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 Systemic disorder
Occasionally, allergic or pseudoallergic reactions, such as itching, urticaria or rash, may occur. These mild reactions may develop into severe reactions with dyspnea and decreased blood pressure, sometimes shock. If urticaria occurs, the doctor must be informed immediately.
In sporadic cases, a decrease in blood sodium concentration and allergic vasculitis or skin photoallergy may occur.
·Disorder of blood and lymph system:
Hematological changes during glimepiride treatment: rare, thrombocytopenia, leucopenia, red blood cell reduction, granulocyte deficiency, hemolytic anemia and whole blood cell reduction in sporadic cases.
·Metabolic and nutritional disorders:
Due to the hypoglycemic effect of glimepiride tablets, hypoglycemia or hypoglycemia may occur for an extended period based on information about other known sulfonylurea drugs.
Possible symptoms of hypoglycemia include headache, extreme hunger, nausea, vomiting, burnout, sleepiness, sleep disorders, restlessness, aggressive behavior, decreased attention, impaired alertness and responsiveness, depression, mental disorder, language disorders, aphasia, visual disorders, tremors, local paralysis, sensory abnormalities, dizziness, weakness, loss of self-control, delirium, convulsion The patients were also unconscious, shallow breathing and bradycardia.
In addition, signs of reverse regulation of adrenaline may occur, such as sweating, wet skin, anxiety, tachycardia, hypertension, palpitation, angina and arrhythmia.
The clinical phenomenon of severe hypoglycemia attack may be similar to that of stroke.
When hypoglycemia is corrected, these symptoms are almost always relieved.
·Eye abnormality:
Especially at the beginning of treatment, the change of blood glucose may cause temporary visual damage. The reason may be that the tension temporarily changes and the refractive index of lens changes, which depends on the blood glucose level.
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 (for example, trauma, surgery, thermal infection), blood glucose regulation may not be ideal, and it may be necessary to temporarily switch to insulin in order to maintain good metabolic control.
matters needing attention
In the first weeks of treatment, the risk of hypoglycemia may increase, especially if it is necessary to monitor carefully.
The factors that are prone to hypoglycemia include:
·Unwilling or incapable of cooperating (often seen in elderly patients).
·Malnutrition, irregular eating time or missed meals.
·Diet changes.
·There is an imbalance between physical consumption and carbohydrate intake.
·Use alcoholic beverages, especially without meals.
·Renal function damage.
·Severe liver function damage.
·Overdose glimepiride.
·Some of the compensatory endocrine system diseases (such as some thyroid dysfunction and hypophysis or adrenal cortex dysfunction) that affect carbohydrate metabolism or reverse regulation of hypoglycemia.
·Use with some other drugs (see [drug interactions].
·Glimepiride was used in the absence of indications.
If these hypoglycemia risk factors exist, it is necessary to adjust the dose of glimepiride tablets or the overall treatment plan. This is also applicable when a disease occurs during treatment or when the patient's lifestyle changes.
For the elderly, when hypoglycemia develops, there is autonomic neuropathy, or patients with β receptor blockers, clonidine, reserpine, guanidine or other sympathetic nerve block drugs, the symptoms of low blood sugar reflecting the reverse regulation of adrenaline in the body (see adverse reactions) may be mild or nonexistent.
The symptoms of hypoglycemia disappeared after oral administration of carbohydrates (glucose or sucrose).
It is known from other sulfonylureas that hypoglycemia can recur despite the successful control of hypoglycemia. Therefore, patients should be closely observed.
Severe hypoglycemia requires immediate treatment and follow-up by doctors, and in some cases, patients need hospitalization. Patients with G6PD deficiency may be treated with sulfonylurea drugs, which may lead to hemolytic anemia. Because glimepiride is a sulfonylurea drug, patients with G6PD deficiency should pay attention to it and consider the substitution of non sulfonylurea drugs. Hypoglycemia or hyperglycemia may cause impaired alertness and responsiveness, especially when treatment begins or changes, or when glimepiride is 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 injury to the fetus. Patients in pregnancy must switch to insulin. For patients who plan to get pregnant, their doctors should be informed.
lactation
In order to prevent possible breast milk intake and possible child injury, breast-feeding women are prohibited from taking glimepiride tablets. If necessary, the patient must switch to insulin or stop breastfeeding.
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