Bivilizid Glipizide 5mg BRV medicine supports diet, blood sugar control (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Glipizide
Ingredient Urethritis, bacterial / infection, dermatitis

Ingredient

Composition information	Content
Glipizide	5mg

Uses

indications

Bivilizid 5mg drug is indicated in the following cases:

The drug is used as an auxiliary substance for diet and exercise to control blood sugar in adults with type 2 diabetes. Group of drugs: anti -diabetes drugs Sulfonylure.

Glipizid is a oral medication that reduces blood glucose in the sulfonylurea. The main mechanism of action of the glipizid is to stimulate insulin secretion from the beta cells of the pancreas. The stimulation of insulin secretion with glipizid to respond to a meal is the most important thing. The insulin concentration does not increase, although it is prolonged glipizid, but the response to insulin after meals continues to be strengthened after at least 6 months of treatment. In patients with diabetes, the response to insulin for a meal takes place within 30 minutes after drinking glipizid, but the increase in insulin levels does not last longer than the time requiring food. There is also more and more evidence that the pancreatic effects are related to enhancing the effects of insulin to form an important factor for the activity of the glipizid.

After taking a single dose of a single glipizid, the effect of controlling blood sugar levels lasted for up to 24 hours, even if the drug concentration in plasma has decreased to the minimum level during that time.

pharmacokinetics

absorption:

The absorption of gastrointestinal glipizids in humans is uniform, fast and completely. The peak concentration of plasma is reached from 1 to 3 hours after taking a single dose. The disposal time of the drug is about 2 to 4 hours in normal people, when used by intravenous or orally. The metabolism and excretion are similar for both lines to use, showing the initial transformation is negligible. Blipizid does not accumulate in plasma when used repeated by oral. The total absorption is not affected by food in ordinary volunteers, but the absorption is slower about 40 minutes. Therefore, glipizid is more effective when used 30 minutes before meals than a test meal in diabetics.

Distribution:

Serum protein cohesion has been studied in volunteers using oral glipizid or intravenously showing the cohesion with protein after 1 hour of use of 98% to 99%. The apparent distribution of the glipizid after intravenous injection is 11 liters, showing the positioning in the cellular compartment outside the cell. In mice, by the method of taking radioactive objects without glipizids or any metabolites detected in the brain or spinal cord of male mice or female mice, as well as in the fetus of pregnant female mice. However, in another study, a very small amount of radioactive substances was discovered in the mouse fetus that was used for radioactive markers.

Metabolism:

Glipizid metabolism is very much and occurs mainly in the liver.

Era:

Maximum metabolites are mainly inactive hydroxylation and polarized compounds, excreted mainly through urine. Under 10% of the glipizid in constant form found in urine.

Before taking Bivilizid Glipizide 5mg BRV medicine supports diet, blood sugar control (3 blisters x 10 tablets)

How to use

oral medication. In general, the drug needs to be used 30 minutes before meals to minimize blood sugar after eating.

Dosage

like other hypoglycemic drugs, the dose must be adjusted for each individual.

Short -term use may be sufficient to control blood sugar during the temporary stages of loss of control in patients who are often well controlled by blood sugar by diet.

Starting dose:

The recommended starting dose is 5 mg, orally before breakfast or lunch. Patients with mild diabetes, elderly patients or people with liver disease may start taking a dose of 2.5 mg.

Standard dose:

Need to adjust the dose of 2.5 mg or 5 mg steps, determined depending on the amount of glucose in the blood apart at least a few days apart. The maximum single dose is recommended for 15 mg. If it is not effective enough, can split daily doses will be more effective.

Dosage per 15 mg must be divided.

Maintenance dose:

Some patients may be effectively controlled in a one -day one -day usage. The total daily dose is over 15 mg, it should be divided.

The maximum recommended dose is 20 mg per day.

Children: Safety and effectiveness when used for children has not been established.

Elderly and high -risk patients:

In the elderly, weak and malnourished people or patients with renal or liver failure, the starting and maintenance should be cautious to avoid blood sugar drop reactions.

