Maninil
Maninil: 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. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Maninil
ATX code: A10BB01
Active ingredient: glibenclamide (glibenclamide)
Manufacturer: Berlin-Chemie (Germany), Menarini-Von Heyden (Germany)
Description and photo updated: 2019-27-08
Prices in pharmacies: from 81 rubles.
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Maninil is an oral hypoglycemic drug.
Release form and composition
The drug is produced in the form of tablets: flat-cylindrical, with a risk and a chamfer on one side; 1.75 mg - pale pink, 3.5 and 5 mg - pink (120 pcs. in colorless glass bottles, in a cardboard box 1 bottle and instructions for use of Maninil).
The composition of 1 tablet includes:
- Active substance: glibenclamide - 1.75, 3.5 or 5 mg (in micronized form);
- Auxiliary components (1.75 / 3.5 / 5 mg, respectively): lactose monohydrate - 68.99967 / 63.9967 / 90 mg, potato starch - 26 / 27.75 / 48.697 mg, gimetellose - 11/11/0 mg, colloidal silicon dioxide - 2 / 3.5 / 0 mg, magnesium stearate - 0.25 / 0.25 / 1.5 mg, talc - 0/0 / 2.25 mg, gelatin - 0/0/2, 55 mg, crimson dye (Ponso 4R) (E124) - 0.00033 / 0.0033 / 0.003 mg.
Pharmacological properties
Pharmacodynamics
Maninil is an oral hypoglycemic drug from the group of II generation sulfonylurea derivatives.
The use of glibenclamide promotes the stimulation of insulin secretion, which occurs due to its binding to specific receptors of the pancreatic β-cell membrane. Also, while taking the drug, there is an increase in the release of insulin, a decrease in the threshold for glucose irritation of β-cells of the pancreas, an increase in insulin sensitivity and the degree of its binding to target cells, an increase in the effect of insulin on the absorption of glucose by the liver and muscles, which leads to a decrease in glucose concentration in blood. The action develops in the second stage of insulin secretion. Reduces the thrombogenic properties of blood, has a hypolipidemic effect, inhibits lipolysis in adipose tissue.
Maninil at a dose of 1.75 and 3.5 mg in micronized form is a high-tech, specially milled form of glibenclamide, which allows the substance to be absorbed more quickly from the gastrointestinal tract. Due to the earlier achievement of C max (maximum concentration of the substance) of glibenclamide in plasma, the hypoglycemic effect in time practically corresponds to the rise in the concentration of glucose in the blood after meals. This property makes the influence of Maninil more physiological and softer. The duration of hypoglycemic action ranges from 20 to 24 hours.
The hypoglycemic effect of the drug at a dose of 5 mg develops in 2 hours, its duration is 12 hours.
Pharmacokinetics
Suction:
- Maninil 3.5 and 1.75: absorption from the gastrointestinal tract is rapid and almost complete. The full release of the micronized active substance occurs in 5 minutes;
- Maninil 5: the degree of absorption from the gastrointestinal tract is from 48 to 84%. Time to reach C max –1–2 hours. The absolute bioavailability ranges from 49 to 59%.
Plasma protein binding: Maninil 3.5 and 1.75 - more than 98%, Maninil 5 - 95%.
Glibenclamide is almost completely metabolized in the liver, with the formation of two inactive metabolites. Excretion of one of them occurs with bile, the second - with urine.
T 1/2 (half-life): Maninil 1.75 and 3.5 - 1.5-3.5 hours, Maninil 5 - from 3 to 16 hours.
Indications for use
Maninil tablets are prescribed for type 2 diabetes mellitus as monotherapy or simultaneously with other oral hypoglycemic drugs, with the exception of glinides and sulfonylurea derivatives.
Contraindications
- Type 1 diabetes mellitus;
- Leukopenia;
- Diabetic coma and precoma, diabetic ketoacidosis;
- Condition after removal of the pancreas;
- Severe hepatic and renal failure (with creatinine clearance less than 30 ml per minute);
- Paresis of the stomach, intestinal obstruction;
- Decompensation of carbohydrate metabolism in infectious diseases, injuries, burns or after major surgical operations, when insulin therapy is indicated;
- Deficiency of glucose-6-phosphate dehydrogenase;
- Hereditary lactose intolerance, lactase deficiency or lactose and glucose malabsorption syndrome;
- Age up to 18 years (the efficacy and safety of Maninil's use in this age group of patients have not been studied);
- Pregnancy and the period of breastfeeding (lactation);
- Hypersensitivity to the components of the drug, as well as to other sulfonylurea derivatives, sulfonamides, probenecid, diuretics (diuretics) containing a sulfonamide group in the molecule (due to the possibility of cross-reactions).
