Description overdue on 08/12/2014
- Latin name: Amaryl M
- ATC code: A10BD02
- Active substance: Glimepiride + metformin (Glimepiride + Metformin)
- Manufacturer: SANOFI AVENTIS (France)
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions on Amaryl M (method and dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Analogs
- With alcohol
- Reviews
- Price, where to buy
Composition
One tablet drug includes active substance: glimepiride micronized - 1 mg, 2 mg metformin hydrochloride 250 or 500 mg.
As well as supporting ingredients: lactose monohydrate, povidone COA, sodium carboxymethyl starch, microcrystalline cellulose, crospovidone, and magnesium stearate.
Foil shell consists of hypromellose, titanium dioxide, macrogol 6000, carnauba wax.
Product form
Produced Amaryl M tablets, film-coated, with the content of 1 mg + 250 mg and 2 mg + 500 mg. The drug is packaged 10 pieces and packed in blister 3 blisters in a pack.
Pharmacological action
Amaryl M has combined hypoglycemic action .
Pharmacodynamics and pharmacokinetics
One of the active ingredients of the drug - glimepiride It is able to stimulate the secretion and release insulin from the beta cells of the pancreas, and improve the sensitivity of peripheral tissues to the effects of endogenous insulin.
The other active component - metformin hypoglycemic agents is included in the group of biguanides. This hypoglycemic effect of the substance is shown when saving secretion insulin Even a little. Metformin does not have much effect on the beta cells of the pancreas, secretion of insulin and its reception in dosage does not lead to the development of hypoglycemia .
It is believed that metformin is able to potentiate the effectiveness of insulin, increases the sensitivity of tissues to him, inhibit gluconeogenesis in the liver, to reduce production of free fatty acids, decrease the oxidation of fats, appetite, carbohydrate absorption in the gastrointestinal tract, and so forth.
The maximum drug concentration in plasma is achieved within 2 hours after repeated 5 receiving 4 mg per day. Inside the body marked his full absolute bioavailability. Eating food has no particular influence on absorption, only slightly slowing its speed. The bulk of the metabolites Amaryl M eliminated via the kidneys, and the rest - through the intestines.
It was found that the drug can penetrate the placental barrier and is excreted in breast milk.
Indications
The main indication for Amaryl M is a type 2 diabetes with a condition of diet, physical activity and underweight, if:
- glycemic control is not achieved through a combination of diet, physical attack loads, reducing the weight and monotherapy with metformin or glimepiride;
- Combination therapy glimepiride and metformin substituted by one receiving combined drug.
Contraindications
Do not take this medicine if:
- Type 1 diabetes;
- diabetic ketoacidosis , Diabetic coma and precoma, acute or chronic metabolic acidosis ;
- hypersensitivity to the drug;
- severe hepatic impairment;
- renal failure and renal dysfunction;
- tendency to develop lactic acidosis ;
- any stress;
- the age of 18;
- malabsorption of food and medicines from the gastrointestinal tract;
- chronic alcoholism, acute alcohol intoxication;
- lactase deficiency, galactose intolerance, glucose-galactose malabsorption;
- lactation, pregnancy and so on.
Side effects
Admission Amaryl M, especially at the initial stage, can cause a variety of adverse events affecting major organ systems.
Hypoglycemia is often protracted and is accompanied by: headache , Acute hunger, nausea, vomiting, confusion, lethargy, sleep disorders . concern , Aggressiveness, poor concentration and alertness, psychomotor slowing reactions depression . confusion , Speech and vision, tremor and so on.
At the same time attacks of severe hypoglycemia can resemble cerebral circulation. Get rid of unwanted symptoms can be eliminated expression of glucose.
Instructions on Amaryl M (method and dosage)
Dosage Amaryl M is typically determined by the content of the target concentration of glucose in the blood of man. To obtain the necessary metabolic control, treatment is initiated with use of the lowest dose.
During treatment should regularly identify indicators of glucose concentration in the blood and urine. Also requires regular monitoring of glycosylated hemoglobin in the blood.
In case of improper admission of the drug or skip the next dose is not recommended to fill it using a higher dosage.