People who are taking other oral hypoglycemic drugs:

As well as other sulfonylura hypoglycemic drugs, no transition when transferring patients to glipizid. Patients need to be carefully monitored (for 1-2 weeks) to drop blood sugar when transferring from sulfonylure drugs that have longer -selling time (such as chlorpropamid) to glipizid due to the overlapping potential of the drug.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when using overdose? The overdose of sulfonylure including glipizids can cause blood sugar drops. Symptoms of mild hypoglycemia do not lose consciousness or neurological abnormalities that need to be actively treated with oral glucose and adjust the dosage of glipizid and/or diets. It is necessary to continue closely monitoring until the doctor ensures that the patient has escaped from the danger. Severe severe hemorrhagic reactions with coma, convulsions or other nervous damage rarely occur, but must be treated at the hospital immediately.

If coma due to hypoglycemia is diagnosed or skeptical, patients should be intravenous with concentrated glucose solution (50%). Next, it is necessary to transmit more dilute glucose solution (10%) continuously at a speed that can maintain blood sugar at over 100 mg/dl (5.55 mmol/l). Patients should be closely monitored for at least 48 hours and depending on the patient's condition at this time the doctor should decide whether or not to monitor more. Ghlipizid removal from plasma may last longer in people with liver disease. Due to the strong link to the protein of the glipizid, the separation will probably not benefit.

In case of emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.

Side Effects

When using the drug, there are common unwanted effects (ADR) such as:

Side effects arranged by classification and frequency listed in the following table:

Disorder classification

Common

(≥1/100 -

less common

(≥1/1000 - Unknown frequency Blood. head. Vomiting, diarrhea, abdominal pain, upper abdominal pain. eczema. grant. Blood, increased blood creatinine.

Notify the physician with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Bivilizid drugs contraindicated in the following cases:

Hypersensitivity to other glipizids, other sulfones or sulfonamids or any ingredients of the drug. period and breastfeeding.

Be cautious when using

Please see more information about the drug in the instruction sheet of the use of the drug attached.

Need to be very cautious when taking drugs for patients in the following cases:

Lack of glucose-6-phosphate dehydrogenase (G6PD)

Because the glipizid belongs to the sulfonylurea drug group, caution should be used for patients with G6PD deficiency. Treatment for patients with G6PD deficiency with sulfonylura drugs can lead to hemolytic anemia and should choose to use another alternative method.

Legging of blood sugar

All sulfonylura drugs have the potential to cause serious hypoglycemia. Renal failure or liver failure can increase blood glipizid levels and liver failure can reduce the ability to renew glucose, both increase the risk of serious blood sugar drop reactions. Elderly, depressed or malnourished patients and people with impaired adrenal or pituitary function are particularly sensitive to the hypoglycemic effect of hypoglycemic drugs.

Hemodiac drops can be difficult to recognize in the elderly and in people who are taking beta-adrenergic inhibitors. Hemodiac drop is more likely to occur when eating and drinking is not enough calories, after exercise or prolonged exercise, when drinking alcohol or when taking more than one of the hypoglycemic drugs.

loss of blood sugar control

When a patient was stable with the regime of diabetes exposed to stress such as fever, trauma, bacterial or surgical surgery, it could lose blood sugar control. In those times, it may be necessary to stop using glipizid and treatment with insulin.

The effectiveness of any oral hypoglycemic drug, including glipizids, the effect of lowering blood sugar to the desire to be reduced in some patients for a period of time, may be due to the severity of the disease or the response to the drug is reduced. This phenomenon is called secondary failure, to distinguish it from the first -life failure, when the drug is not effective for a patient right after starting to take the drug. It is necessary to adjust the appropriate dose and follow the diet fully before classifying the patient is a secondary defeat.

Kidney disease and liver disease

Mobile pharmacokinetics and/or pharmacological pharmacology of the glipizid may be affected in patients with kidney function or liver function. If the blood sugar drop occurs in these patients, it may be necessary to be hospitalized for appropriate and prolonged treatment.

Patient information should pay attention

Patients need to be notified of the increased risks and benefits of glipizids and alternative treatments. They should also be notified of the importance of adhering to the guidance on diet, regular exercise programs and regularly checking the amount of sugar in urine and/or blood sugar.

The risks of hypoglycemia, symptoms and treatment, and conditions that lead to the progression of the disease should be explained to patients and family members responsible. Fair and secondary failure also needs to be explained.

Subclinical tests

Periodically monitor blood sugar and urine. Measuring the amount of glycosylated hemoglobin may be helpful.

lactose

Because this product contains Lactose Monohydrate excipients, it is not advisable to use for patients with rare genetic problems in galactose, lactase deficiency, or under absorption of glucose-galactose.

