Gliclada 60mg Krka treatment for diabetes (2 blisters x 15 tablets)

The concentration increases gradually in the first 6 hours, reaching a stable state, maintained from 6 to 12 hours after using the drug.

Gliclazid is easy to absorb through the gastrointestinal tract.

Gliclazid is completely absorbed. Food does not change the speed and level of absorption.

distribution

about 95% linked to plasma proteins. The distribution volume is about 30 liters.

A single dose every day of prolonged Gliclada release maintains the concentration in gliclazid plasma more than 24 hours.

transformation

Gliclazid is metabolized mainly in the liver and excreted through urine: less than 1% of the formless form is found in urine. No active metabolites are found in plasma.

Elimination

Sell waste time of gliclazid from 12 to 20 hours.

There is no clinical change in pharmacokinetic parameters in elderly patients.

Gliclada extension release may be combined with BiguanID, Alpha-glucosidase or insulin inhibitors.

In patients who are not well controlled with the Gliclada long -lasting release, can be combined with insulin under strict medical supervision.

Special patient group

Elderly:

Gliclada extended release is indicated as the recommended medication regimen for patients under 65 years old.

In patients with mild to moderate kidney failure:

For these patients, the drug utensils can be used as in patients with normal kidney function with careful monitoring of patients. These data have been confirmed in clinical trials.

In patients at risk of hypoglycemia:

Children and adolescents:

There is no clinical research data on efficiency and safety and adolescence (under 18 years old).

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 to do when overdose?

Symptoms

Overdose of Gliclazid causes hypoglycemia.

Symptoms at the average level of hypoglycemia without losing consciousness or no nerve signs are treated by adding carbohydrates, adjusting the dosage of the drug or changing the diet.

closely monitor until the doctor is sure that the patient has survived the danger.

Severe hypoglycemic reactions are accompanied by coma, convulsions, neurological disorders that may occur and require immediate emergency hospitalization.

Management

If the case of coma hypoglycemia (has been diagnosed or suspected, the patient needs to be injected quickly with a 50 ml intravenous vein of glucose solution (20% to 30%).

Then continue to infect dilute glucose solution (10%) at an appropriate speed to maintain blood sugar levels higher than 1g/l.

Patients should be closely monitored and depending on the condition of the patient during this time, the doctor will decide whether to continue monitoring monitoring is necessary.

Division does not work for patients due to the close connection between gliclazid and plasma protein.

In an 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 dose to compensate for missed dose.

There may be symptoms of hypoglycemia: headache, intense hunger, nausea, vomiting, fatigue, sleep disorders, agitation, aggression, lack of concentration, reducing awareness, slow reaction, depression, visual disorders, language, tremor, recklessness, dizziness, dizziness, feeling of helplessness, loss of self -control, delusion, inferiority, depravity, and depression, depression, and depression. Vong.

Normally, symptoms will disappear after taking carbohydrates (sugar).

However, artificial sweeteners are ineffective.

Testing with other diabetes sulfones indicates that hypoglycemia may recur even when the above measures have proved to be originally effective.

If the hypoglycemia is severe or prolonged, and even if it is temporarily controlled by sugar, medical care is required or hospitalized immediately.

Other unwanted effects

Gastrointestinal disorders include abdominal pain, nausea, vomiting, indigestion, diarrhea, constipation. These symptoms occur not common.

can avoid or minimize the undesirable effect by taking Gliclazid at breakfast.

The following unwanted effects are reported as rare

Skin and subcutaneous disorders: rash, itching, urticaria, erythema, reaction

Disorders of blood and lymphatic systems: Hematology changes are very rare, may include anemia, leukemia, thrombocytopenia, and granulocytes. These disorders will recover when stopping gliclazid.

Liver-liver disorders increase liver enzyme (AST, ALT, alkaline enzyme phosphatase), hepatitis. Stop treatment if jaundice appears.

Eye disorders: A transient visual disorders can occur, especially at the beginning of treatment, due to changes in blood sugar.

Cases of reduced red blood cells, granulocytes, hemolytic anemia, hypoglycemia and allergic vasculitis have been described for other diabetes sulfons.

In cases of other diabetes sulfonylures, observations show that there is an increase in liver enzyme and even impaired liver function (for example, bile stasis, jaundice) and hepatitis after stopping the drug or liver failure, leading to death in a special case.

When experiencing side effects of the drug, patients need to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Caution when using

Hypoglycemia

This drug is only used for patients with a moderate diet (including breakfast). It is important to have a stable amount of carbohydrates regularly to avoid increasing the risk of hypoglycemia if eaten late, the amount of food is absorbed or low carbohydrates.

Hypoglycemia can occur in a low -calorie diet, prolonged or over -exercise, drinking alcohol or in combination with other hypoglycemic drugs.

Hypoglycemia may occur after using diabetes sulfonylurine. Some cases may be serious or prolonged. Necessary hospitalization and need to monitor blood sugar for a few days.

Choose the patient carefully, the dosage and the patient's instruction are clearly necessary to reduce the risk of hypoglycemia.