In the treatment of Amaryl M occurs gradually improved metabolic control and improvement of the sensitivity of tissues to Insulin That reduces the need for Glimepiride . Therefore, we must promptly to reduce the dosage or stop taking the drug, in order to avoid hypoglycaemia.
In most cases, appoints 1-2 single daily at the same time taking the drug with food.
The maximum daily dose glimepiride is - 8 mg and metformin - 2000 mg. The optimum dose is considered to be a single technique, according to the instruction on Amaryl M - 2 mg plus 500 mg, respectively.
Generally, treatment Amaryl M assumes its long-term use.
Overdose
With an overdose of Amaryl M may develop hypoglycemia, sometimes leading to coma and convulsions, as well as the emergence of lactic acidosis .
In such cases, treatment is prescribed depending on the severity hypoglycemia . If the form is marked by light without loss of consciousness, neurological changes, it is recommended to take into dextrose (glucose), and then adjust the dosage of medication and diet. For some time the need to continue close monitoring of the patient is a danger to health and life will not be completely eliminated.
Severe hypoglycemia, followed by coma, convulsions and other neurological symptoms require immediate hospitalization. Further treatment is carried out in the hospital, depending on the symptoms.
Cooperation
Simultaneous treatment with glimepiride and certain medications can affect its metabolism, for example - the use of inductors CYP2C9, Rifampicin, fluconazole and so on.
Furthermore, there are drugs which are able to enhance the hypoglycemic effect: Insulin , Oral hypoglycemic agents, Allopurinol ACE inhibitors, anabolic steroids and male sex hormones, coumarin anticoagulants, Chloramphenicol, cyclophosphamide, fenfluramine, Feniramidol, fluoxetine, guanethidine, ifosfamide, miconazole, fluconazole, probenecid, aminosalicylic acid, phenylbutazone , Quinolone antimicrobial agents, tetracyclines, salicylates, sulfinpyrazone and many others.
Also, a combination of a number of drugs may reduce the hypoglycemic effect, for example, Acetazolamide . barbiturates . GCS . Diazoxide , Diuretics, Epinephrine or sympathomimetics Glucagon , Laxatives (with prolonged use) nicotinic acid (high dose), estrogens, progestogens, phenothiazines, phenytoin, Rifampicin , Thyroid hormones.
Moreover, if Amaryl M taken together with the histamine H2 receptor, Clonidine or Reserpine Then we can expect the gain and reduced hypoglycemic effect.
With the introduction of iodinated contrast may develop kidney failure, which leads to the accumulation metformin and increased risk of lactic acidosis . In such cases, for two days to stop taking the drug.
A similar effect can be expected, while the reception and Amaryl M antibiotics Having expressed nephrotoxic effect ( Gentamicin ), And other drugs.
Therefore, the appointment of Amaryl M is necessary to inform your doctor about the possible use of other drugs, to prevent their dangerous interactions.
Terms of sale
The drug prescription.
Storage conditions
The medicine should be stored in a secure location away from children, with temperatures up to 30 ° C.
Shelf life
3 years.
Analogs Amar M
Galvus Met
The main counterparts Amar M are: Glemaz, Gemauno, Diamerid and Meglimid .
Alcohol and Amaryl M
Simultaneous treatment Amaryl M and alcohol in any quantity is able to weaken or strengthen the hypoglycemic effect glimepiride .
In addition, increases the risk of lactic acidosis Mainly when skipping or insufficient food and the presence of liver failure. Therefore, the use of alcohol and drugs containing ethanol is better to abstain.
Reviews of Amaryl M
The problem of choice of drugs is particularly acute diabetes is discussed at various forums and websites. Modern pharmacology offers a range of drugs such action, but as the reviews Amaryl M, many diabetics is prescribed this medicine.
It is known that patients with diabetes should not only be timely to take pills, but also follow the diet, get exercise, and so on. However, many users report that they receive a dose of Amaryl M 2 mg plus 500 mg, which allows you to effectively maintain their health.
As for professionals, they recommend that patients timely access them on any issues of concern, to watch their way of life and the feelings that accompany the treatment. Only such an approach will optimize the therapeutic process and improve the quality of life.
Price Amaryl M, where to buy
This drug is dispensed in pharmacies. The average price of Amaryl M 2 mg plus 500 mg, in the amount of 30 pieces is 500-564 rubles.
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