Description
Glidib Pharmacodynamics
Oral hypoglycemic agent, sulfonylurea derivative of II generation. Stimulates insulin secretion by the pancreas, increases insulin-secreting action of glucose and peripheral tissue sensitivity to insulin. Stimulates the activity of intracellular muscle glycogen synthase enzymes. Shortens the time interval from the moment of food intake to the beginning of insulin secretion. Restores the early peak of insulin secretion (unlike other sulfonylurea derivatives, such as glibenclamide, which have an effect mainly during the second stage of secretion). In addition to its effect on carbohydrate metabolism, it has an effect on the microcirculation. It reduces postprandial hyperglycemia, reduces platelet adhesion and aggregation, delays the development of parietal thrombosis, normalizes vascular permeability and prevents the development of microthrombosis and atherosclerosis, restores the process of physiological parietal fibrinolysis, counteracts the increased response to epinephrine of vessels in microangiopathies. Slows down the development of diabetic retinopathy at nonproliferative stage; in diabetic nephropathy against the background of long-term use, a significant reduction in proteinuria is noted. It does not lead to weight gain, as it mainly influences the early peak of insulinosecretion and does not cause hyperinsulinemia; it promotes weight loss in obese patients by following an appropriate diet. It has anti-atherogenic properties, lowers the blood concentration of total cholesterol.
Indications
Diabetes mellitus type 2 in adults (when diet and exercise are ineffective).
Contraindications
Hypersensitivity, diabetes mellitus type 1, diabetic ketoacidosis, diabetic precoma and coma, severe hepatic and/or renal insufficiency, concomitant therapy with miconazole, pregnancy, lactation, age under 18 years, lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
With caution:
Older age, irregular and/or unbalanced diet, severe cardiovascular disease (incl. coronary heart disease, atherosclerosis), hypothyroidism, adrenal or pituitary insufficiency, hypopituitarism, renal and/or hepatic insufficiency, long-term therapy with glucocorticosteroids, alcoholism, insufficiency of glucose-6-phosphate dehydrogenase, concomitant therapy with phenylbutazone and danazol.
Dosage and administration
- Orally, with meals, the initial daily dose is 80 mg, the average daily dose is 160-320 mg (in two doses – in the morning and in the evening). The dose depends on the age, severity of diabetes, and blood glucose concentration on an empty stomach and 2 hours after a meal.
- In elderly patients or in chronic renal insufficiency of mild to moderate severity (creatinine clearance – 15-80 ml/min), the drug is prescribed in the same dosage.
