Oltar

Oltar is an effective antidiabetic drug that is prescribed for diabetes.

Indications Oltara

It is used for type 2 diabetes, in situations where physical activity, weight loss and strict adherence to the prescribed diet do not produce the desired result.

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Release form

The product is produced in tablets, 30 pieces per blister pack. The box contains 1 blister with tablets.

There are dosage forms with tablet volumes of 1, 2 and 3 mg.

Pharmacodynamics

The substance glimepiride effectively reduces sugar levels. The drug is used for therapy in insulin-dependent diabetes mellitus. The active component acts mainly by stimulating insulin release from pancreatic β-cells. This action occurs due to the increased response of β-cells to physiological stimulation by sugar.

Glimepiride helps release insulin by acting on potassium channels dependent on ATP elements (located inside the β-cell membrane). In addition, the substance has an extrapancreatic effect, increasing the sensitivity of peripheral tissues to insulin, as well as reducing the liver absorption of insulin.

Pharmacokinetics

After oral administration, glimepiride demonstrates complete bioavailability. Food intake has little effect on drug absorption – its degree in this case decreases insignificantly. Peak serum values are noted after 2.5 hours after oral administration of the tablet. Peak values in blood serum are linearly correlated with the dosage sizes of the drug.

Glimepiride has a low distribution volume (approximately 8.8 l), which is similar to that of albumins. The substance also has a high level of protein synthesis (more than 99%) and low clearance rates (48 ml/minute).

The half-life from blood serum is on average about 5-8 hours. After a single dose of the drug, radioactive marks recorded the following radioactivity indicators - 58% in urine and 35% in feces. At the same time, no unchanged active component was noted in the urine.

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Dosing and administration

The size of the daily initial portion is 1 mg. If there is no result after taking this dosage, it is necessary to gradually, observing an interval of 1-2 weeks, increase the daily dose to 2-4 mg. The dose should not be increased even more - this does not enhance the medicinal effect of the drug (although there are isolated cases of increasing the maximum daily dose to 6 mg). The entire daily dosage must be taken in 1 dose - together with the main (first) meal. Then the tablets should be washed down with water.

If hypoglycemia develops after taking 1 mg of the drug, its use should be discontinued, leaving only the appropriate diet as treatment.

During therapy, it may be necessary to reduce the dose of glimepiride due to improved metabolic processes, as well as increased tissue sensitivity to insulin.

Oltar can be prescribed for monotherapy, and in addition, it can be used in combination with metformin or insulin.

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Use Oltara during pregnancy

There is limited information on the use of the drug in pregnant women. Therefore, when planning a pregnancy, it is necessary to transfer the patient to insulin drugs as quickly as possible.

Contraindications

Among the contraindications:

• presence of ketoacidosis;
• ketoacidotic coma;
• diabetes mellitus type 1;
• severe liver or kidney disease;
• hypersensitivity to glimepiride and other sulfonylurea agents;
• intolerance to the auxiliary elements of Oltar.

Side effects Oltara

Taking the drug may lead to the development of certain side effects:

• reactions from the systemic bloodstream: thrombocytopenia, leukopenia, pancytopenia or granulocytopenia are occasionally observed, as well as agranulocytosis and hemolytic anemia. All these conditions can often be cured;
• immune disorders: isolated cases of hypersensitivity symptoms manifested in the form of suffocation, anaphylaxis and a strong decrease in blood pressure. Very rarely, patients develop an allergic form of vasculitis, as well as cross-intolerance to sulfonamides and sulfonylurea derivatives or related drugs;
• metabolic disorders: hypoglycemia occasionally occurs;
• damage to the visual organs: at the initial stage of therapy, the development of treatable visual disorders is possible (due to fluctuations in glucose levels);
• Gastrointestinal symptoms: nausea, a feeling of fullness in the stomach, vomiting, diarrhea and abdominal pain. If these symptoms develop, the drug should be discontinued;
• damage to the organs of the hepatobiliary system: increased activity of liver enzymes. Hepatitis, jaundice, liver failure and cholestasis are observed sporadically;
• skin reactions: appearance of urticaria, itching or exanthema. Photosensitivity develops occasionally;
• electrolyte imbalance: hyponatremia is observed occasionally.

