Item nanme:Glimepiride Tablets Item character:This product is pink
Indication: It is suitable for type 2 diabetes mellitus whose diet control, exercise therapy and weight loss can not fully control blood sugar. Glimepiride tablets are not suitable for the treatment of type 1 diabetes (for example, diabetic patients with a history of ketoacidosis), diabetic ketoacidosis, or coma or coma of diabetic precursors.
Item specifications:2mg*90tab/box
Usage and dosage:consumption
In principle, the dose of glimepiride tablets should be adjusted according to the target blood glucose level. The dose of glimepiride tablets must be the lowest dose sufficient to achieve the target metabolic control.
Blood glucose and urine sugar levels must be measured regularly during the treatment of glimepiride tablets. In addition, it is suggested to measure hemoglobin glycosylated regularly.
If an error occurs such as missed administration, it is not allowed to correct it by taking a higher dose of drug later.
Measures to deal with the inability to take drugs at the prescribed time (especially forgetting to take drugs or not eating) or for various reasons must be discussed and agreed by both doctors and patients.
·Start dose and dose adjustment
The initial dose was 1mg glimepiride tablets per day.
If necessary, increase daily dose. It is suggested to monitor blood glucose regularly for dose adjustment, and it is suggested that the dosage should be increased gradually, for example, every 1-2 weeks, the dosage should be gradually increased to 2mg, 3mg, 4mg and 6mg daily.
·Dose range of patients with diabetes mellitus
In patients with diabetes mellitus, the daily dose is 1mg to 4mg glimepiride. Daily dose of more than 6mg is more effective for a few patients.
·Distribution of administration
The time and distribution of the drug administration is determined by the doctor according to the patient's current lifestyle. Generally, one time a day can be recommended to take immediately before breakfast, if not breakfast, take immediately before the first dinner.
It is very important not to miss meals after taking the medicine.
The need for glibenclamin in treatment may decrease due to improved diabetes control and increased insulin sensitivity. Therefore, in order to avoid hypoglycemia, we must consider reducing dose in time or discontinuing glimepiride tablets. If the patient's weight and lifestyle have changed, or there are other factors that increase the sensitivity of hypoglycemia or hyperglycemia, the dosage adjustment should also be considered.
·Duration of treatment
It is a long-term treatment to use glimepiride under normal conditions.
·Change from other oral antidiabetics to glimepiride tablets
There was no clear dose relationship between glimepiride tablets and other oral diabetes drugs. When glimepiride tablets are used instead of other oral hypoglycemic drugs, it is recommended that the same method be used as the initial dose starting at 1mg per day. That's also true
It is suitable for patients who have previously used another oral diabetes treatment drug at the maximum dose.
The efficacy and duration of the drugs used in the treatment of diabetes must be considered. Temporary cessation of medication may be required to avoid hypoglycemia risk from the combination of efficacy.
·Change from insulin to glimepiride
In addition to individual cases, patients with type 2 diabetes treated with insulin can be treated with glimepiride. Replacement of insulin with glimepiride tablets should be performed under close monitoring by doctors.
usage
Glimepiride tablets must be swallowed in sufficient liquid (approximately 1 / 2 cups) and shall not be chewed.
·Special population
Renal insufficiency
Information on glimepiride tablets is limited for patients with renal dysfunction. Patients with impaired renal function may be more sensitive to the hypoglycemic effect of glimepiride tablets (see [pharmacokinetics].
Adverse reactions General disorder
Occasionally, allergic or pseudoallergic reactions such as itching, urticaria or rashes may occur. These mild reactions may develop into severe reactions with dyspnea and hypotension, sometimes into shock. If urticaria occurs, the doctor must be informed immediately.
In sporadic cases, decreased blood sodium concentration and allergic vasculitis or skin photoallergy may occur.
·Disorder of blood and lymphatic system
Hematological changes during the treatment of glimepiride tablets: rare, thrombocytopenia, leucopenia, Erythropenia, agranulocytosis, hemolytic anemia and pancytopenia in sporadic cases.
·Metabolic and nutritional disorders:
Due to the hypoglycemic effect of glimepiride tablets, hypoglycemia or prolonged hypoglycemia may occur based on the known information of other sulfonylureas.
