Quite popular drug "Gluconorm" is prescribed if necessary to monitor the status of the diabetic. INN "Gluconorma" - glibenclamide and metformin. The combined drug is intended for oral use. Its components belong to different pharmacological groups and stabilize each other, increasing the overall effect on the human body. The combined drug proved to be very effective, so many analogues soon appeared. Consider the main features.
Main ingredient
To understand why gluconorm diabetes tablets are effective, you should turn to the features of the two main ingredients. Metformin in modern pharmaceuticals is classified as biguanide. This drug allows you to reduce the concentration of sugars in blood plasma, as it increases the susceptibility of peripheral tissues to insulin activity. Under the influence of this agent, glucose is more actively captured by tissue cells. At the same time, the ability of the mucous membranes to absorb carbohydrates during the passage of the gastrointestinal tract decreases. Proper use of the drug slows down hepatic glucose neogenesis. The medication improves the fat profile of the blood and lowers total cholesterol in the circulatory system. Under the influence of the drug, blood saturation decreases with low-density lipoproteins, triglycerides, while the hypoglycemic reaction is not provoked.
Other components of the drug
The second main substance present in the drug is glibenclamide. Gluconorm has been introduced into the composition of Gluconorm because of its ability to maintain and increase the effectiveness of biguanide. Glibenclamide belongs to the second generation of drugs from the class made by the transformation of sulfonylurea. This compound activates the production of insulin, since it lowers the threshold of excitability of beta cells by pancreatic sugar contained in the blood. At the same time, insulin susceptibility is increasing.
As observations have shown, glibenclamide can increase the activity of target cells with which insulin binds. The release of this hormone increases, the hormonal effect on the absorption of glucose becomes more pronounced. Glibenclamide affects the activity of the liver, muscle cells responsible for the absorption of sugars. Under its influence, the lipolysis process in the adipose tissue slows down. The drug is active in the second stage of insulin production.
How to replace?
Since the combination of drugs has proven to be reliable and effective, many medicines have been developed that are similar to the Gluconorm drug in its main ingredients. Among the most frequently appointed are Bagomet, produced by the Valeant enterprise, and Glibenfage, produced by the domestic Farmsintez enterprise. Sometimes, as an alternative, the doctor offers the patient "Glibomet." A relatively good replacement for Gluconorm is Glibekomb, represented by Akrikhin, a Russian pharmaceutical company.
Glucovans, manufactured by the French company Merck, has a good reputation. Another possible analogue is Metglib, presented by the Russian company Canonfarm. All of the above funds belong to the class of combined, contain the above active compounds. In some cases, as a replacement for Gluconorm, the doctor may propose other medicines containing other compounds that effectively control blood quality.
Close, but not identical - Glucophage
Among others, sometimes doctors are advised to consider this tool, which contains one of the main ingredients of Gluconorm. It is quite affordable. Instructions for use "Glucophage", reviews about this tool indicate its rather high effectiveness in diabetes due to the presence of metformin in the composition. On average, 150-300 rubles are asked in pharmacies for one package containing 60 capsules. The specific cost is determined by the dosage of the active compound and the characteristics of the release, as well as the pricing policy of the store.
The pharmaceutical product is designed for diabetics, contains biguanide intended for oral use - this is stated in the instructions for use of Glucofage. Price, reviews about this tool indicate that this is a quality and reliable product, long and well known to our compatriots. It is available in tablet form and is intended for people with type 2 diabetes.
Rules and Features
In order for the treatment of type 2 diabetes mellitus with the Glucofage drug to be effective, you need to use the drug in strict accordance with the recommendations of the manufacturer and your doctor. The medication is intended for oral administration or during a meal, or immediately after it. If a person does not receive insulin, Glucophage is taken one gram twice in the first three days. You can use half the dose three times daily for three days. From the fourth day, the patient should receive a gram three times a day until the 14th day inclusive. After 15 days, it is allowed to reduce the dose, based on indicators of the concentration of sugars in urine. To maintain a stable state, the patient should receive from a gram to twice as much volume per day.
There is a variant of "Glucophage" with prolonged action - it is presented under the name "Retard". One capsule contains 850 mg of metformin. Such a medicine should be used twice a day: in the morning and evening. The maximum daily dosage is three grams.
