic acidosis);
- Deficiency of glucose-6-phosphate dehydrogenase;
- The period of pregnancy and breastfeeding;
- Hypersensitivity to the components of the drug and to sulfonylurea derivatives.
It is recommended to take the drug with caution for diseases of the thyroid gland, febrile syndrome, hypofunction of the adrenal cortex and / or the anterior pituitary gland.
Instructions for the use of Glibomet: method and dosage
The tablets are taken orally with meals.
The doctor prescribes the dosage and treatment period individually based on clinical indications, taking into account the concentration of glucose in the blood and the state of carbohydrate metabolism.
The starting dose is usually 1-3 tablets per day. In the course of treatment, the patient is selected a dose that is effective to achieve a stable normalization of blood glucose levels.
The maximum daily dose of Glibomet should not exceed 6 tablets.
Side effects
- From the hematopoietic system: rarely - thrombocytopenia, leukopenia, erythrocytopenia; very rarely - megaloblastic or hemolytic anemia, agranulocytosis, pancytopenia;
- From the nervous system: infrequently - headache;
- From the digestive system: rarely - loss of appetite, nausea, metal taste in the mouth, abdominal pain, vomiting, diarrhea; in some cases - increased activity of hepatic transaminases;
- From the side of metabolism: rarely - hypoglycemia; very rarely - lactic acidosis;
- From the side of the skin: rarely - itchy skin, urticaria, photosensitivity, erythema;
- Others: against the background of the simultaneous intake of alcohol - a disulfiram-like reaction, with characteristic signs in the form of increased blood pressure, headache, palpitations, reddening of the skin of the upper half of the body and face, nausea, vomiting.
Overdose
In case of an overdose of Glibomet, the development of lactic acidosis caused by the action of metformin and hypoglycemia caused by the action of glibenclamide is possible.
Symptoms of lactic acidosis are severe weakness, decreased blood pressure, reflex bradyarrhythmia, drowsiness, confusion and loss of consciousness, hypothermia, respiratory distress, muscle pain, diarrhea, nausea, and vomiting.
Symptoms of hypoglycemia include headache, fear, temporary neurological disorders, impaired coordination of movements, pathological drowsiness, sleep disorders, general anxiety, tremors, paresthesia in the oral cavity, weakness, pallor of the skin, increased sweating, heart palpitations, and hunger. Progressive hypoglycemia can lead to loss of self-control and fainting.
If you suspect the development of lactic acidosis, Glibomet should be immediately canceled and the patient should be urgently sent to the hospital. The most effective treatment for an overdose is hemodialysis.
Mild hypoglycemia can be dealt with by ingesting a small piece of sugar, drinks, or foods in which carbohydrates are high (a glass of sweetened tea, jam, honey).
In case of loss of consciousness, it is recommended to inject 40–80 ml of a 40% glucose solution (dextrose) intravenously, and then infuse a 5–10% dextrose solution. Additional administration of 1 mg of glucagon subcutaneously, intramuscularly or intravenously is allowed. If the patient does not come to his senses, it is necessary to repeat the sequence of actions. In the absence of a clinically significant effect, intensive therapy should be used.
special instructions
It is necessary to stop taking Glibomet if symptoms of lactic acidosis appear in the form of general weakness, vomiting, abdominal pain, muscle cramps, and urgently consult a doctor.
Taking the drug is recommended to be accompanied by regular monitoring of the level of creatinine in the blood: for patients with normal renal function - at least 1 time per year, for patients with a level of creatinine in the blood close to the upper limit of the norm and for elderly people - 2-4 times a year.
Glibomet should be discontinued 2 days before a planned surgery using anesthesia (spinal or epidural anesthesia). It is allowed to continue taking the drug with the resumption of oral nutrition, but not earlier than 2 days after the operation, if normal renal function is confirmed.
During the period of treatment, it is recommended to be careful when performing potentially hazardous activities and driving vehicles, since there is a possibility of hypoglycemia and, as a consequence, a decrease in the speed of psychomotor reactions and the ability to concentrate.
The effectiveness of treatment depends on strict adherence to the doctor's prescriptions, his recommendations regarding the exercise and diet regimen, and regular monitoring of blood glucose levels.
When using Glibomet, you should refrain from drinking alcohol, since ethanol can cause hypoglycemia and / or a disulfiram-like reaction (abdominal pain, vomiting, nausea, a feeling of heat on the upper body and facial skin, dizziness, headache, tachycardia) …
With impaired renal function
According to the instructions, Glibomet is contraindicated in case of renal dysfunction or renal failure (CC should be more than 135 mmol / L for men and 110 mmol / L for women).
Drug interactions
The effect of Glibomet increases with the simultaneous administration of beta-blockers, coumarin derivatives (warfarin, syncumar), allopurinol, cimetidine, monoamine oxidase (MAO) inhibitors, oxytetracycline, sulfonamides, chloramphenicol, phenylbutazone and its derivatives, probes saliphenecylide, phenylbutazone and its derivatives, probes saliphenecylide, sulfinpyrazone, miconazole (for oral administration), ethanol.
The hypoglycemic effect of the drug reduces the combination with glucocorticosteroids, adrenaline, oral contraceptives, thiazide diuretics and barbiturates, thyroid hormone preparations.
Concomitant use of beta-blockers may mask signs of hypoglycemia, in addition to increased sweating.
With the simultaneous use of Glibomet with cimetidine, the risk of developing lactic acidosis increases, with anticoagulants, their effect is enhanced.
The risk of developing lactic acidosis in a patient increases with x-ray studies with intravascular use of iodine-containing contrast agents.
Analogs
Analogs of Glybomet are: Amaryl, Avandamet, Avandaglim, Gluconorm, Glukovans, Glimecomb, Galvus Met, Glukofast, Bagomet Plus, Kombogliz, Metglib, Yanumet.
Terms and conditions of storage
Store at temperatures up to 30 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Glybomet
Among patients who regularly take the drug, there are often positive reviews about Glybomet, however, there are mentions of minor side effects. Many patients who have been diagnosed with type 2 diabetes mellitus combine the use of Glibomet with other drugs, so they cannot accurately confirm the effectiveness of drug treatment. Some people were not satisfied with the side effects of this therapy, and they eventually switched to analogues of Glibomet, which indicates the need for an individual approach when prescribing treatment.
The presence of two active components in Glibomet's composition in some cases can provoke an individual intolerance to the drug. It should be remembered that in diabetes mellitus, only a doctor can determine the appropriateness of prescribing this medication, develop a treatment regimen and adjust the dose.
Price for Glibomet in pharmacies
The approximate price for Glibomet in pharmacies is 320–350 rubles (40 tablets are included in the package).
Glibomet: prices in online pharmacies
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Drug name Price Pharmacy |
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Glibomet 2.5 mg + 400 mg film-coated tablets 40 pcs. RUB 290 Buy |
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Glibomet tablets p.o. 400mg + 2.5mg 40 pcs. 308 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