The possible symptoms of hypoglycemia include headache, extreme hunger, nausea, vomiting, tiredness, drowsiness, sleep disorders, restlessness, aggressive behavior, decreased attention, impaired vigilance and responsiveness, depression, mental confusion, language disorders, aphasia, visual disorders, tremor, local paralysis, paresthesia, dizziness, weakness, loss of self-control, delirium, convulsion Drowsiness and loss of consciousness, even coma, shallow breathing and bradycardia.
In addition, there may be signs of reverse adrenergic regulation, such as sweating, wet skin, anxiety, tachycardia, hypertension, palpitations, angina and arrhythmias.
The clinical phenomenon of severe hypoglycemia attack may be similar to stroke.
When hypoglycemia is corrected, these symptoms are almost always relieved.
·Eye abnormalities:
Especially at the beginning of treatment, the change of blood glucose may lead to temporary visual impairment. The reason may be the change of lens diopter caused by the temporary change of tightness, which depends on the blood glucose level.
·Gastrointestinal disorders:
Occasionally gastrointestinal symptoms such as nausea, vomiting and diarrhea, upper abdominal pressure or fullness and abdominal pain may occur.
In sporadic cases, hepatitis, elevated liver enzymes and / or cholestasis and jaundice may occur, which may develop into life-threatening liver failure, but can be recovered after the withdrawal of glimepiride tablets.
Taboo: This product cannot be used in the following situations:
·Allergic to glimepiride, other sulfonylureas, other sulfonamides or any component of the product.
·Pregnant women.
·Lactating women.
·Type 1 diabetes, diabetic coma, ketoacidosis
We have not accumulated the experience of glimepiride tablets in patients with severe liver injury and dialysis patients. For patients with severe liver injury, insulin should be used, and the most important thing is to achieve the best metabolic control.
Matters needing attention: warning
In stress conditions (e.g., trauma, surgery, thermal infection), blood glucose regulation may not be ideal. In order to maintain good metabolic control, it may be necessary to switch to insulin temporarily.
matters needing attention
During the first few weeks of treatment, the risk of hypoglycemia may increase, and careful monitoring is particularly necessary.
The risk factors of hypoglycemia include:
·Unwilling or unable to cooperate (mostly in elderly patients).
·Malnutrition, irregular eating time or missed meals.
·Diet changes.
·There is an imbalance between physical exertion and carbohydrate intake.
·Use alcoholic beverages, especially without meals.
·Renal function damage.
·Severe liver function damage.
·An overdose of glimepiride tablets.
·Some diseases of the decompensated endocrine system (such as some thyroid disorders and anterior pituitary or adrenocortical insufficiency) that affect carbohydrate metabolism or the reverse regulation of hypoglycemia.
·In combination with some other drugs (see drug interactions).
·Glimepiride tablets were used without indication.
If there are these risk factors for hypoglycemia, it is necessary to adjust the dosage of glimepiride tablets or the whole treatment regimen. This also applies when diseases or lifestyle changes occur during treatment.
For the elderly, when hypoglycemia gradually develops, there are autonomic neuropathy, or combined β In patients with receptor blockers, clonidine, reserpine, guanidine or other sympathetic blocking drugs, hypoglycemia reflecting the reverse regulation of adrenaline in the body (see [adverse reactions]) may be mild or non-existent.
After immediate oral administration of carbohydrates (glucose or sucrose), the symptoms of hypoglycemia almost disappeared.
We know from other sulfonylureas that although hypoglycemia can be controlled successfully at first, hypoglycemia will still recur. Therefore, patients should be closely observed.
Severe hypoglycemia requires immediate treatment and follow-up by doctors. In some cases, patients need to be hospitalized. The use of sulfonylureas in patients with G6PD deficiency may lead to hemolytic anemia. Because glimepiride belongs to sulfonylurea, patients with G6PD deficiency should pay attention to it, and non sulfonylurea should be considered. Hypoglycemia or hyperglycemia may result in impaired alertness and responsiveness, especially at the beginning or after a change in treatment, or when glimepiride tablets are taken irregularly. This may affect, for example, the ability to drive or operate the machine.
Medication for pregnant and lactating women: gestation
Glimepiride tablets are forbidden during pregnancy. Otherwise, there is a risk of damaging the fetus. The pregnant patients must switch to insulin. For patients who plan to conceive, their doctors should be informed.
lactation
In order to prevent possible breast milk intake and possible child injury, lactating women are prohibited from taking glimepiride tablets. If necessary, the patient must switch to insulin or stop breastfeeding.
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