Gliclazide, Metformin

Brand Akrikhin

In stock 1656 Items

Available since: 2019-09-19

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Clinical Pharmacology

GLIMECOMB is a fixed combination of two oral hypoglycemic agents of different pharmacological groups: gliclazide and metformin. It has pancreatic and extra-pancreatic effects.
Gliclazide stimulates insulin secretion by the pancreas, increases the sensitivity of peripheral tissues to insulin. Stimulates the activity of intracellular enzymes - muscle glycogen synthetase. Restores the early peak of insulin secretion, shortens the time from the moment of eating to the start of insulin secretion, reduces postprandial hyperglycemia. In addition to affecting carbohydrate metabolism, it affects microcirculation, reduces adhesion and aggregation of platelets, retards the development of parietal thrombosis, normalizes vascular permeability and prevents the development of microthrombosis and atherosclerosis, restores the process of physiological parietal fibrinolysis, counteracts an increased reaction to adrenaline in microorganisms with microanalysis and microorganism. It slows down the development of diabetic retinopathy at the non-proliferative stage; in diabetic nephropathy, on the background of long-term use, a significant decrease in proteinuria is noted. It does not lead to an increase in body weight, as it has a predominant effect on the early peak of insulin secretion and does not cause hyperinsulinemia; promotes weight loss in obese patients with proper diet.
Metformin belongs to the group of biguanides. Reduces the concentration of glucose in the blood by inhibiting gluconeogenesis in the liver, reducing the absorption of glucose from the gastrointestinal tract and increasing its utilization in the tissues. Reduces the serum concentration of triglycerides, cholesterol and low-density lipoproteins (determined on an empty stomach) and does not change the concentration of lipoproteins of other densities. Promotes stabilization or weight loss. In the absence of insulin in the blood, the therapeutic effect does not appear. Hypoglycemic reactions does not cause. It improves blood fibrinolytic properties by suppressing tissue-type inhibitor of profibrinolysin activator (plasminogen).

Indications

Type 2 diabetes mellitus with the ineffectiveness of diet therapy, exercise and prior therapy with metformin or gliclazide.
Substitution of previous treatment with two drugs (metformin and gliclazide) in patients with type 2 diabetes with a stable and well-controlled blood glucose level.

Composition

1 tab.
gliclazide	40 mg
metformin hydrochloride	500 mg

Excipients: sorbitol, povidone, croscarmellose sodium, magnesium stearate.

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Dosage and Administration

The drug is administered orally, during or immediately after a meal. The dose of the drug is determined by the doctor individually for each patient, depending on the level of blood glucose.
Typically, the initial dose is 1 - 3 pills per day with a gradual selection of the dose to achieve a stable compensation of the disease.
Usually the drug is taken 2 times a day (yrpom and evening). The maximum daily dose is 5 pills.

Adverse reactions

Metabolism: in violation of the dosing regimen and inadequate diet - hypoglycemia (headache, fatigue, hunger, increased sweating, severe weakness, palpitations, dizziness, impaired coordination of movements, temporary neurological disorders; with the progress of hypoglycemia, patients may lose self-control and consciousness); in some cases - lactic acidosis (weakness, myalgia, respiratory disorders, drowsiness, abdominal pain, hypothermia, reduction of blood pressure, reflex bradyarrhythmia).

From the digestive system: dyspepsia (nausea, diarrhea, feeling of heaviness in the epigastrium, "metallic" taste in the mouth), loss of appetite - the severity decreases when taking the drug during a meal; rarely - liver damage (hepatitis, cholestatic jaundice - requires discontinuation of the drug, increased activity of “liver” transaminases, alkaline phosphatase).

From the side of blood-forming organs: rarely, inhibition of bone marrow hematopoiesis (anemia, thrombocytopenia, leukopenia).
Allergic reactions: itching, urticaria, maculopapular rash.
In cases of side effects, the dose should be reduced or the drug temporarily discontinued.

Other: visual impairment.
Common side effects of sulfonylurea derivatives: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, allergic vasculitis; life threatening liver failure.

Contraindications

It is not recommended to use the drug in persons over 60 years old who perform heavy physical work, which is associated with an increased risk of developing lactic acidosis.

Drug interactions

Influence on ability to drive motor transport and control mechanisms:

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.

Pregnancy and Lactation

Contraindicated use of the drug Glymecomb during pregnancy. When planning pregnancy, as well as in the event of pregnancy in the period of taking the drug Glymecomb, it should be canceled and insulin therapy prescribed.

Glymecomb contraindicated in breastfeeding, since the active substances are able to stand out with breast milk. In this case, you must go to insulin therapy or stop breastfeeding.

Special instructions

Glymecomb treatment is carried out only in combination with a low-calorie diet with a low carbohydrate content. Blood glucose should be regularly monitored on an empty stomach and after a meal, especially in the first days of drug treatment.

Glymecomb can only be prescribed to patients who receive regular meals, always including breakfast and providing sufficient intake of carbohydrates.

Overdosage

Overdose or the presence of risk factors can trigger the development of lactic acidosis, as the drug includes metformin. If you have symptoms of lactic acidosis, you must stop taking the drug. Lactic acidosis is a condition requiring emergency medical care; lactic acidosis treatment should be carried out in the hospital.
The most effective treatment is hemodialysis.
Overdose can also lead to the development of hypoglycemia due to the presence in the composition of the drug gliclazide. When hypoglycemia mild or moderate glucose (dextrose) or sugar solution is taken orally.In the case of severe hypoglycemia (loss of consciousness), a 40% dextrose (glucose) solution or glucagon is administered intravenously, intramuscularly, subcutaneously. After the recovery of consciousness, the patient must be given food rich in carbohydrates in order to avoid the re-development of hypoglycemia.

Studies and clinical trials of Gliclazide, Metformin (Click to expand)