Maninil should be taken with caution in patients with acute alcohol intoxication, chronic alcoholism, febrile syndrome, thyroid disease (with dysfunction), hypofunction of the adrenal cortex or the anterior pituitary gland, as well as in patients over 70 years of age (due to the risk of hypoglycemia).
Maninil, instructions for use: method and dosage
Maninil tablets are taken orally, without chewing and with a small amount of liquid, preferably before meals. If the daily dose is 1-2 tablets, it is taken once in the morning, just before breakfast. Higher doses should be taken in 2 divided doses (morning and evening).
If you accidentally skip one dose of Maninil, the next pill should be taken at the usual time, without increasing the dose.
The regimen for taking the drug is determined by age, the severity of the course of the disease, the concentration of glucose in the blood on an empty stomach and 2 hours after eating.
In case of insufficient effectiveness of the prescribed initial dose, under medical supervision, it is gradually increased (from several days to 1 week) until it is sufficient to stabilize carbohydrate metabolism (but not higher than the maximum).
When switching from taking other hypoglycemic drugs, Maninil is prescribed in the usual initial dose under medical supervision with a gradual increase to the optimal one.
The daily dose (initial / maximum) is:
- Maninil 1.75: 1.75-3.5 / 10.5 mg (if the daily dose is higher than 3 tablets, the use of Maninil 3.5 is recommended);
- Maninil 3.5: 1.75-3.5 / 10.5 mg;
- Maninil 5: 2.5-5 / 15 mg.
Due to the risk of hypoglycemia in elderly patients, with severe functional disorders of the liver or kidneys, weakened patients and patients with reduced nutrition, the initial and maintenance doses of Maninil should be reduced.
Side effects
During the use of Maninil, the development of disorders from some body systems is possible (> 1/100, 1/1000, 1/10 000, <1/1000 - rarely, <1/10 000, including isolated cases - very rarely):
- Digestive system: infrequently - a feeling of heaviness in the stomach, nausea, abdominal pain, belching, vomiting, metallic taste in the mouth, diarrhea;
- Immune system: infrequently - purpura, pruritus, urticaria, increased photosensitivity, petechiae; very rarely - generalized allergic reactions, accompanied by arthralgia, skin rash, fever, jaundice and proteinuria; anaphylactic shock, allergic vasculitis;
- Hematopoietic system: rarely - thrombocytopenia; very rarely - agranulocytosis, erythropenia, leukopenia; in isolated cases - hemolytic anemia, pancytopenia;
- Liver and biliary tract: very rarely - intrahepatic cholestasis, short-term increase in the activity of liver enzymes, hepatitis;
- Metabolism: often - hypoglycemia (in the form of a feeling of hunger, tremor, hyperthermia, tachycardia, drowsiness, weakness, headache, moisture of the skin, impaired coordination of movements, general anxiety, feelings of fear, transient neurological disorders, including speech disorders, the appearance of paralysis or paresis or altered perception of sensations); increase in body weight;
- Others: very rarely - disorders of accommodation and visual impairment, increased diuresis, hyponatremia, transient proteinuria, disulfiram-like reaction when drinking alcohol (the most common signs of the effect include: vomiting, nausea, abdominal pain, tachycardia, feeling of heat in the upper body and facial skin, headache, dizziness), cross-allergy to probenecid, sulfonamides, sulfonylurea derivatives, diuretics (diuretics) containing a sulfonamide group in the molecule.
Overdose
The main symptoms: hypoglycemia, which manifests itself in the form of hunger, hyperthermia, tachycardia, drowsiness, weakness, skin moisture, impaired coordination of movements, general anxiety, tremor, headache, fear, transient neurological disorders (for example, speech and vision disorders, manifestations of paralysis or paresis, or a change in the perception of sensations). In case of progression of hypoglycemia, loss of consciousness and self-control, the development of hypoglycemic coma may occur.
Therapy:
- hypoglycemia of mild degree: the patient needs to ingest a sugar cube, drinks or food with a high sugar content (honey, jam, a glass of sweet tea);
- loss of consciousness: intravenous glucose (from 40 to 80 ml of 40% dextrose solution), then infusion of 5-10% dextrose solution. Additionally, 1 mg of glucagon can be administered (intravenously, intramuscularly or subcutaneously). If the patient does not regain consciousness, this measure can be repeated; in some cases, intensive care is required.
special instructions
During the use of Maninil, you must strictly adhere to the doctor's instructions regarding self-monitoring of the concentration of glucose in the blood and adherence to the diet.
