Glurenorm

Glurenorm (active ingredient: glyquidone) is an oral hypoglycemic drug that belongs to the sulfonylurea class. It is used to treat type 2 diabetes mellitus when diet, exercise, and weight loss do not provide adequate control of blood glucose levels.

Glyquidone stimulates the pancreas to produce insulin, thereby lowering blood glucose levels. Unlike some other drugs in this class, Glyquidone has a shorter half-life and a rapid onset of action, allowing for more effective control of post-meal glucose levels.

Glurenorm is usually prescribed as part of a comprehensive treatment for type 2 diabetes that includes lifestyle changes such as diet and exercise. The drug can be used alone or in combination with other hypoglycemic agents if gliquidone alone is not enough to achieve target blood glucose levels.

Indications Glurenorma

Glurenorm is used to treat type 2 diabetes, especially in cases where diet and physical activity are not effective enough to achieve normal blood glucose levels.

Release form

Glurenorm is available as oral tablets.

Pharmacodynamics

1. Insulin stimulation: Glurenorm acts by stimulating the release of insulin from pancreatic β-cells. This occurs by binding to receptors on the surface of β-cells and increasing their permeability to potassium, which leads to cell depolarization and insulin release.
2. Increased insulin sensitivity: Glurenorm also improves tissue sensitivity to insulin, allowing them to utilize glucose from the blood more effectively. This is especially important for muscles and adipose tissue.
3. Increased Peripheral Glucose Uptake: In addition to stimulating insulin release, glyquidone also promotes increased peripheral glucose uptake by tissues, which further reduces blood glucose levels.
4. Decreased gluconeogenesis: Glurenorm may also decrease the production of glucose in the liver (gluconeogenesis), leading to decreased blood glucose levels.
5. Correction of postprandial hyperglycemia: Gliquidone helps to reduce glucose levels after meals (postprandial hyperglycemia) by increasing the insulin response to carbohydrates.

Pharmacokinetics

1. Absorption: Gliquidone is usually rapidly and completely absorbed from the gastrointestinal tract after oral administration.
2. Distribution: After absorption, glyquidone is rapidly distributed in the body. It binds to plasma proteins to a significant extent.
3. Metabolism: Glyquidone is metabolized in the liver, where it undergoes conversion, primarily by oxidation and glucuronidation.
4. Excretion: Gliquidone metabolites and unmetabolized drug are excreted primarily via the kidneys. The half-life of gliquidone in the blood is approximately 5-7 hours.
5. Factors Affecting Pharmacokinetics: In elderly patients or in patients with impaired renal function, the half-life of gliquidone may be increased. It is also important to consider potential interactions with other drugs that may affect the metabolism and elimination of gliquidone from the body.

Dosing and administration

Directions for use:

1. Taking with food: Glurenorm is usually taken orally, 30 minutes before a meal. This is important for the drug to be as effective as possible, as it should stimulate insulin production when food enters the stomach.
2. Regularity of administration: The drug should be taken regularly, according to the schedule established by the doctor, to ensure stable control of blood glucose levels.

Dosage:

The dosage of Glurenorm may vary depending on the individual patient's needs, response to treatment and target blood glucose levels.

1. Initial dose: Usually starts with 30 mg of gliquidone once daily.
2. Dose titration: The dose may be gradually increased based on the patient's blood glucose response. Dose increases are usually made at intervals of several weeks.
3. Maintenance dose: The usual maintenance dose is 30-120 mg per day. The dosage should not exceed 120 mg per day.
4. Maximum Dose: The maximum dose allowed is 120 mg per day.

Use Glurenorma during pregnancy

1. General information:

   • Like other sulfonylurea drugs, glyquidone is not recommended for use during pregnancy. These drugs can cause hypoglycemia, which poses risks to both mother and fetus.
   • Animal studies have shown some risks to the fetus, but complete clinical data on the safety of gliquidone use during human pregnancy are lacking.

2. Risks to the fetus:

   • Sulfonylureas, including glyquidone, can cross the placenta, potentially leading to neonatal hypoglycemia in the newborn, requiring close medical supervision after birth.

3. Treatment alternatives:

   • During pregnancy, insulin is generally recommended for diabetes management because it does not cross the placenta and poses no risk of hypoglycemia to the fetus. Insulin is considered the gold standard for treating diabetes during pregnancy.

Contraindications

1. Diabetes mellitus type 1: Glurenorm is contraindicated for the treatment of diabetes mellitus type 1, which is characterized by an absolute or almost complete absence of insulin in the body.
2. Ketoacidosis: Glurenorm is also contraindicated in the presence of ketoacidosis, a serious complication of diabetes mellitus characterized by high levels of ketone bodies in the blood.
3. Hepatic impairment: In patients with severe hepatic impairment, Glurenorm may be contraindicated due to possible impairment of gliquidone metabolism and elimination.
4. Renal impairment: Glurenorm is excreted via the kidneys, so its use may be contraindicated in patients with severe renal impairment.
5. Pregnancy and breastfeeding: There is limited data on the safety of gliquidone during pregnancy and breastfeeding, so its use in such cases requires special attention and consultation with a doctor.
6. Allergy: Patients with a known allergy to glyquidone or other components of the drug should avoid its use.

Side effects Glurenorma

Side effects of Glurenorm (Gliquidone) may include hypoglycemia (low blood sugar), nausea, vomiting, diarrhea, hypoglycemic coma, allergic reactions (including hives, itching, and skin rash), and increased liver enzymes.

Overdose

1. Hypoglycemia: Overdosing on Gliquidone can cause a significant drop in blood glucose levels, which can cause various symptoms of hypoglycemia, including hunger, trembling, sweating, weakness, low blood pressure, confusion, seizures, and even loss of consciousness. If hypoglycemia occurs, immediate steps must be taken to restore blood glucose levels.
2. Treatment of hypoglycemia: Treatment of hypoglycemia following gliquidone overdose involves taking a quick carbohydrate source such as fruit juice, glucose, or a sugary drink, followed by a slow carbohydrate source to prevent recurrence of hypoglycemia. In severe cases, intravenous glucose may be required and glucose levels monitored for some time after the condition has stabilized.
3. Medical care: If you suspect an overdose of Gliquidone, seek immediate medical attention. The doctor can perform the necessary medical procedures, such as intensive therapy with glucose or insulin, to return the blood glucose level to normal.

Interactions with other drugs

1. Salicylates: Increased hypoglycemic effect of gluquidone.
2. Sulfonylurea (SUL) and their derivatives: The hypoglycemic effect of gluquidone may be enhanced.
3. Antimicrobials: Some antibiotics (eg, sulfonamides, tetracyclines) and antifungals may enhance the hypoglycemic effect of gluquidone.
4. Beta-blockers: Masking of symptoms of hypoglycemia such as tachycardia and sweating.
5. Alcohol-containing drugs: Interaction with alcohol may enhance the hypoglycemic effect of gluquidone.
6. Drugs affecting renal function: Increased half-life of gluquidone, which may require dose adjustment.
7. Drugs affecting liver function: Impaired metabolism of gluquidone and increased concentration of it in the blood.
8. Other hypoglycemic agents: Increased risk of hypoglycemia when used together.