Gliclazide

Chemical name

N-[[(Гексагидроциклопе��та[c]пиррол-2(1Н)-ил)ами��о]карбонил]-4-метилбен золсульфонамид

Gross

C15-H21-N3-O3-S

Of drugs

The drugs-gipoglikemicescoe. Increases insulin secretion beta-kletkami pancreas and improves utilization of glucose. It stimulates the activity of muscle glikiencintetaza. Effective in metabolicescom, latent diabetes, in patients with экзогенно-конституци��нальным obesity. Normalizes glycolic profile after several days of treatment. Reduces time after eating before secreting insulin, restores early peak secreting insulin and lowers giperglikemia resulting from the admission of food. Improves hematologic indicators, the flow properties of blood coagulates system and circulation. Warn mikrovskulitov development, including defeat netted shell eye. Suppress agregatia platelets, increases the index of relative disaggregation increases geparinovu and fibrinoliticescuu activity increases tolerance to geparino. Is antioxidant properties, improves vascularizatia kongyunctiv provides continuous flow in mikrososudah, reduces mikrozastoja signs. The ADA нефропатии редуцирует протеинурию.В experiments for the study of chronic and specific toxicity have been detected signs of carcinogenicity, мутагенности and teratogenicity (rats, rabbits), as well as the impact on fertility (rats). Fully and rapidly absorbed from the digestive tract, C_max achieved through 2-6 hrs (tablets for the modified-release of the 6-12 h), after the reception. Equilibrium concentration in the plasma created in 2 days. Linking blood plasma is 85-99%, the volume of from 13 to 24 litres. Duration of the one-time admission is 24 hours (for tablets with a modified-release more than 24 hours). The liver is oxidized, gidrauxilirovaniu, glukuronidirovaniu education eight inactive metabolites, one of whom has expressed an impact on microcirculation. Place in the form of metabolites in the urine (65%) and through blood (12%). T_1/2 - 8-12 hrs (tablets for the modified-release of about 16 hours).

Indications

Diabetes mellitus type 2 monotherapy and in combination with insulin or other oral gipoglikemicakimi drugs.

Restrictions on the use of

Children's age (the effectiveness and safety of the children to be determined).

Pregnancy and lactation

Contraindicated. At the time of treatment should stop breastfeeding.

Contraindications

Hypersensitivity, diabetes mellitus type 1, incl. uvenilny, ketoacidosis, diabetic (with ketoacidosis) and giperosmolarnaya coma, extensive injuries and burns, liver failure and severe renal insufficiency, and the hypothesis Ray, pregnancy, breast-feeding.

Side-Effects

From the stomach : very rarely Diarrhoeal events (nausea, vomiting, stomachache), it is rarely Jeltuha.so the circulatory system and blood : obratimaya zitopenia, eozinofilia, Anemia.so the Skin : rarely skin allergies фотосенсибилизация.С�� the metabolic : Gipoglikemia.so the nervous system and sensory organs : weakness, headache, dizziness, changes in taste sensations.

Patient interaction

Effect increase ACE inhibitors, 25.06.1997, бета-адреноблокаторы, фибраты, бигуаниды, chloramphenicol, циметидин, cumarins, фенфлурамин, fluoxetin, салицилаты, гуанетидин, MAO inhibitors, miconazole, флуконазол, пентоксифиллин, теофиллин, фенилбутазон, фосфамиды, тетрациклины.Барбитураты, chlorpromazine, глюкокортикоиды, симпатомиметики, глюкагон, салуретики, rifampicin, hormones thyroid, lithium salt, high doses of nicotinic acid, oral contraceptives and estrogen-гипогликемию weaken.

Overdosing

Symptoms : gipoglikemicakie of up to the coma, brain swelling. Treatment : glucose ingestion inward, if necessary, to / in a glucose solution (50%, 50 ml). Monitoring of the level of glucose, urea nitrogen, electrolytes in the blood serum. In oteke brain-mannit (in / in), dexamethasone.

Precautions

During selection doses, especially in combination with insulinoterapiei need a sugar profile, and the dynamics of fast, further shows regular monitoring of blood glucose. To prevent gipoglikemii need to be clearly back reception preparation for the reception of food to avoid starvation and to renounce the use of alcohol. The combined application бета-адреноблокаторо�� can mask symptoms gipoglikemii. The nizkokalorina a diet with low carbohydrate content. Be wary of during the drivers of vehicles and people skills relate to the high concentration of attention.

Dosing and Administration

Inside, within 30 minutes before or during delivery. Therapeutic doses of 40-320 mg (depending on the level of glycemia). At the beginning of 40-160 mg morning, and then to 320 mg / sut. Doses greater than 160 mg, appointed a number of techniques (at least two). In combination with insulin during the day that 180 Mg.tabletki with modified release : initial dose of 30 mg; Further dose can be increased no earlier than two weeks; Maximum daily dose of 120 mg (1 per day at the luncheon).

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