Maninil is an oral hypoglycemic drug belonging to the group of sulfonylurea derivatives of the II generation.
Release form and composition
Dosage form Maninil - tablets: flat-cylindrical, pink in color, with a risk and a chamfer on one side (120 pcs. In bottles of colorless glass, 1 bottle in a cardboard box).
The active ingredient of the drug is glibenclamide (in micronized form). 1 tablet contains 1.75 mg, 3.5 mg or 5 mg.
- Tablets 1.75 and 3.5 mg: potato starch, lactose monohydrate, gimetellose, magnesium stearate, colloidal silicon dioxide, crimson dye (Ponso 4R) (E124);
- Tablets 5 mg: gelatin, talc, potato starch, lactose monohydrate, magnesium stearate, crimson dye (Ponso 4R) (E124).
Indications for use
Maninil is intended for the treatment of type 2 diabetes. It is used as a monopreparation or as part of a complex treatment in combination with other oral hypoglycemic agents, with the exception of clays and sulfonylurea derivatives.
- Type 1 diabetes;
- Diabetic precoma and coma;
- Diabetic ketoacidosis;
- State after resection of the pancreas;
- Deficiency of glucose-6-phosphate dehydrogenase;
- Hereditary lactose intolerance, lactase deficiency, glucose / lactose malabsorption syndrome;
- Paresis of the stomach, intestinal obstruction;
- Severe renal failure (creatinine clearance less than 30 ml / minute);
- Severe liver failure;
- Decompensation of carbohydrate metabolism after major surgeries, burns, injuries and infectious diseases, if insulin therapy is indicated;
- Age up to 18 years;
- Lactation period;
- Hypersensitivity to the components of the drug or probenecid, diuretics containing a sulfonamide group in the molecule, sulfonamides and other sulfonylurea derivatives.
Relative (special caution required):
- Diseases of the thyroid gland, accompanied by a violation of its function;
- Hypofunction of the adrenal cortex or anterior pituitary gland;
- Febrile syndrome;
- Acute alcohol intoxication;
- Chronic alcoholism;
- Age over 70 years.
Dosing and Administration
The dose of Maniline is determined depending on the severity of the disease, the patient's age and the concentration of fasting blood glucose and 2 hours after a meal.
It is necessary to take a preparation before food, washing down with enough liquid. If necessary, the tablet can be divided in half, but you can not chew or grind. A daily dose of up to 2 tablets is usually recommended to be taken 1 time per day - before breakfast. Higher doses are divided into 2 doses - in the morning and in the evening.
The initial dose may be from 1.75 mg to 5 mg. With insufficient effect under the supervision of a physician, the dose is gradually increased to the optimum, which will stabilize the carbohydrate metabolism. Increasing the dose is carried out at intervals of several days to 1 week. The maximum permissible daily dose is 10.5 mg (6 tablets 1.75 mg or 3 tablets 3.5 mg). In some cases, an increase in the daily dose of up to 15 mg (3 tablets of 5 mg) is allowed.
The transfer of the patient to Maninil from another hypoglycemic drug is carried out under the supervision of a physician, starting with a minimum dose, gradually increasing it to the required therapeutic value.
Older people, debilitated and patients with reduced nutrition, as well as patients with severe impaired renal or liver function and reduce the initial and maintenance doses of the drug, because they have a risk of developing hypoglycemia.
In the case of skipping the next dose, take the pill at the usual time, it is forbidden to take a double dose!
