Diamerid
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 141 rubles.
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Diamerid is an oral hypoglycemic drug.
Release form and composition
Dosage form of Diamerid's release - tablets: flat-cylindrical, with a chamfer, slight inclusions are permissible; 1 and 3 mg - pink with a brownish tint, 2 and 4 mg - from yellow or light yellow to cream in color (in blisters of 10 pcs., in a cardboard box of 3 or 6 packs).
Composition of 1 tablet:
- active substance: glimepiride - 1, 2, 3 or 4 mg (in terms of 100% substance);
- auxiliary components (1/2/3/4 mg): magnesium stearate - 0.6 / 0.6 / 1.2 / 1.2 mg; lactose monohydrate - 78.68 / 77.67 / 156.36 / 155.34 mg; croscarmellose sodium - 4.7 / 4.7 / 9.4 / 9.4 mg; povidone - 2.5 / 2.5 / 5/5 mg; poloxamer - 0.5 / 0.5 / 1/1 / mg; microcrystalline cellulose - 12/12/24/24 mg; yellow dye iron oxide - 0 / 0.03 / 0 / 0.06 mg; red dye iron oxide - 0.02 / 0 / 0.04 / 0 mg.
Indications for use
Diamerid is prescribed for the treatment of type 2 diabetes mellitus in cases of ineffectiveness of previous measures (diet and exercise).
The drug can be used as monotherapy or in combination with insulin or metformin.
Contraindications
Absolute:
- lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
- leukopenia;
- diabetic ketoacidosis, diabetic coma and precoma;
- type 1 diabetes mellitus;
- conditions accompanied by impaired absorption of food and the development of hypoglycemia (including infectious diseases);
- functional disorders of the kidneys / liver in severe course (including patients on hemodialysis);
- pregnancy and the period of breastfeeding;
- age up to 18 years;
- individual intolerance to the components of the drug, including hypersensitivity to other sulfonylurea derivatives or sulfonamide drugs (associated with the likelihood of developing hypersensitivity reactions).
The appointment of Diamerid requires caution in the presence of conditions requiring the transfer of the patient to insulin therapy, including extensive burns, major surgical interventions, multiple severe injuries, impaired absorption of food and drugs from the gastrointestinal tract (gastric paresis, intestinal obstruction).
When pregnancy occurs or in cases of planning it, a woman should be transferred to insulin therapy.
Method of administration and dosage
Diamerid is taken orally.
The tablets are taken without chewing, whole, with a sufficient amount of liquid (about 100 ml). It is not recommended to skip meals after taking the drug.
The doctor determines the dosage regimen individually, based on the results of regular monitoring of the concentration of glucose in the blood.
At the beginning of therapy, Diamerid is prescribed 1 mg per day. After achieving the optimal therapeutic effect, it is recommended to take this dose as a maintenance dose.
In cases of lack of glycemic control, the daily dose should be increased step by step (with intervals of 1-2 weeks) under regular monitoring of the blood glucose concentration to 2, 3 or 4 mg per day. Higher doses are only effective in exceptional cases. The maximum is 6 mg per day.
The time and frequency of taking the drug are determined by the doctor. The scheme for using Diamerid should take into account the patient's lifestyle. The daily dose should be taken in 1 reception immediately before or during a hearty breakfast or the first main meal.
Diamerid is intended for long-term therapy, which should be carried out under the control of blood glucose.
In cases of lack of glycemic control in patients taking metformin, Diamerid may be additionally prescribed.
The dose of metformin usually does not change, Diamerid at the beginning of therapy should be prescribed in the minimum dose, which is gradually increased up to the maximum. The combination therapy should be carried out under the close supervision of a specialist.
If, when taking the maximum dose of Diamerid as monotherapy, it is not possible to achieve glycemic control, it is possible to additionally prescribe insulin, which is prescribed in the minimum dose at the beginning of therapy. If necessary, its gradual increase is possible. The combination therapy should be carried out under the close supervision of a specialist.
