Glamaz is a hypoglycemic drug used in the treatment of non-insulin-dependent diabetes mellitus, with pancreatic (stimulating the secretion and release of insulin from pancreatic cells) and extrapancreatic (improving the sensitivity of muscle and adipose tissue to the effects of insulin) of the actions.
Release form and composition
Glemase is produced in the form of tablets, the main active ingredient of which is glimepiride.
Cellulose, sodium croscarmelose, magnesium stearate, microcrystalline cellulose, dyes are used as excipients in the preparation.
Glemaz is available in blisters of 15, 30 and 60 pieces per pack.
Indications for use
According to the instructions, Glemaz is used as a means of monotherapy and complex therapy of diabetes of the second type.
According to the instructions, Glemaz does not apply when:
- Diabetes mellitus type one;
- Diabetic ketoacidosis and diabetic precoma and coma;
- Accompanied by a violation of the absorption of food and the development of hypoglycemia conditions;
- Severe disorders in the liver and kidneys;
- Severe renal dysfunction (including patients on hemodialysis);
- The patient has hypersensitivity to any of the components of the drug, as well as to sulfonamides and other sulfonylurea derivatives;
- Pregnancy and breastfeeding;
as well as under the age of 18 years.
According to the instructions, Glemaz is used with caution in conditions that require the transfer of the patient to insulin therapy, namely:
- Extensive burns;
- Major surgical interventions;
- Severe multiple injuries;
- Disorders of absorption in the gastrointestinal tract.
Dosing and Administration
According to the instructions, Glemaz is intended for oral administration.
The initial and maintenance dose of the drug is selected based on the data of regular monitoring of blood glucose levels.
First, 1 mg of the drug is prescribed once a day. After reaching the optimal therapeutic effect, this dosage is taken as a maintenance. If there is no glycemic control, the daily dosage is gradually increased every 1-2 weeks to 2-4 mg per day (under the constant control of the blood glucose level). The maximum daily dose of the drug is 8 mg.
The drug is taken before breakfast or during it, drinking half a glass of liquid. It is not recommended to skip meals after taking Glemaz.
Glamase can also be used in complex therapy with metformin. Treatment with the drug begins with minimal doses while maintaining the same dose of metformin. Further, the dosage of Glemez gradually increases under close medical supervision.
If glycemic control cannot be achieved with the use of Glemez in maximum dosages as monotherapy or in combination with maximum dosages of metformin, it is possible to conduct complex therapy with insulin. At the same time, the dose of Glemase assigned to the patient remains unchanged, and insulin is started to be used in minimal dosages with their gradual increase under strict medical supervision.
When transferring a patient from the use of insulin to Glamesa, a minimum dose of the latter is prescribed (1 mg).
If it is necessary to transfer a patient from the use of another oral hypoglycemic agent to this drug, its initial dose should be no more than 1 mg. Increase dosage Glemaz produce gradually.
When using Glemase, certain adverse reactions may develop:
- Metabolism: hypoglycemic reactions (can be difficult and not always easy to stop);
- Digestive system: heaviness in epigastria, nausea, vomiting, diarrhea, abdominal pain, cholestasis, increased activity of hepatic transaminases, hepatitis, jaundice;
- Organ of vision: transient visual disturbances associated with changes in blood glucose levels;
- Hematopoietic system: thrombocytopenia, leukopenia, aplastic or hemolytic anemia, granulocytopenia, erythrocytopenia, agranulocytosis, pancytopenia;
- Allergic reactions: urticaria, skin rash, itching, accompanied by shortness of breath, low blood pressure, sometimes the development of anaphylactic shock;
- Others: headache, hyponatremia, asthenia, late skin porphyria, photosensitization.
When applying Glemaz should be borne in mind that:
- The drug must be taken strictly at the time prescribed by the doctor and in the recommended doses. Skipping the next medication can not be eliminated by taking a higher dose. The patient should be informed about the actions that he should take when skipping a meal or drug;
- At the beginning of therapy, the risk of hypoglycemia may increase, therefore, during this period, the patient needs more careful medical observation;
- The development of hypoglycemia after taking 1 mg of Glemez says that glucose can only be controlled by diet;
- At achievement of compensation of a diabetes mellitus sensitivity of an organism of the patient to insulin increases. Therefore, the need for the drug may be reduced. In order to prevent the development of hypoglycemia should be on time to cancel the drug or reduce its dosage. The dose of Glemase should also be adjusted with changes in the patient’s lifestyle, body weight, and other factors that influence the increased risk of hypoglycemia or hyperglycemia;
- Symptoms of hypoglycemia may be mild or absent in elderly patients, patients suffering from vegetative neuropathy, as well as receiving treatment with reserpine, β-blockers, guanethidine, clonidine;
- During the period of Glemase therapy, patients should be regularly monitored for liver function, peripheral blood, glucose levels and glycolized hemoglobin in the blood;
- When the urticaria appears during treatment with the drug, the patient should immediately consult a doctor, as there is a danger of developing cross-allergy with sulfonamides, other sulfonylurea derivatives, and allergic vasculitis;
- Due to the possibility of hypoglycemia or hyperglycemia, patients should be careful when performing potentially hazardous activities associated with the need for high concentration of attention and speed of psychomotor reactions.
Structural analogues of this drug are such drugs as Amaryl, Meglimid, Glimepirid, Glemauno, Diameride, Glumedeks, Gliamal piva.
Terms and conditions of storage
Glamase is stored at a temperature of not more than 25º in places with limited access of children, not more than two years.