- Metabolism: often - weight gain, hypoglycemia (hyperthermia, skin moisture, weakness, drowsiness, hunger, loss of motor coordination, general anxiety, headache, tremor, fear, tachycardia, transient neurological disorders, including paresis or paralysis, changes in perception of sensations, speech and vision disorders);
- Digestive system: infrequently - metallic taste in the mouth, abdominal pain, feeling of heaviness in the stomach, nausea, diarrhea, belching, vomiting;
- Liver and biliary tract: very rarely - intrahepatic cholestasis, a temporary increase in liver enzymes, hepatitis;
- Hematopoietic system: rarely - thrombocytopenia; very rarely - agranulocytosis, erythropenia, leukopenia; in rare cases - hemolytic anemia, pancytopenia;
- Immune system: infrequently - purpura, urticaria, increased photosensitivity, petechiae, itching; very rarely - anaphylactic shock, allergic vasculitis, generalized allergic reactions, accompanied by fever, skin rash, proteinuria, arthralgia and jaundice;
- Other: very rarely - increased diuresis, hyponatremia, proteinuria, accommodation disorders, visual impairment, disulfiram-like reaction when taking alcohol (most often manifested symptoms such as sensation of heat of the skin of the face and upper body, abdominal pain, nausea, vomiting, dizziness, headache, tachycardia), cross-allergy to sulfonamides, sulfonylurea derivatives, probenecid, diuretics containing a sulfonamide group in the molecule.
The entire period of treatment is necessary to strictly adhere to the recommendations of the doctor for self-monitoring of glucose concentration in the blood and diet, avoid prolonged exposure to the sun.
It should be remembered that intense exercise, insufficient supply of carbohydrates, prolonged abstinence from food, as well as vomiting and diarrhea are risk factors for the development of hypoglycemia.
Older people are more likely to develop hypoglycemia, so they need more careful dose selection and regular monitoring of glucose concentrations in the blood, especially at the beginning of therapy.
Peripheral neuropathy and concomitant medications that act on the central nervous system, lower blood pressure (including beta-blockers) can mask the symptoms of hypoglycemia.
Ethanol can cause hypoglycemia and a disulfiram-like reaction, so during treatment it is necessary to refrain from the use of alcoholic beverages.
Infectious diseases associated with febrile syndrome, extensive burns, injuries and surgical interventions may require discontinuation of the drug and insulin administration.
During treatment, it is recommended to use caution when driving and engaging in activities with potentially dangerous consequences, which require speed of reaction and increased attention.
The following medications may enhance Manil's effect: insulin and other oral hypoglycemic drugs, coumarin derivatives, inhibitors of the angiotensin-converting enzyme, quinolone derivatives, monoamine oxidase inhibitors, antifungal drugs (fluconazole, miconazole, clofibrate, and I would not have to use the one on any other type of, I would look for some kind of, I would not look like the one I would not look like I would like the on-one would look like I’ll not like the орам а орам осп орам орам] but I’m not looking for) and I’m not going to use any kind of text and look for any type of type of remedy: Maninil; , beta-adrenoblockers, fenfluramine, disopyramide, fluoxetine, probenecid, tetracyclines, sulfonamides, salicylates, tritoqualines, n derivatives irazolones, perhexylin, phosphamides (for example, ifosfamide, cyclophosphamide, trofosfamide), anabolic drugs and male sex hormones, pentoxifylline (in high doses when used parenterally), urine-acidifying preparations (calcium chloride, ammonium chloride).
Simultaneously with the increased hypoglycemic effect, reserpine, guanethidine, clonidine and beta-blockers, as well as drugs with a central mechanism of action can weaken the severity of symptoms that are precursors of hypoglycemia.
The following drugs can reduce the effect of Manil: glucocorticosteroids, nicotinates (in high doses), barbiturates, slow calcium channel blockers, oral contraceptives and estrogens, thyroid gland hormone preparations, lithium salts, sympathomimetic drugs, thiazide diuretics, glucagon, phenotypes, and chromosomes, chromosomes, chromosomes, lithium salts, sympathomimetic drugs, thiazide diuretics, glucagon, phenotypes, and chromic diaphragms, lithium salts, sympathomimetic drugs, thiazide diuretics, glutagon, and chromosomals, and chromosomes; , acetazolamide, rifampicin, isoniazid.
Antagonists of H 2 receptors can both strengthen and weaken the hypoglycemic effect of the drug.
Maninil may weaken or enhance the effect of coumarin derivatives.
There are isolated cases when pentamidine caused a strong increase and decrease in the concentration of glucose in the blood.
Terms and conditions of storage
Keep out of reach of children at temperature: 1.75 and 3.5 mg tablets - up to 30 ºС, 5 mg tablets - up to 25 ºС.
Shelf life - 3 years.