When transferring a patient from another oral hypoglycemic drug to Diamerid, its initial daily dose should be 1 mg (even if the patient is transferred from the maximum dose of another oral hypoglycemic drug). Any increase in the dose of Diamerid should be carried out in stages in accordance with the above recommendations. The effectiveness, dose and duration of action of the hypoglycemic agent used should be taken into account. In some cases, especially when taking hypoglycemic drugs with a long half-life, a temporary (over several days) discontinuation of therapy may be required, which will help to avoid an additive effect that increases the likelihood of hypoglycemia.
When carrying out insulin therapy in patients with type 2 diabetes mellitus, with compensation for the disease and with preserved secretory function of β-cells of the pancreas, in exceptional cases, it is possible to replace insulin with Diameride (at the beginning of therapy, use the minimum dose). The translation should be carried out under the close supervision of a professional.
Side effects
- organ of vision: transient visual disturbances (observed, as a rule, at the beginning of therapy; due to a change in the concentration of glucose in the blood);
- metabolism: hypoglycemic reactions (develop mainly soon after taking Diamerid and can proceed in severe forms; they are not always easy to stop; their appearance is largely determined by individual factors, especially nutrition and the dose used);
- hematopoietic system: thrombocytopenia (in moderate / severe course), leukopenia, granulocytopenia, erythrocytopenia, aplastic / hemolytic anemia, pancytopenia, agranulocytosis;
- digestive system: vomiting, nausea, a feeling of discomfort / heaviness in the epigastrium, pain in the abdomen, diarrhea (the drug can be discontinued in very rare cases), increased activity of liver enzymes, jaundice, cholestasis, hepatitis (sometimes with the development of liver failure);
- dermatological reactions: in some cases - late cutaneous porphyria, photosensitivity;
- allergic reactions: urticaria (in the form of itching, skin rash; is usually mild in nature, but can progress, accompanied by shortness of breath, a drop in blood pressure, up to the development of anaphylactic shock; requires immediate attention to a specialist), cross-allergy with other sulfonamides, sulfonylurea derivatives or other sulfonamides, allergic vasculitis;
- others: in some cases - hyponatremia, asthenia, headache.
special instructions
Patients should adhere to the prescribed dosage regimen. The skipping of a single dose cannot be compensated for by the subsequent administration of a higher dose.
The onset of hypoglycemia after taking 1 mg of Diamerid means the ability to control glycemia solely through diet.
When compensation for type 2 diabetes mellitus is achieved, an increase in insulin sensitivity is observed. In this regard, in the process of therapy, the need for Diamerid may decrease. To avoid the development of hypoglycemia, you need to temporarily reduce the dose or cancel the treatment. Dose adjustment is also required in cases of changes in the patient's weight, lifestyle, or when other factors appear that increase the likelihood of hyper- or hypoglycemia.
To achieve optimal blood glucose control, along with regular intake of the drug, it is important to adhere to an adequate diet and do regular and sufficient exercise.
The clinical symptoms of hyperglycemia include intense thirst, increased urinary frequency, dry skin, and dry mouth.
In the first weeks of using Diamerid, the likelihood of hypoglycemia may increase (in these cases, especially careful monitoring of the patient's condition is required). With irregular meals or skipping meals, hypoglycemia may occur.
The main factors contributing to the appearance of hypoglycemia:
- unwillingness / lack of ability (especially in old age) of the patient to cooperate with the doctor;
- eating disorders, including changing your diet, fasting, irregular / inadequate nutrition, skipping meals;
- drinking alcohol, especially in combination with skipping meals;
- imbalance between carbohydrate intake and exercise;
- violation of hepatic function in severe course;
- overdose of Diamerid;
- impaired renal function;
- combined use with some other drugs;
- some uncompensated diseases of the endocrine system that affect carbohydrate metabolism, including dysfunction of the thyroid gland, insufficiency of the adrenal cortex, or pituitary insufficiency.
The presence / appearance of the above factors, as well as episodes of hypoglycemia, should be reported to the doctor, since in these cases, especially careful monitoring of the patient's condition is required. In the presence of these factors, dose adjustment / the entire therapy regimen may be required. Similar measures are taken in cases of intercurrent illness or when the patient's lifestyle changes.