Factors that increase the risk of hypoglycemia:

kidney failure and liver failure

Gliclazid pharmacokinetics and pharmacokinetics may change in patients with severe renal impairment and liver failure. The stage of hypoglycemia occurs for these patients, so the monitoring priority should be given.

Patient information

The risk of hypoglycemia, along with symptoms, treatment methods, and conditions that affect blood sugar should be explained to patients and families.

Patients need to be notified of the importance of diet, exercise, and regular monitoring of blood sugar

Poor blood sugar control

Hematuria control in diabetics can be affected by any of the following factors: fever, trauma, infection or surgical intervention. In some cases, it is necessary to use insulin.

The hypoglycemic effect of any type of diabetes oral medication, including gliclazid, is reduced over time in these patients may be due to the severity of the severity of diabetes, or due to reduced response to treatment.

This phenomenon is called secondary failure, unlike the first -fledged failures, which is when an active ingredient is not effective in the first standard treatment therapy.

But first need to consider adjusting the appropriate dose and the compliance with the diet then put the patient into the secondary defeat group.

Testing

Measure hemoglobina1c concentration (HBA1C) or venous blood sugar levels are recommended in evaluation of blood sugar control. Self -monitoring blood sugar can also be helpful.

Diabetes sulfonylura can cause hemolytic anemia for patients with G6PD deficiency, which should be cautious for these patients and consider replacing drugs in case of necessity.

excipients

Gliclada release extended lactose. Patients with rare genetic problems: galactose intolerance, lactase deficiency or glucose-galactose malabsorption should not be used.

Women during pregnancy and lactation

Pregnancy

There is no study of the use of gliclazid in pregnant women, and even for other diabetes sulfons acids, there are very little data.

Do not use gliclazid for pregnant women.

Gliclazid does not cause teratogen on animals.

It is necessary to control diabetes before pregnancy to minimize the risk of birth defects related to uncontrolled diabetes.

Hypoglycemic medication is not suitable for pregnant women. Insulin is the first choice for these patients. Therefore, oral medication for diabetes should be replaced with insulin before pregnancy or as soon as you detect pregnancy.

Breastfeeding period

There is no research to confirm Gliclazid or its metabolites excreted through breast milk. Because there is a risk of neonatal hypoglycemia should be contraindicated to gliclazid for breastfeeding women.

The effect of the drug on the ability to drive and operate machinery

The ability to concentrate or the reaction is impaired if the blood sugar is too low or too high or due to visual problems caused by the above phenomena.

Remember that you may endanger yourself or others (for example when driving or using machines). Notify your doctor if:

Interactive drug

The following drugs increase the risk of hypoglycemia

Contraindications to coordinate with:

Miconazole: (Using systemic sugar or gel using oral mucosa) increases hypoglycemic effects, starting are symptoms of hypoglycemia or may cause coma.

Do not be proposed:

phenylbutazon (systemic sugar) increases the hypoglycemic effect of sulfonylurus medications for hypoglycemia (due to replacement associated with plasma proteins and reducing them),

Alcohol: Increasing hypoglycemic reaction (by inhibiting compensation reactions) can lead to the beginning of coma. Do not use alcohol or alcohol -containing drugs.

Collaborate requires preventive measures:

In some cases, hypoglycemia may occur when one of the following drugs is used, for example: other diabetes medications (insulin, acarboose, biguanid), 8-blockers, fluconazol, angiotensin metabolic enzyme inhibitors (captopril, enalapril), H, Maols, Sulfonamids, and anti-inflammatory drugs steroid.

The following drugs may be the cause of hyperglycemia

Do not be proposed:

danazol:

Due to Danazol's diabetes. If it is impossible to avoid the use of these drugs, warn the patient and emphasize the importance of urine and blood sugar monitoring.

It is necessary to adjust the dose of diabetes medications during and after treatment with Danazol.

Collaborate requires preventive measures:

chlorpromazin (sedative):

High doses (> 100 mg per day of chlorpromazin) increase blood sugar levels (reducing insulin release).

Warning to the patient and emphasizing the importance of monitoring blood sugar. Needed to adjust the dosage of active ingredients for diabetes in and after treatment with sedatives.

Glucocorticoid (using body and on -site in the joints, applying to the skin and through the rectum) and tetracosactrin: hyperglycemia caused by fat metabolism (reducing carbohydrates caused by glucocorticoid).

Warning to the patient and emphasizing the importance of blood sugar monitoring, especially at the beginning of treatment. Need to adjust the dose of active ingredients to treat inner sugar and after treatment with glucocorticoid.

ritodrin, salbutamol, terbutalin (intravenous).

Hyperglycemia due to the effects of B2 isomers. Emphasize the importance of monitoring blood sugar. If necessary, switch to insulin.

Combined with consideration

Anticoagulant treatment (for example: Warfarin): Sulfonylura drugs used in diabetes can lead to an increase in the effect of anticoagulants when simultaneously used. Need to adjust the anticoagulant dose.