One of the most dangerous diseases is diabetes. The human body is slowly destroyed due to metabolic disorders. The source of a dangerous process is the pancreas, which ceases to produce insulin. The glucose level rises, water metabolism worsens. This significantly affects the duration and quality of human life. There are many drugs that help maintain normal blood glucose levels in patients with diabetes. Consider the drug "Novonorm", instructions for use, as well as reviews of those who took this remedy.
Forms and composition of the drug
The drug "Novonorm" is available in Denmark and Germany. The main substance is repaglinide.
The medicine is produced in the form of round tablets, convex on both sides. On one side there is a symbol of the manufacturing company.
The instruction of tablets "Novonorm" indicates that they may contain 0.5 mg, 1 mg or 2 mg of the active substance.
Additional substances in the composition:
- Microcrystalline cellulose.
- Calcium hydrogen phosphate.
- Corn starch.
- Povidone.
- Potassium Polacryline
- Poloxamer.
- Magnesium stearate.
- Glycerin 85%.
- Iron oxide, which gives color to the tablets.
How does the drug work?
Novonorm is a quick-acting oral medicine that stimulates insulin secretion. Lowers glucose by producing pancreatic hormone. The effectiveness of the drug depends on how much beta cells are left that have retained their functions in the pancreas.
The main active substance belongs to the group of meglitinides. It is a derivative of amino acids. It can bind to potassium channels that are on the membrane of the pancreatic beta cells. The active substance repaglinide helps to block calcium channels, as a result of which calcium enters the cells and helps insulin synthesis.
The effect of the drug begins 10 minutes after administration. The maximum effect occurs after 50 minutes. It is recommended to take Novonorm 15 minutes before meals.
After the medicine is taken, after a certain time, the production of insulin and the rise in glucose during eating coincide, as a result of which sugar will easily leave the vessels.
The drug "Novonorm" with a high level of sugar is more active. Three hours after taking the pill, insulin levels normalize. This type of stimulation of insulin production is considered facilitated. At the same time, beta cells do not waste their potential too quickly, thereby preventing the spread of diabetes.
The results of preclinical studies have shown that the drug "Novonorm" is not dangerous for people. Experiments were performed on animals, which showed that the active substance of the drug does not have a teratogenic effect.
However, experiments confirmed reproductive toxicity. And also repaglinide in experiments on animals was found in the milk of lactating individuals.
Before taking Novonorm tablets, the instructions for use must be carefully studied.
How is the medicine excreted
As indicated earlier, the drug is very easily absorbed, due to its rapid effect. Gastrointestinal tract is quickly absorbed. It is processed by the liver. After an hour, 92% is excreted in the feces, 8% is excreted by the kidneys. Therefore, if the patient has impaired renal function, the drug should be prescribed with caution. Five hours later, the active substance is completely excreted from the body.
Who is prescribed the drug
The instruction "Novonorma" recommends the drug to those who are diagnosed with type 2 diabetes:
- Provided that a diabetic cannot adapt to the necessary diet. Of great importance is the amount of carbohydrates in the diet. The dosage of the drug in this case must be adjusted.
- If the disease is only diagnosed with glycated hemoglobin above 9%.
- With the rapid development of diabetes.
- With insufficient production of insulin, if the first phase is disturbed.
If there is a contraindication to the use of sulfonylurea preparations, they are not recommended to be taken together with Novonorm.
Who should not take the remedy
It is necessary to highlight in which cases the drug "Novonorm" is contraindicated. Instructions for use note the following categories:
- With type 1 diabetes. No insulin production occurs with complete destruction of beta cells.
- With insufficient liver function. If its work is disturbed, the level of active substance increases significantly.
- When treating with gemfibrozil. The drug increases the concentration of the active substance by 2.4 times, which can lead to a strong drop in blood glucose levels. Excretion of the drug from the body increases by three hours.
- In conditions such as ketoacidosis and the resulting complications. Perhaps a violation of the absorption of repaglinide, so they switch to insulin injections.