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Overdose

The main symptom of glimepiride intoxication is hypoglycemia, which manifests itself in the form of vomiting with nausea, a feeling of anxiety, weakness or severe hunger, as well as headaches, hyperhidrosis and tachycardia. In addition, there is a sleep disorder with mydriasis, hypertonia with tremor, as well as a psychosyndrome of an endocrine nature (behavioral disorders appear - such as a feeling of irritability, aggressiveness and confusion, as well as a state of depression and deterioration in concentration). Motor uncertainty and a feeling of drowsiness appear, convulsions occur, and a state of coma or a disorder of the nervous effect on the vascular and respiratory system develops. Focal signs (diplopia with hemiplegia and aphasia) and primitive automatism (symptoms such as grimacing and smacking, and at the same time grasping movements) also occur.

To eliminate the disorders, it is necessary to first remove the medicine from the body: wash the stomach, induce vomiting, take sodium sulfate with activated carbon. In case of hypoglycemia (if loss of consciousness is not observed), 20 g of sugar/glucose or fruit juice should be taken.

If a severe stage of hypoglycemia occurs, during which loss of consciousness occurs, a catheter should be urgently inserted into a vein and a 20% glucose solution (approximately 40-100 ml) should be administered to the victim. It is also possible to use the method of intramuscular or subcutaneous administration - for this, glucagon (1-2 ml) is used. After consciousness is fully restored, it is necessary to consume carbohydrates orally (in the amount of 20-30 g) at intervals of 2-3 hours for the next 24-48 hours (this is necessary to prevent relapse). After recovery from the hypoglycemic state, the patient's glucose levels should be monitored for another 48 hours.

If the patient remains unconscious, it is necessary to continue administering glucose (5-10% solution). If there are no changes in the clinical picture, it is necessary to look for another cause of loss of consciousness that is not related to hypoglycemia. At the same time, it is necessary to perform therapy for cerebral edema (taking dexamethasone with sorbitol) and monitor the patient's condition.

Interactions with other drugs

When the drug is combined with certain other drugs, its hypoglycemic effect may be reduced or undesirably increased. Glimepiride affects the body via hemoprotein P450 2C9. It has been found that the metabolism processes of this substance are affected by activators (such as rifampicin) or inhibitors (such as fluconazole) of hemoprotein P450 2C9 used in combination.

The hypoglycemic effect of Oltar is enhanced when combined with sulfinpyrazone, as well as with oxyphenbutazone, azapropazone and phenylbutazone. The same effect occurs when combining drugs with oral hypoglycemic drugs, tetracyclines, MAOIs, sulfonamides (with prolonged action), insulin, PAS and salicylates. In addition, with sex hormones (male) and anabolic agents, antibacterial drugs from the category of quinolone derivatives, as well as probenecid, chloramphenicol, fenfluramine, anticoagulants from the coumarin series and miconazole with pentoxifylline (high doses). This list includes ACE inhibitors, fibrates, fluoxetine with tritoqualine, sympatholytics, allopurinol, trofosfamide and cyclophosphamide, as well as fluconazole and ifosfamide.

Weakening of the hypoglycemic effect of the drug occurs in the case of combination with progestogens and estrogens, as well as thiazide diuretics, saluretics, thyroid function stimulating drugs, epinephrine and GCS, as well as sympathomimetics and phenothiazine derivatives with chlorpromazine. Also when combined with niacin and its derivatives, phenytoin, laxatives (with their long-term use), glucagon and diazoxide, as well as with rifampicin, barbiturates and acetazolamide.

Drugs that block β-adrenoreceptors and H2-endings, as well as clonidine with reserpine, are capable of both potentiating and weakening the hypoglycemic effect of the drug. Under the influence of sympatholytics (including clonidine with reserpine, drugs that block β-adrenoreceptors, and guanethidine), the influence of the compensatory adrenergic effect, which helps to reduce glucose levels, may decrease or disappear altogether.

Glimepiride worsens or potentiates the effects of coumarin derivatives.

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Storage conditions

Oltar should be kept out of reach of small children, in normal conditions for medicines. Temperature indicators – no more than 30°C.

Shelf life

Oltar can be used for 2 years from the date of manufacture of the medicinal product.