With prolonged abstinence from food, insufficient provision of the body with carbohydrates, intense physical activity, diarrhea or vomiting, the risk of hypoglycemia increases.
Simultaneous administration of Maninil with drugs that have an effect on the central nervous system, lowering blood pressure, including beta-blockers, as well as peripheral neuropathy can mask signs of hypoglycemia.
In elderly patients, the risk of hypoglycemia is slightly higher, and therefore they need a more careful dose selection and regular monitoring of fasting blood glucose concentration and after a meal, especially at the beginning of drug use.
Alcohol increases the risk of hypoglycemia and the appearance of a disulfiram-like reaction, for this reason it is recommended to refuse to take it during treatment.
Extensive burns, trauma and major surgical interventions, infectious diseases with febrile syndrome can cause the withdrawal of Maninil and the appointment of insulin.
Prolonged sun exposure during therapy is not recommended.
Influence on the ability to drive vehicles and complex mechanisms
During the use of Maninil, patients must be careful while driving and performing other potentially hazardous work that requires increased attention and rapid psychomotor reactions.
Application during pregnancy and lactation
Maninil is not prescribed during pregnancy / lactation.
In case of pregnancy, therapy is canceled.
Pediatric use
For patients under 18 years of age, the drug is not prescribed.
With impaired renal function
In severe renal failure (in patients with creatinine clearance less than 30 ml / min), therapy is contraindicated.
For violations of liver function
In severe liver failure, therapy is contraindicated.
Use in the elderly
Maninil is prescribed to elderly patients with caution.
Drug interactions
With the simultaneous use of Maninil with some drugs, the following effects may occur:
- Angiotensin-converting enzyme inhibitors, non-steroidal anti-inflammatory drugs, anabolic drugs and male sex hormones, insulin and other oral hypoglycemic agents (eg, biguanides, acarbose), azapropazone, beta-blockers, quinolone and coumarin analogues, cinolone and coumarin analogues, cinolone and coumarin analogues, antifungal drugs (miconazole, fluconazole), fluoxetine, monoamine oxidase inhibitors, para-aminosalicylic acid, pentoxifylline (high dose for parenteral administration), perhexiline, pyrazolone derivatives, phosphamides (eg, ifosfamide, siclofosfamidene), tsiklophilicide sulfonamides, tritoqualin and tetracyclines: increasing the hypoglycemic effect of Maninil;
- Barbiturates, isoniazid, diazoxide, glucocorticosteroids, glucagon, nicotinates (in high doses), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, oral contraceptives and estrogens, thyroid hormone preparations, lymphatic hormone blockers, sympathomimetic channel blockers hypoglycemic action of Maninil;
- Clonidine, beta-blockers, reserpine and guanethidine, as well as drugs with a central mechanism of action: weakening the sensation of precursors of hypoglycemia signs;
- Antagonists of H 2 -receptors: strengthening or weakening of the hypoglycemic action of Maninil;
- Coumarin derivatives: strengthening or weakening their action;
- Drugs that acidify urine (ammonium chloride, calcium chloride): enhancement of Maninil's action;
- Pentamidine: a strong increase or decrease in the concentration of glucose in the blood (in isolated cases).
Analogs
Analogues of Maninil are: Glidanil, Glibamide, Glibenclamide.
Terms and conditions of storage
Keep out of reach of children at temperature:
- Maninil 1.75 and 3.5 - up to 30 ° C;
- Maninil 5 - up to 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Maninil
Reviews about Maninil are mostly positive. Patients and doctors note its high efficiency. There are reports of the development of adverse reactions in the form of vomiting and dizziness, which may be associated with an incorrectly selected dosage.
The price of Maninil in pharmacies
The approximate price for Maninil is 112-132 rubles. (120 tablets of 1.75 mg), 153-167 rubles. (120 tablets of 3.5 mg) or 116-127 rubles. (120 tablets, 5 mg each).
Maninil: prices in online pharmacies
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Drug name Price Pharmacy |
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Maninil 5 5 mg tablets 120 pcs. RUB 81 Buy |
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Maninil 1.75 1.75 mg tablets 120 pcs. 94 r Buy |
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Reviews Maninil 1.75 94 r Buy |
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Maninil 5 tablets 5mg 120 pcs. RUB 105 Buy |
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Maninil 3.5 3.5 mg tablets 120 pcs. 118 RUB Buy |
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Maninil 1.75 tablets 1.75mg 120 pcs. 122 RUB Buy |
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Maninil 3.5 tablets 3.5mg 120 pcs. 133 rbl. 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!