In elderly patients, in patients with autonomic neuropathy or in patients receiving concomitant therapy with guanethidine, beta-blockers, reserpine, clonidine, the symptoms of hypoglycemia may be smoothed or absent altogether.
Hypoglycemia in almost all cases can be quickly stopped by immediate intake of carbohydrates (sugar or glucose). In this regard, the patient should always have at least 20 g of glucose (4 pieces of sugar) with him. Sweeteners are ineffective in the treatment of hypoglycemia.
Despite the initial success in stopping hypoglycemia, the development of its relapse can be observed, which requires constant monitoring of the patient's condition. Severe hypoglycemia requires immediate treatment under the supervision of a specialist, and sometimes hospitalization.
During therapy, regular monitoring of liver function and peripheral blood patterns should be carried out (in particular, this applies to the number of platelets and leukocytes).
In stressful situations (for example, trauma, surgery, febrile infectious diseases), it may be necessary to transfer the patient to insulin.
There is no experience with the use of Diamerid in patients with impaired renal / hepatic function in severe course or in patients on hemodialysis (insulin is indicated).
During therapy, you should regularly monitor the concentration of glucose in the blood, as well as the concentration of glycosylated hemoglobin.
Certain adverse reactions (in the form of severe hypoglycemia, serious changes in the blood picture, severe allergic reactions, liver failure) under certain circumstances can be life-threatening. In cases of severe / unwanted reactions, the patient should immediately inform the specialist about them. You should not continue taking the drug on your own.
At the beginning of the course, when switching from one drug to another or with irregular intake of Diamerid, there may be a decrease in concentration of attention and speed of psychomotor reactions caused by hyper- or hypoglycemia, which affects the ability to drive vehicles. Patients should take measures to prevent the occurrence of these conditions. Patients who have no / decreased severity of precursor symptoms are advised to refuse to drive vehicles.
Drug interactions
With the combined use of Diamerid with certain drugs / substances, the following effects may develop (before prescribing any drug, a medical consultation is required):
- acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine and other sympathomimetic agents, glucagon, laxatives (with prolonged use), nicotinic acid derivatives, nicotinic acid (in high doses), estrogens, progestagens, chirophazine derivatives, including phenothiazines, phenytoin, rifampicin, thyroid hormones, lithium salts: weakening of the hypoglycemic effect and, as a consequence, an increase in the concentration of glucose in the blood;
- insulin, metformin or other oral hypoglycemic drugs, angiotensin-converting enzyme inhibitors, allopurinol, anabolic steroids and male sex hormones, chloramphenicol, coumarin derivatives, cyclophosphamide, trophosphamide and isophosphamide, fenfluraminox, fibrates, phylumethyloxylamine (with parenteral administration of high doses), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolone antibiotics, salicylates and aminosalicylic acid, sulfinpyrazones, some prolonged-release sulfonamides, tetracyclines, tritoqualin, fluconazole action, the likelihood of an increase and hypoglycemic
- reserpine, clonidine, blockers of H 2 -histamine receptors: potentiation / weakening of the hypoglycemic action of Diamerid;
- drugs that suppress bone marrow hematopoiesis: an increase in the likelihood of myelosuppression;
- coumarin derivatives: strengthening / weakening of their action;
- beta-blockers, clonidine, reserpine, guanethidine: weakening or absence of clinical signs of hypoglycemia;
- alcohol (chronic / single use): strengthening / weakening of the hypoglycemic effect of Diamerid.
Analogs
Diamerid's analogs are: Glimepirid, Amaryl, Glemauno, Glaim, Glemaz, Meglimid, Glumedex and others.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Diamerid: prices in online pharmacies
|
Drug name Price Pharmacy |
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Diamerid 1 mg tablets 30 pcs. 141 r Buy |
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Diamerid tablets 2mg 30 pcs. 151 RUB Buy |
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Diamerid 2 mg tablets 30 pcs. 151 RUB Buy |
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Diamerid 3 mg tablets 30 pcs. 216 r Buy |
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Diamerid 4 mg tablets 30 pcs. 236 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!
