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Yanumet
Medicinal medication Yanumet is a complex hypoglycemic agent based on metformin and sitagliptin.
The encoding of the drug according to ATC: A10BD07.
Indications of the yanumet
Sugar-reducing medication Yanumet is used for type II diabetes mellitus. Of particular relevance is the appointment of Janumet with concomitant obesity, and also in the absence of the effect of diet therapy.
In most cases, Yanumet is taken together with sulfonylureas based medications.
The drug can be prescribed for self or for combined treatment.
Pharmacodynamics
The sugar-reducing drug Yanumet fully demonstrates its effectiveness in internal use. The active ingredients have differences in chemical structure and pharmacological properties from similar insulin preparations, sulfonylureas, amylin, γ-receptor agonists and many others. Etc. By suppressing dipeptidyl peptidase-4, the active component increases the level of incretin hormones that are produced inside the intestine. Usually the amount of such hormones increases due to food intake. Incretinovye substances are considered an element of the internal physiological process of glucose homeostasis.
When the blood sugar level is exceeded or is within normal limits, incretin hormones stimulate active production of insulin. In addition, its release by β-cells in the pancreas is activated, which is explained by the action of control intracellular processes.
Also, the drug Yanumet helps to suppress the excessive release of glucagon. Lowering the glucagon level while increasing the amount of insulin leads to a decrease in the production of glucose in the liver. As a result of such processes, glycemia decreases.
At a low glucose level, the above properties do not appear.
The active components of Yanumet prevent the processes of hydrolysis of incretin hormones with the enzyme dipeptidyl peptidase-4. As a consequence, plasma concentrations of GLP-1 and HIP increase, glucose-dependent insulin production increases and glucagon release is reduced. Metformin reduces the production of glucose and the degree of its absorption in the intestinal cavity, and enhances the susceptibility to insulin by glucose disposal.
Pharmacokinetics
The use of a single dose of the drug Yanumet is able to suppress the activity of the dipeptidyl peptidase-4 enzyme during the day after administration. This increases the level of circulating hormones in the blood 2 or 3 times.
Absorption of active ingredients can be at least 85%.
Up to 80% of the substance leaves the body in an unchanged form with the urinary fluid. Only up to 15% can be excreted with feces.
Contraindications
Before starting treatment with Yanumet, it is necessary to familiarize yourself with the list of possible contraindications:
- increased susceptibility of the body to allergies to the ingredients of the drug;
- severe kidney or liver disease;
- hypoxic conditions (insufficient function of the respiratory system and cardiac activity, heart attack, stroke, acute anemia);
- dehydration;
- severe infections;
- severe surgical interventions, craniocerebral trauma;
- chronic alcohol abuse;
- any form of metabolic acidosis;
- Strictly restricted calories (up to 1000 kcal per day);
- conducting diagnostic procedures using radioactive iodine;
- period of gestation and feeding of the child.
Side effects of the yanumet
The probability of adverse events during treatment Yanumet is considered minimal, however in some cases it is possible:
- emaciation;
- dyspeptic disorders;
- pain in the abdomen (eliminated by eating the drug with food);
- the taste of metal in the oral cavity;
- hypoglycemia;
- signs of lactate acidosis (fatigue, lowering blood pressure and temperature, heart rhythm disturbances, muscle pain);
- rashes on the type of dermatitis.
Dosing and administration
The treatment schedule of Yanumet is always determined by the doctor individually, taking into account the concomitant prescriptions, the body's response to drugs, the dynamics of the improvement of the condition.
The maximum daily dose should not exceed 100 mg of sitagliptin.
Yanumet is usually taken during breakfast and dinner, with a slow increase in dosage (to reduce the risk of adverse events).
Overdose
When taking a large amount of the drug Yanumet, lactoacidosis can occur:
- muscle pain;
- apathy, fatigue;
- frequent breathing;
- heart failure, complicated by high acidity;
- abdominal pain;
- vomiting;
- convulsions;
- disorientation;
- a coma, a loss of consciousness.
In such situations, supportive symptomatic treatment and dialysis may be prescribed.
Interactions with other drugs
The effectiveness of Yanumet can be weakened by the action of diuretics, corticosteroids, glucagon, thyroid hormones, estrogens, nicotinic acid, phenothiazines, sympathomimetics, isoniazid, calcium antagonists.
The hypoglycemic effect is increased by insulin, drugs with sulfonylurea, ACE inhibitors and MAO, cyclophosphamide, non-steroidal anti-inflammatory drugs.
In combination with other drugs, no clinically important interaction was found.