- Surgical interventions. Probably metabolic disorder. Apply a temporary injection of the drug.
- Infectious diseases and life-threatening injuries. Stressful situations may require administration of insulin.
- Pregnancy. No studies have been conducted.
- Patients under 18 and over 75 years old. There were no studies in this category.
- Hypersensitivity to the components of the drug. Perhaps the development of anaphylactic shock, allergic reactions.
Contraindications are of great importance for Novonorm. You should know them so as not to harm your health.
Rules for taking the drug
It is recommended to follow some rules for the selection of the optimal dose of Novonorm.
When applying, the following recommendations should be considered:
- Monitor glycemia regularly.
- You need to take the medicine with food, 15 minutes after the start of the meal.
- You can also take the pill 30 minutes before eating.
- The initial dose is 0.5 mg of the drug at each meal.
- If the patient has previously used other drugs that control sugar, then it is necessary to start taking with 1 mg.
- If there is no effect for those who started treatment for the first time, that is, if insulin compensation is not achieved, after a week the dose rises to 1 mg.
- Gradually, you can increase the dose by 0.5 mg.
- Up to 4 mg can be taken at a time.
- The daily norm is 16 mg.
- If a meal is skipped, the drug should not be taken.
- When you add another meal, respectively, one more meal is added.
- If the glucose level cannot be controlled with repaglinide, metformin and thiazolidinediones can be taken simultaneously. The dosage of each should be selected based on the dynamics of sugar levels.
If the maximum dose does not solve the problem and sugar continues to grow, it is necessary to adjust the diet. If, in this case, there is no result, then the drug should be changed to a stronger one. All this should be under the supervision of a physician. Your health and life depend on this. Lack of control over the level of insulin in the blood for a diabetic can lead to a diabetic coma.
Side effects of the drug
When taking "Novonorm" side effects are more often manifested in the form of hypoglycemia or hyperglycemia. Symptoms are as follows:
- Hypoglycemia: hunger, tremors, sweating, anxiety, anxiety.
- Allergic reactions: itching, rash, vasculitis, erythema.
- Visual acuity is impaired. Perhaps at the initial stage of taking the drug, when the glucose level is not constant.
- It is very rarely possible on the part of the cardiac system to develop acute coronary syndrome.
- Nausea.
- Vomiting
- Violation of the gastrointestinal tract.
- Disorder of the liver.
- Hypersensitivity to the skin.
Interaction with other medicines
Describing the dosage of Novonorm, the instruction indicates that some drugs affect glucose synthesis.
Care should be taken when taking repaglinide in conjunction with CYP2C8 and CYP3A4 inhibitors.
"Cyclosporin" increases the concentration of repaglinide in the blood.
It should also be borne in mind that some drugs prolong the hypoglycemic effect of the drug. These include:
- Monoamine oxidase inhibitors.
- Gemfibrozil.
- Trimethoprim.
- "Itraconazole".
- Cyclosporin.
- Non-selective beta-blockers.
- ACE inhibitors.
- Nonsteroidal anti-inflammatory drugs.
- Salicylates.
- Octreotide.
- Anabolic steroid.
- Alcohol-containing drinks.
You should not take "Gemfibrozil", "Fenofibrate" at the same time as Novonorm.
The simultaneous use of "Trimethoprim" and "Novonorma" leads to an increase in the concentration of the second 1.6 times. Use with caution. Constantly monitor blood sugar.
The combined use of "Rifampicin" and repaglinide-based drugs requires dosage adjustment of the latter.
Taking repaglinide with Ketoconazole increases the concentration of the former by 1.2 times. The glucose level changes by less than 8%.
Use with Itraconazole increases the concentration of the basic substance, but does not affect glucose levels.
Use with agents whose active substance is repaglinide does not change the performance of the following drugs:
- Cimetidine.
- Simvastatin.
- Nifedipine
- Estrogens.
- "Digoxin".
- Theophylline.
- Warfarin.
When prescribing these drugs together with Novonorm, the instruction indicates that dosage adjustment is not required.
Reduce the effect of repaglinide:
- Barbiturates
- Oral contraceptives.
