Diaglinide
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from 197 rub.
Buy
Diaglinide is an oral hypoglycemic drug.
Release form and composition
Dosage form - tablets: flat-cylindrical, white with a creamy or yellowish shade of color (tablets 0.5 and 2 mg) or from light yellow to yellow interspersed (tablets 1 mg), with a bevel (10 pcs. In contour cell packages, in a cardboard box 2 or 6 packages).
Composition of 1 tablet:
- active substance: repaglinide - 0.5, 1 or 2 mg;
- excipients: meglumine, potassium polacrilin, microcrystalline cellulose, lactose monohydrate, magnesium stearate, colloidal silicon dioxide, poloxamer, and iron oxide yellow dye - in tablets 1 mg.
Indications for use
Diagnlinide is indicated for the treatment of type 2 diabetes mellitus in case of ineffective diet therapy, weight loss and physical activity. It is used as monotherapy or in combination with thiazolidinediones or metformin, if monotherapy with one of the drugs - repaglinide, metformin or thiazolidinediones - failed to achieve satisfactory glycemic control.
Contraindications
Absolute:
- lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
- infectious diseases, major surgical interventions or other conditions requiring insulin therapy;
- diabetic ketoacidosis;
- diabetic precoma and coma;
- type 1 diabetes mellitus;
- severe liver dysfunction;
- age up to 18 years;
- pregnancy and breastfeeding;
- simultaneous use of gemfibrozil;
- known hypersensitivity to any component of the drug.
Relative:
- febrile syndrome;
- chronic renal failure;
- mild to moderate liver dysfunction;
- alcoholism;
- malnutrition;
- general serious condition.
Clinical studies of the use of repaglinide in patients under the age of 18 and over 75 have not been conducted.
Method of administration and dosage
The drug is prescribed in addition to physical activity and diet therapy.
Diaglinid should be taken orally, preferably 15 minutes before the main meal, but it can also be taken in the interval from 30 minutes before the immediate start of the meal.
The optimal dose for each patient is selected individually, depending on the blood glucose level.
It is recommended to start treatment with a daily dose of 0.5 mg. If the patient has previously received another oral hypoglycemic agent, then the recommended starting dose is 1 mg per day. If necessary, the dose is then adjusted every 1–2 weeks. The average daily dose is 4 mg 3 times a day. The highest permissible daily dose is 16 mg.
Transfer to Diaglinide from other oral medications can be carried out immediately. However, the exact ratio of the doses of the two drugs has not been established, so it is not recommended to exceed the initial dose of 1 mg.
In cases where Diaglinid is used as part of a complex therapy, the same initial dose is used as in monotherapy. Further, the doses of each drug are adjusted individually depending on the achieved blood glucose level.
Side effects
Most often, hypoglycemia develops against the background of therapy, depending on such individual factors as the dose of the drug, dietary habits, physical activity, stressful situations.
Distribution of side effects depending on the frequency of their development: often - from ≥ 1/100 to <1/10; infrequently - from ≥ 1/1000 to <1/100; rarely - from ≥ 1/10 000 to <1/1000; very rarely - <1/10 000; unknown - it is impossible to estimate the frequency from the available data.
Diaglinide can have the following side effects:
- on the part of metabolism: often - hypoglycemia (usually mild, eliminated by the intake of carbohydrates, in rare cases requires medical attention, in particular intravenous administration of dextrose or glucose; the risk of hypoglycemia increases with the simultaneous use of other drugs); unknown - hypoglycemia with loss of consciousness, hypoglycemic coma;
- from the immune system: very rarely - reactions of generalized hypersensitivity and immunological reactions (for example, vasculitis); unknown - hypersensitivity reactions (rash, itching, urticaria);
- from the digestive system: often - diarrhea, abdominal pain; very rarely - constipation, vomiting; unknown - nausea;
- on the part of the cardiovascular system: rarely - cardiovascular diseases (especially the development of acute coronary syndrome);
- from the liver and biliary tract: very rarely - increased activity of liver enzymes, liver dysfunction;
- on the part of the organ of vision: very rarely - visual disturbances (usually of a transient nature).
special instructions
Diaglinide is used in cases when it is not possible to control glycemia, and with physical exertion and diet therapy, the symptoms of diabetes mellitus persist.
