GLYMECOMB PILLS 40MG + 500MG

Release form

Pills.

Composition

Active substances: Metformin hydrochloride in terms of 100% substance - 500 mg, gliclazide in terms of 100% substance - 40 mg;
Excipients: sorbitol, povidone, croscarmellose sodium, Magnesium stearate.

Packaging

In packing of 30 and 60 pieces.

Mechanism of action

Glymecomb is a fixed combination of two oral hypoglycemic agents of different pharmacological groups: gliclazide and metformin. It has pancreatic and extra-pancreatic effects.
Gliclazide stimulates insulin secretion by the pancreas, increases the sensitivity of peripheral tissues to insulin. Stimulates the activity of intracellular enzymes - muscle glycogen synthetase. Restores the early peak of insulin secretion, shortens the time from the moment of eating to the beginning of insulin secretion, reduces postprandial hyperglycemia. In addition to affecting carbohydrate metabolism, it has an effect on microcirculation, reduces adhesion and aggregation of platelets, retards the development of parietal thrombosis, normalizes vascular permeability and prevents the development of microthrombosis and atherosclerosis, restores the process of physiological parietal fibrinolysis, counteracts an increased reaction to adrenaline vascular in microantibodies and microantizations.Slows the development of diabetic retinopathy in the non-proliferative stage; in diabetic nephropathy, on the background of long-term use, a significant decrease in proteinuria is observed. It does not lead to an increase in body weight, as it has a predominant effect on the early peak of insulin secretion and does not cause hyperinsulinemia; promotes weight loss in obese patients with proper diet.
Metformin belongs to the group of biguanides. Reduces the concentration of glucose in the blood by inhibiting gluconeogenesis in the liver, reducing the absorption of glucose from the gastrointestinal tract and increasing its utilization in the tissues. Reduces the serum concentration of triglycerides, cholesterol and low-density lipoproteins (determined on an empty stomach) and does not change the concentration of lipoproteins of other densities. Promotes stabilization or weight loss. In the absence of insulin in the blood, the therapeutic effect does not appear. Hypoglycemic reactions does not cause. It improves blood fibrinolytic properties by suppressing tissue-type inhibitor of profibrinolysin activator (plasminogen).

Glimekomb, indications for use

Diabetes mellitus type 2 with the ineffectiveness of diet, exercise and previous therapy with metformin or gliclazide.
Substitution of previous therapy with two drugs (metformin and gliclazide) in patients with type 2 diabetes with a stable and well-controlled blood glucose level.

Contraindications

Hypersensitivity to metformin, gliclazide or other derivatives of sulfonylureas, as well as to excipients;
type 1 diabetes;
diabetic ketoacidosis, diabetic precoma, diabetic coma;
hypoglycemia;
severe renal impairment;
Acute conditions that can lead to changes in kidney function: dehydration, severe infection, shock;
acute or chronic diseases accompanied by tissue hypoxia: cardiac or respiratory failure, recent myocardial infarction, shock;
liver failure;
porphyria;
pregnancy, breastfeeding period;
simultaneous use of miconazole;
infectious diseases, large surgical interventions, injuries, extensive burns and other conditions requiring insulin therapy;
chronic alcoholism, acute alcohol intoxication;
lactic acidosis (including in history);
use for at least 48 hours before and within 48 hours after radioisotope or x-ray examinations with the introduction of an iodine-containing contrast agent;
adherence to a low-calorie diet (less than 1000 calories / day).
It is not recommended to use the drug in persons older than 60 years who perform heavy physical work, which is associated with an increased risk of developing lactic acidosis.

Dosage and administration

The drug Glymecomb apply inside, during or immediately after a meal.The dose of the drug is determined by the doctor individually for each patient, depending on the level of blood glucose.
Typically, the initial dose is 1 - 3 pills per day with a gradual selection of the dose to achieve a stable compensation of the disease.
Usually the drug is taken 2 times a day (yrpom and evening). The maximum daily dose is 5 tablets.

Side effects

Metabolism: in violation of the dosing regimen and inadequate diet - hypoglycemia (headache, fatigue, hunger, increased sweating, severe weakness, palpitations, dizziness, impaired coordination of movements, temporary neurological disorders; with the progress of hypoglycemia, patients may lose self-control and consciousness); in some cases - lactic acidosis (weakness, myalgia, respiratory disorders, drowsiness, abdominal pain, hypothermia, reduction of blood pressure, reflex bradyarrhythmia).
Gastrointestinal: dyspepsia (nausea, diarrhea, feeling of heaviness in the epigastrium, "metallic" taste in the mouth), loss of appetite - the severity decreases when taking the drug during a meal; rarely - liver damage (hepatitis, cholestatic jaundice - requires discontinuation of the drug, increased activity of “liver” transaminases, alkaline phosphatase).
From the side of blood-forming organs: rarely, inhibition of bone marrow hematopoiesis (anemia, thrombocytopenia, leukopenia).
Allergic reactions: itching, urticaria, maculopapular rash.
In cases of side effects, the dose should be reduced or the drug temporarily discontinued.
Other: visual impairment.
Common side effects of sulfonylurea derivatives: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, allergic vasculitis; life-threatening liver failure.

Special notes

Glimecomb treatment is carried out only in combination with a low-calorie diet with a low carbohydrate content. Blood glucose should be regularly monitored on an empty stomach and after meals, especially in the first days of drug treatment.

Glymecomb can only be prescribed to patients who receive regular meals, always including breakfast and ensuring sufficient intake of carbohydrates.

Drug interaction

Influence on ability to drive motor transport and control mechanisms:

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.

Overdosage

Overdose or the presence of risk factors may trigger the development of lactic acidosis, as the drug includes metformin. If you experience symptoms of lactic acidosis, you must stop taking the drug. Lactic acidosis is a condition requiring emergency medical care; lactic acidosis treatment should be carried out in a hospital.
The most effective treatment is hemodialysis.
Overdose can also lead to the development of hypoglycemia due to the presence in the composition of the drug gliclazide. When hypoglycemia mild or moderate glucose (dextrose) or sugar solution is taken orally. In case of severe hypoglycemia (loss of consciousness), a 40% dextrose (glucose) solution or glucagon is administered intravenously, intramuscularly, subcutaneously. After the recovery of consciousness, the patient must be given food rich in carbohydrates in order to avoid the repeated development of hypoglycemia.

Storage conditions

In a dry, dark place, at a temperature not higher than 25 ° C.