The effect of the drug on driving and operating machinery

There is no research on the effects of glipizid on driving or operating machinery. However, there is no evidence that glipizids can affect these possibilities. Patients need to know the symptoms of hypoglycemia and be cautious when driving or operating machinery, especially when the optimal blood sugar stability has not been achieved, such as changing from one drug to another or when using the drug is not regular.

Use drugs for women during pregnancy and lactation

Pregnant women:

Godizid is contraindicated during pregnancy.

The drug has been found to have a mild toxicity for fetuses in mouse reproductive studies. There is no teratogenic effect in rats or rabbits.

Hypoglycemia (from 4 to 10 days) has been reported in newborns born from mothers who use sulfonylure at birth.

Because recent information shows that abnormal blood glucose concentration during pregnancy is associated with the incidence of congenital abnormalities, many experts recommend using insulin during pregnancy to maintain blood sugar levels as close to normal.

breastfeeding women:

There is no sufficient data on breast milk excreted. Therefore, glipizid is contraindicated for nursing women.

Drug interaction

The following substances can increase hypoglycemia:

Contraindicated combination

Miconazole: Increasing hypoglycemic effect, can lead to hypoglycemic symptoms or even coma.

There is no recommendation to use in combination

Non -steroid anti -inflammatory drugs (such as phenylbutazon). Increasing the hypoglycemic effect of sulfonylurea (replacing the cohesion with plasma proteins of sulfonylurea and/or reducing sulfonylure elimination).

Alcohol: Increasing hypoglycemic reaction, can lead to coma due to hypoglycemia.

Be careful when combining

Fluconazole: Increasing the time of sulfonylurea, which can increase the symptoms of hypoglycemia.

Voriconazole: Although not studied, voriconazole may increase sulfonylurea levels in plasma, (for example, tolbutamid, glipizid and glybid) and thus causing blood sugar drops. Need to carefully monitor blood sugar when used at the same time.

Salicylate (acetylsalicylic acid): Increases the hypoglycemic effect when using acetylsalicylic acid high doses (the hypoglycemic effect of acetylsalicylic acid).

Beta inhibitors: All beta inhibitors can cover some symptoms of hypoglycemia (such as suspense and tachycardia). Most beta blockers are not selected on the heart, increasing the frequency and severity of hypoglycemia.

Angiotensin transfer enzyme inhibitors: The use of angiotensin transferring enzyme inhibitors can lead to increased hypoglycemic effect in diabetes patients treated with sulfonylure.

cimetidine: The use of cimetidine may be related to reducing blood sugar after eating in patients treated with glipizid.

The hypoglycemia of sulfonylurea, generally can also be enhanced by monoamine inhibitors of oxidase, quinolones and drugs strongly connected with protein such as sulfonamid, chloramphenicol, probenecid, coumarin and fibrats. When using (or stop using) these drugs for patients who are taking glipipid, closely monitor hypoglycemia (or loss of blood sugar control).

The following substances can lead to hyperglycemia:

There is no recommendation to use in combination

Danazol: Due to the effect of Danazol's diabetes. If it is impossible to avoid combining, a warning should be warned for patients to monitor blood sugar and urine. The dose of anti -diabetes may be needed during the treatment with Danazol and after the drug stopped.

Need kidney while combining

Phenothiazine (such as chlorpromazin) with high doses (> 100 mg/day): increasing blood sugar levels (due to reduced insulin release).

Corticosteroids: increasing blood sugar.

Sympathomical medications (Ritodrin, Salbutamol, Terbutalin): Increases blood glucose levels due to Beta-2-ADRENERGIC receptor stimulation.

Progestogen: Due to diabetes at high doses of progestogen. It is necessary to warn the patient to monitor blood sugar and urine. The dose of anti -diabetic drugs can be adjusted during treatment or stopping treatment with neurological drugs, corticosteroids or progestogen.

Other drugs: Other drugs can cause hyperglycemia and lead to loss of blood sugar control including thiazids and other diuretics, thyroid products, estrogen, oral contraceptives, phenytoin, nicotinic acid, calcium inhibitors and isoniazid.

When using or stopping using these drugs for patients who are using glipizid, closely monitor blood sugar drop problems.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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