Dizyde

Dibizid is a hypoglycemic pill used in the case of non-insulin-dependent diabetes mellitus.

Indications Dizyde

It is used with insulin-dependent diabetes mellitus, not compensated by physical exertion and dietary regimen (also prescribed for people with lipid metabolism disorders and obesity). 

Release form

The release of the drug substance is realized in tablet form, in the amount of 10 pieces inside the cell plates. In a pack - 6 such records.

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Pharmacodynamics

Glipizid reduces the increased blood sugar values (reaction to food), stimulating the secretion of insulin through the ß-cells of the insular tissue in the pancreatic region. The extra pancreatic effect consists of a decrease in gluconeogenesis, as well as an increase in the sensitivity of the muscles and liver cells to insulin. It has fibrinolytic properties.

Metformin is a hypoglycemic agent that increases the sensitivity of peripheral and hepatic tissues relative to insulin. At the same time, it has a positive effect on plasma lipid indices and potentiates fibrinolytic effect. When using metformin in patients does not increase weight.

Pharmacokinetics

Pharmacokinetic characteristics of drugs are developed due to the activity of its elements (metformin with glipizide).

Glipizid fully and at high speed absorbed by the use of medication inside. Absorption in the absence of food in the stomach is not more than 60-120 hours. Food can inhibit absorption.

A substance synthesized to 98% with blood plasma protein is subject to rapid distribution. Glipizid and its metabolic products are not defined inside the brain and CSF.

Glipizid maintains linear pharmacokinetic parameters using dosages of 5-60 mg. Excretion is carried out during hepatic transformation; less than 10% of the portion taken is excreted in an unchanged condition with feces and urine. Metabolic products are also excreted in the urine (80%), as well as feces (10%). Half-life is 2-4 hours.

The bioavailability index of the element metformin when used orally is equal to 50-60%; it is absorbed inside the gastrointestinal tract after 6 hours, after which it passes through tissues at high speed. Renal excretion of metformin has 2 stages. 95% of the absorbed element is excreted at the 1st stage with a half-life of 6 hours. The rest is at the 2nd stage with a half-life of 20 hours. Metformin is not synthesized inside plasma with protein. In an unchanged state excreted in the urine (40-60%) and feces (30%).

Dosing and administration

Adult portions are selected by patients individually; the initial one is usually 0.5-1 tablet per day. It should be increased gradually, with the need - up to 1-2 pieces 1-2 times per day. Maximum per day you can take 4 pills. Reception takes place before eating.

After 10-15 days of therapy, the dosage should be adjusted, taking into account the indications of measurements of serum sugar values.

A slow increase in dosage helps to reduce the likelihood of negative symptoms associated with digestion.

In the transition to therapy with Dibizida, you must first cancel the use of another hypoglycemic drug.

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Use Dizyde during pregnancy

Dibizid prohibited from use during pregnancy or breastfeeding.

Contraindications

Main contraindications:

• the presence of strong sensitivity to therapeutic elements or sulfonylurea derivatives;
• insulin-dependent type diabetes mellitus, DKA, coma, or diabetic coma;
• liver function disorder, adrenal cortex insufficiency and renal impairment disorders (QC values <60 ml / minute);
• thrombocyto-, leuco- or granulocytopenia;
• surgical procedures (including complex ones);
• allergy to sulfonamides;
• shock or dehydration;
• X-ray or radioisotope examinations, when a contrast component containing iodine is introduced into the vessels;
• conditions in which lactic acidosis may occur;
• the presence of lactic acidosis at the moment or in history;
• acute infections, as well as diseases in the chronic stage at which hypoxia may occur;
• insufficiency of respiratory or cardiac activity, myocardial infarction in the acute stage;
• acute cerebral blood flow disorder;
• chronic fever and alcoholism;
• conditions associated with hypoxia (infections affecting the kidneys, sepsis, and bronchopulmonary diseases);
• APN in acute;
• under the regime of a low-calorie diet (below 1000 calories per day);
• use in people from 60 years who are engaged in hard physical labor - due to the increased likelihood of lactic acidosis.

Side effects Dizyde

Negative symptoms due to glipizide:

• disorders associated with the senses and NA: dizziness, headaches and drowsiness;
• disorders of hemostasis and hematopoiesis, as well as the work of the cardiovascular system: agranulocytosis, palpitations, thrombocyto-, leuko- or pancytopenia, and besides this anemia of a hemolytic or aplastic nature;
• problems with metabolism: porphyria, diabetes insipidus type and hyponatremia;
• damage to the gastrointestinal tract function: diarrhea, obstipation, vomiting or hepatitis of a cholestatic nature (sclera and epidermis become yellowish, urine is darkening and discoloration of feces, pain occurs in the right hypochondrium);
• symptoms of the epidermis: urticaria, eczema, maculopapular rash, itching, common rash and photosensitivity;
• Other manifestations: increased levels of alkaline phosphatase, LDH, or indirect bilirubin.

Adverse symptoms triggered by the use of metformin hydrochloride:

• Gastrointestinal disorders: dyspeptic symptoms (nausea, diarrhea, loss of appetite and metallic taste), vomiting, taste disorders and bloating;
• endocrine dysfunction: hypoglycemia (mainly due to the use of inadequate therapeutic rations);
• problems associated with metabolism: hyponatremia or lactic acidosis is singly noted;
• lesions of the hematopoietic system: an anemia of a megaloblastic nature may develop;
• manifestations affecting the digestive activity: hepatitis and liver work disorder.

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Overdose

Poisoning medication can trigger hypoglycemia. If intoxication has occurred, gastric lavage should be done immediately, after which a 10% or 40% glucose solution should be used as an IV method, constantly monitoring plasma sugar values.

After using metformin in a dose of 85 mg, hypoglycemia did not occur, but this caused the appearance of lactic acidosis. In this case, it is necessary to cancel the therapy, and send the victim to an emergency hospitalization, after which, after ascertaining the lactate parameters, determine the exact diagnosis. The most effective method of excretion of lactate and drugs from the body is to perform hemodialysis. In addition, symptomatic events are held.

Interactions with other drugs

Glipizid.

Drugs that can displace the substance from the centers of synthesis with plasma protein, are able to potentiate its antidiabetic effect. Among such substances are salicylates, warfarin, and sulfonamides.

In addition, NSAIDs, β-blockers and MAOs have a potentiating effect on glipizide.

Strengthening the properties of glipizid occurs when drinking alcohol.

Metformin.

Combined use with cimetidine caused an increase in plasma metformin in 7 volunteers who participated in the research. The level of clearance of the substance inside the kidneys also decreased; there was competition for proximal disbursement through the tubules. To reduce the likelihood of lactic acidosis in people who combine metformin and cimetidine, you need to use the medicine in half portions.

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Storage conditions

Dibizid needs to be kept in a dry place, closed from small children. Temperature values - maximum 25 ° С.

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Shelf life

Dibizid can be used within a 36-month period from the date of manufacture of the pharmaceutical product.

Application for children

There is no information regarding the drug efficacy and safety of the use of drugs in pediatrics, which is why it is not used in children.

Analogs

Analogues of drugs are such means as Glibofor, Amaryl M, Duglimax, as well as Glucovance with Glibomet and Dianorm-M.