If the patient receives insulin, the dose is up to 40 units, the dosage option described earlier must be observed. Over time, the amount of insulin coming from outside is gradually reduced. If the patient is shown more than 40 units of insulin daily, the use of Glucophage and a decrease in the amount of synthetic hormone are practiced with extreme care. If possible, the patient is sent for inpatient treatment.
Glibenfage
Among the analogues and substitutes for Gluconorm, the drug Glibenfage attracts attention. It belongs to the category of combined antidiabetic medicinal formulations, intended for oral administration. Has extrapancreatic, pancreatic activity. The composition of the drug contains glibenclamide, due to which the production of insulin is activated. Metformin inhibits glucose hepatic neogenesis. The hypoglycemic effect is observed a couple of hours after the drug is ingested, and is fixed for half a day. Studies have shown that glibenclamide is absorbed in a short time during passage into the digestive tract. The efficiency of the process is estimated at 84%. The maximum concentration is achievable in approximately 7-8 hours. The ability to enter into strong bonds with whey proteins is estimated at 97%. In the liver, metabolic processes are localized. They cover the bulk of the intake of the active substance. Transformation products are metabolites that do not have pharmacological activity. On average, half of the substance is eliminated by the renal system, the second half - with bile. The elimination half-life is estimated at 10-16 hours.
When planning treatment for type 2 diabetes mellitus with Glibenfage, the doctor evaluates the effect of metformin on the patient’s body. It is necessary to take into account the kinetic features of this compound and the reaction of the body of a particular patient. Normally, metformin is absorbed during the passage of the gastrointestinal tract, the effectiveness of this process is estimated at 48-52%. Elimination is carried out by the renal system. The main percentage of the excreted compound is the parent molecule. A small portion is eliminated by the intestinal tract. The elimination half-life varies between 9-12 hours.
Usage: when and how?
This analogue of Gluconorm is prescribed if a second type of diabetic disease is detected. A medication is useful if the correction of diet and monotherapy with hypoglycemic drugs for oral administration does not give the desired result.
The optimal amount of medication is determined by the doctor. When choosing a form, they are repelled from the diagnosis and the condition of the patient's body. Typically, at the beginning of the course, the patient is prescribed 0.5 g of metformin and 2.5 mg of glibenclamide. Gradually change the dose in order to achieve maximum effectiveness. Between dose adjustments, it is recommended to withstand weekly or two-week pauses. Glycemia is regularly checked to determine the effectiveness of treatment. More than 0.5 g of metformin, 5 mg of glibenclamide should not be taken per day.
Undesirable consequences
Glibenfage is an analogue of Gluconorm, the administration of which sometimes leads to side effects. The gastrointestinal tract can respond to the drug course with vomiting, pain, nausea. In the circulatory system, the concentration of cyanocobalamin can increase - this is more likely, with a long course. There is a possibility of skin rashes, the appearance of erythema, areas of itching. Urticaria or increased light susceptibility may appear. There are known cases of lactic acidosis, porphyria, an increase in the concentration of urea in the blood serum, and a decrease in the sodium content. There is a chance of a pathological increase in blood creatinine, hypoglycemia.
It is known that sometimes taking Glibenfage provoked thrombocytopenia, leuko-, pancytopenia, anemia, agranulocytosis. There is a danger of disulfiram-like reactions. This is likely if ethanol enters the patient.
Metglib Force
This drug is prescribed if a second type of diabetic disease is established. It is used when the appointment of a special diet does not give the desired result. A combined remedy is necessary if the use of hypoglycemic drugs for oral use does not allow to stabilize the condition. The drug was created for oral use during a meal. Dosage must be selected in a strictly individual format.
Usually, “Metglib Force” is prescribed so that at the beginning of the course the patient receives 0.5 g of metformin, 2.5 mg of glibenclamide. Gradually, the volumes are changed so that the state stabilizes. The pause between volume adjustments is from a week to twice as much time. Adjusting the dose, they are repelled from the parameters of glycemia. A patient should receive no more than 0.5 g of biguanide and no more than 5 mg of the second component per day.