- "Rifampicin".
- Thiazides.
- Danazol
- Corticosteroids.
- Thyroid hormones.
- Sympathomimetics.
- Levonorgestrel.
- "Ethinyl estradiol."
When prescribing the above drugs, you should carefully monitor the level of glucose in the blood.
Features of the use of the drug
It should be noted that the drug "Novonorm" recommends taking the instructions if dieting and physical activity does not help control glucose levels.
With insufficient effectiveness, the drug can cause hypoglycemia.
Used in combination therapy with thiazolidinediones or with NPH-insulin.
Combined treatment with Metformin can cause hypoglycemia.
If the patient is subject to severe stress, fever, surgery, or infectious diseases are detected, then glucose control may be ineffective when using Novonorm. It is recommended to temporarily use small doses of insulin injections. Then you can return to taking the drug.
In the case of complications of diabetes, there may be a decrease in the hypoglycemic effect of the drug. In this case, the diagnosis of secondary diabetes can be made, but before that it is necessary to try to review the patient's diet and load, and also to correct the dosage.
In renal failure, it is necessary to more carefully select the dose of the drug, since such patients have an increased sensitivity to insulin.
Studies for children, the elderly over 75 years of age and for pregnant women have not been conducted. Therefore, it is impossible to assess the safety of taking the drug for these categories.
In the case of hypoglycemia, reactions and attention are significantly inhibited. Therefore, when driving, care must be taken not to become the culprit of a dangerous situation. If the patient does not feel the symptoms of a drop in blood glucose, the ability to drive a vehicle should be reviewed.
Overdose symptoms
When taking the drug in case of an overdose, hypoglycemia may develop. She has the following symptoms:
- Increased sweating.
- Decreased concentration.
- Headaches.
In the event of such symptoms, appropriate measures must be taken. Blood glucose levels should be normalized. For example, take carbohydrates. If hypoglycemia is in severe form, then it can be observed:
- Loss of consciousness.
- Cramps.
- Coma.
In this case, an injection of glucose is necessary. It is also urgent to seek medical help.
You should carefully study the instructions before taking a drug such as Novonorm. Reviews note that compliance with the rules of admission does not lead to an overdose.
Analogs
First of all, I want to note if the drug did not suit you, you need to consult a doctor. There are analogues for Novonorm that can replace this drug.
- "Diagninid" and "Iglinid". The active substance is repaglinide.
- Starlix. Belongs to the group of meglitinides.
Drugs that enhance insulin production:
- Glurenorm.
- Maninil.
- "Diabeton."
- Amaril.
- "Xelevia".
- Galvus.
- Onglisa.
It is necessary to study the instructions for use before taking the drug "Novonorm". Analogs can pick up a doctor.
You should carefully consider the dosage of the selected product. If the composition contains the same active substance, the dosage is maintained. When replacing with a drug with a different basic composition, you should consult a doctor for advice.
Reviews
The drug "Novonorm" reviews is positive. Patients with type 2 diabetes are noted for their ease of use. Subject to dosage and diet, as well as physical activity, sugar can be kept normal.
Many note that it is convenient to combine the intake of tablets and food. Eat food, drink a pill, eat no food, do not take the drug. It is very convenient for busy people throughout the day.
Some switched to taking Novonorm after other drugs. Glucose values are reduced and health is improved.
For kidney diseases, Novonorm is also used. Reviews note that a decrease in sugar to hypoglycemia is very rare at the same time, attacks are easy to stop.
For some, the difficulty in determining the dosage of the drug creates difficulty. Since the amount of food eaten is always different. Therefore, taking 0.5 mg may be an insufficient dose, and taking 4 mg - an overdose.
Patients note the convenience of taking the drug in tablets. No need to do injections. Therefore, the drug deserves a lot of positive reviews.
Instructions for use "Novonorm" says that it goes well with all drugs that reduce blood sugar.
The medicine perfectly maintains the level of glucose and stimulates the body to independently produce it. Great support for early type 2 diabetes patients.