During treatment, regular fasting and postprandial blood glucose monitoring is indicated.
Repaglinide stimulates the secretion of insulin, therefore it can cause hypoglycemia, the risk of its development increases with combination therapy.
In addition, the risk of hypoglycemia increases with fasting, alcohol consumption, and nonsteroidal anti-inflammatory drugs. The patient should be warned about this.
When choosing a dose (both initial and maintenance) for malnourished patients and those who do not receive adequate nutrition, care must be taken and the patient's condition must be monitored in order to prevent the development of hypoglycemia.
Also, caution is needed when selecting a dose for patients with severe renal impairment.
People with impaired liver function have a higher concentration of repaglinide and its metabolites in the blood than patients with normal liver function. For this reason, Diaglinid is contraindicated in patients with severe impairment, and caution should be exercised in patients with mild to moderate impairment. It is also necessary to increase the intervals between dose increases in order to be able to more accurately assess the individual response to therapy.
Infectious diseases accompanied by a febrile syndrome, extensive burns, trauma and major surgical operations may require the appointment of insulin and, therefore, the withdrawal of Diaglinide.
During hyperglycemia and hypoglycemia, the speed of reactions and the ability to concentrate may be impaired, which is dangerous in cases where these reactions are especially necessary, for example, when driving and working with complex mechanisms. The doctor should warn patients about the need to comply with measures to prevent the development of hyper- and hypoglycemia. This is especially necessary for patients in whom the symptoms-precursors of developing hypoglycemia are absent or expressed slightly, and patients suffering from frequent episodes of hypoglycemia. In such cases, it is recommended to decide whether it is advisable to drive vehicles and perform potentially dangerous work.
Drug interactions
Repaglinide can interact with drugs that affect glucose metabolism.
The metabolism and clearance of repaglinide can be altered by drugs that have an effect, suppress or activate the enzymes of the cytochrome P 450 system. Particular care is needed when using CYP2C8 and CYP3A4 inhibitors in combination.
The concentration of repaglinide in plasma can also be increased by inhibitors of the anion transport protein OATP1B1 (for example, cyclosporin).
The following drugs can weaken the hypoglycemic effect of repaglinide: glucocorticosteroids, sympathomimetics, barbiturates, oral contraceptives, thyroid hormones, thiazides, rifampicin, danazol, carbamazepine.
The following drugs can enhance and / or prolong the hypoglycemic effect of repaglinide: other hypoglycemic agents, monoamine oxidase inhibitors, non-steroidal anti-inflammatory drugs, anabolic steroids, non-selective beta-blockers, salicylates, angiotensin-converting enzyme inhibitors, kletocyonoprimazolamide, itraconazole, rifampicin, ethanol.
Beta-blockers, when used simultaneously, can mask the symptoms of developing hypoglycemia.
During the period of prescribing or canceling the drugs described above, patients who are already receiving repaglinide should constantly be under medical supervision in order to detect violations of glycemic control in time.
Simvastatin, nifedipine and cimetidine, which are substrates of CYP3A4, do not significantly affect the pharmacokinetic parameters of repaglinide.
Repaglinide has no clinically significant effect on the pharmacokinetic properties of warfarin, digoxin and theophylline.
Analogs
An analogue of Diaglinide is NovoNorm.
Terms and conditions of storage
Store in a dry, dark place out of reach of children at a temperature not exceeding 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Diaglinid: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Diaglinid 0.5 mg tablets 30 pcs. 197 RUB Buy |
|
Diaglinid 1 mg tablets 30 pcs. 209 RUB Buy |
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Diaglinid tab. 1mg n30 210 RUB Buy |
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Diaglinid 2 mg tablets 30 pcs. 277 r Buy |
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Diaglinid tab. 2mg n30 288 r Buy |
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
