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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).
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.
|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.
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.
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.
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.
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.
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)
- Long-term therapy with addition of pioglitazone to metformin compared with the addition of gliclazide to metformin in patients with type 2 diabetes: a randomized, comparative study
- The development and validation of liquid chromatography method for the simultaneous determination of metformin and glipizide, gliclazide, glibenclamide or glimperide in plasma
- Comparison of the micro- and macro-vascular effects of glimepiride and gliclazide in metformin-treated patients with Type 2 diabetes: a double-blind, crossover study
- A comparison of treatment with metformin and gliclazide in patients with non-insulin-dependent diabetes
- Metformin or gliclazide, rather than glibenclamide, attenuate progression of carotid intima-media thickness in subjects with type 2 diabetes
- Long-term effects on lipids and lipoproteins of pioglitazone versus gliclazide addition to metformin and pioglitazone versus metformin addition to sulphonylurea in the treatment of type 2 diabetes
- Long-term efficacy and tolerability of add-on pioglitazone therapy to failing monotherapy compared with addition of gliclazide or metformin in patients with type 2 diabetes
- A Mechanism-based Disease Progression Model for Comparison of Long-term Effects of Pioglitazone, Metformin and Gliclazide on Disease Processes Underlying Type 2 Diabetes Mellitus
- Effects of metformin plus gliclazide compared with metformin alone on circulating endothelial progenitor cell in type 2 diabetic patients
- Nateglinide or gliclazide in combination with metformin for treatment of patients with type 2 diabetes mellitus inadequately controlled on maximum doses of metformin alone: 1-year trial results
- Changes in liver tests during 1-year treatment of patients with Type 2 diabetes with pioglitazone, metformin or gliclazide
- Comparison of nateglinide and gliclazide in combination with metformin, for treatment of patients with Type 2 diabetes mellitus inadequately controlled on maximum doses of metformin alone
- A comparison of efficacy and safety of vildagliptin and gliclazide in combination with metformin in patients with Type 2 diabetes inadequately controlled with metformin alone: a 52-week, randomized study
- Cardiovascular effects of treatment of type 2 diabetes with pioglitazone, metformin and gliclazide
- Comparison of the dipeptidyl peptidase-4 inhibitor vildagliptin and the sulphonylurea gliclazide in combination with metformin, in Muslim patients with type 2 diabetes mellitus fasting during Ramadan: results of the VECTOR study
- Safety and tolerability of pioglitazone, metformin, and gliclazide in the treatment of type 2 diabetes
- Antioxidant effects of gliclazide, glibenclamide, and metformin in patients with type 2 diabetes mellitus
- Effects of gliclazide versus metformin on the clinical profile and lipid peroxidation markers in type 2 diabetes
- UV-Spectrophotometric-Assisted Chemometric Methods for the Simultaneous Determination of Metformin Hydrochloride and Gliclazide in Pharmaceutical Formulations
- The Effects of Gliclazide, Metformin, and Acarbose on Body Composition in Patients with Newly Diagnosed Type 2 Diabetes Mellitus
- We-W42:6 Pioglitazone, but not gliclazide or metformin, improves the adipokine profile of overweight type 2 diabetes patients independent of glycaemic control
- SIMULTANEOUS ESTIMATION OF GLIBENCLAMIDE, GLICLAZIDE, AND METFORMIN HYDROCHLORIDE FROM BULK AND COMMERCIAL PRODUCTS USING A VALIDATED ULTRA FAST LIQUID CHROMATOGRAPHY TECHNIQUE