Glucovans
This tool also belongs to the class of combined. One of the main ingredients is glibenclamide, which is contained in one tablet in an amount of 2.5 mg or 5. Instruction for use "Glucovans" (500 mg of metformin, 2.5-5 mg of glibenclamide) is recommended for the second type of diabetic disease. Micronized glibenclamide, penetrating the body, is effectively absorbed during the passage of the gastrointestinal tract - the level of absorption reaches 95%. The maximum serum concentration is recorded on average after four hours. The volume of distribution is estimated at ten liters, the ability to interfere with serum proteins is 99%. The substance is processed qualitatively by the liver. The reaction products are two pharmacologically ineffective substances, excreted by 40% with urine, 60% with bile. The elimination half-life varies from 4 to 11 hours.
The second active component of the drug is absorbed into the gastrointestinal tract shortly after entering the body. The maximum concentration in blood serum is achievable after 2.5 hours, the absolute bioavailability is estimated at 50-60%. The tool quickly spreads to organic tissues, almost does not interfere with serum proteins. The elimination half-life is estimated at 6.5 hours. Metformin is transformed, but rather weakly, eliminated with urine. Up to a third of the dose is excreted by the intestinal tract in its original form.
About the combination drug
As can be learned from the instructions for use accompanying the Gluconorm analogue, Glucovans is a combination product whose main components are biologically available to the same extent as when used separately. The meal also does not adjust the level of availability of the product. It was found that the absorption rate of glibenclamide is slightly higher if you use the drug with food.
If renal failures are observed, clearance decreases. The half-life becomes longer. The content of metformin in the circulatory system is increasing.
When will it help?
The instructions for use accompanying the Gluconorm analogue clarify the need to use the drug only in the second type of diabetic disease and only in adulthood. The tool is prescribed if the diet program does not give a result, physical practices do not allow to stabilize the patient's condition. A combined drug is prescribed if the patient previously used metformin or took any sulfonylurea transformation products as monotherapy. It is allowed to prescribe "Glucovans" if the patient received two separate drugs: containing metformin and including glibenclamide. If the concentration of sugars in the circulatory system is stable, it is not particularly difficult to control the condition, the agent in question can be prescribed.
The doctor selects the dose of the Gluconorm analogue Glucovans strictly individually. Indicators depend on starting glycemia. Usually, at the beginning of a therapeutic program, the patient receives one tablet once a day. Prescribe a drug containing in each capsule 0.5 g of metformin and 2.5-5 mg of glibenclamide. To exclude hypoglycemia, it is impossible to take more glibenclamide at the beginning of the course than the patient received earlier. If previously only metformin was used, they are guided by the dose of this drug. If it is necessary to increase volumes, they make two-week or longer pauses between volume corrections so that the control of sugar in the circulatory system is reliable and accurate.
Analogs: what else are there?
Sometimes the doctor recommends Metglib. This drug is designed to combat type 2 diabetes. Before starting its use, they try to adjust the patient's condition with physical activity, proper nutrition and medicines containing only one ingredient. If this does not give the desired result, a combined medication is prescribed.
This analogue of Gluconorm is forbidden to take in case of a diabetic disease of the first type. A contraindication is ketoacidosis, which developed against the background of diabetes. You can not use "Metglib" if diabetes has caused precoma, coma, lactic acidosis. With a creatinine concentration in a man from 135 units or more, in women from 110 units and above, the drug is not prescribed due to the weakness of the kidneys.
You can not use the medication when the condition is acute, there is a possibility of deterioration in renal performance. This is observed with dehydration, shock, receiving intravenous iodine-containing drugs. You can not use "Metglib" because of acute poisoning with alcohol, against the background of porphyria and during gestation, breastfeeding. Contraindications are increased susceptibility to any substance used by the manufacturer and the receipt of "Miconazole" by patients.
Demanded and reliable
The drug "Bagomet Plus" usually begin to take one capsule per day. Choose whether to prescribe option 5 + 500 or 2.5 + 500, should be the attending physician. If you need to edit the dose, review blood counts once a week or two, making a decision about changing the dose. If the patient previously took the main components of the drug separately, replacing them with a combined pharmaceutical product, prescribe the amount of the drug, starting from the previous program. Typically, the patient needs to use a tablet or a pair of 2.5 + 500 or 5 + 500 twice a day. The medicine is used after waking up and shortly before bedtime. You cannot receive more than four capsules of the drug per day. The medicine is used during the meal.
Another popular substitute for Gluconorm in pharmacies is presented under the name Glybomet. The composition of this drug, mentioned in the instructions that accompany the medication, begins with glibenclamide. – , . , , , . , , . , , . , . , . . .
Will it help or not?
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