Glyurenorm

Glurenorm (active substance - gliquidone) is an oral hypoglycemic drug that belongs to the sulfonylurea class. It is used to treat type 2 diabetes when diet, exercise, and weight loss do not adequately control blood glucose levels.

Gliquidone stimulates the pancreas to produce insulin, thereby reducing blood glucose levels. Unlike some other drugs in its class, gliquidone has a shorter half-life and a rapid onset of action, allowing for more effective control of glucose levels after meals.

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

Indications Glyurenorm

Glurenorm is used to treat type 2 diabetes mellitus, 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 potassium permeability, which leads to cell depolarization and insulin release.
2. Increasing insulin sensitivity: Glurenorm also improves tissue sensitivity to insulin, which allows them to more efficiently utilize glucose from the blood. This is especially important for muscles and fat tissue.
3. Increases peripheral glucose uptake: In addition to stimulating insulin release, gliquidone also increases peripheral glucose uptake into tissues, which further reduces blood glucose levels.
4. Reduced gluconeogenesis: Glurenorm may also reduce the production of glucose in the liver (gluconeogenesis), leading to lower blood glucose levels.
5. Correction of postprandial hyperglycemia: Gliquidone helps reduce postprandial glucose levels (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, gliquidone is quickly distributed in the body. It binds to blood plasma proteins to a significant extent.
3. Metabolism: Gliquidone is metabolized in the liver, where it undergoes conversion, mainly through oxidation and glucuronidation.
4. Excretion: Gliquidone metabolites and the unmetabolized drug are excreted primarily through the kidneys. The half-life of gliquidone from the blood is about 5-7 hours.
5. Factors influencing pharmacokinetics: In elderly patients or in patients with impaired renal function, an increase in the half-life of gliquidone may be observed. 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

Method of application:

1. Taking with food: Glurenorm is usually taken orally, 30 minutes before meals. This is important for maximum effectiveness of the drug, since it must stimulate the production of insulin as food enters the stomach.
2. Regularity of use: 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 needs of the patient, his response to treatment and target blood glucose levels.

1. Initial dose: Typically start 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 usually occur 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 allowable dose is 120 mg per day.

Use Glyurenorm during pregnancy

1. General information:

   • Like other sulfonylurea drugs, gliquidone is not recommended for use during pregnancy. These drugs can cause hypoglycemia, which poses a risk 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 pregnancy in humans are not available.

2. Risks to the fetus:

   • Sulfonylureas, including gliquidone, can cross the placenta, potentially leading to neonatal hypoglycemia in the newborn, which requires close medical monitoring after birth.

3. Treatment alternatives:

   • During pregnancy, insulin is usually recommended to manage diabetes because it does not cross the placenta and does not pose a risk of hypoglycemia in 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 characterized by high levels of ketone bodies in the blood.
3. Liver impairment: In patients with severe hepatic impairment, Glurenorm may be contraindicated due to possible impairment of the metabolism and elimination of gliquidone.
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: Data on the safety of gliquidone during pregnancy and breastfeeding are limited, so its use in such cases requires special attention and consultation with a doctor.
6. Allergy: Patients with a known allergy to gliquidone or other components of the drug should avoid its use.

Side effects Glyurenorm

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. p>

Overdose

1. Hypoglycemia: An overdose of gliquidone can cause a significant decrease in blood glucose levels, which can cause various symptoms of hypoglycemia, including hunger, shaking, sweating, weakness, low blood pressure, confusion, seizures, and even loss of consciousness. If hypoglycemia develops, immediate measures must be taken to restore blood glucose levels.
2. Treatment of Hypoglycemia: Treatment of hypoglycemia from gliquidone overdose involves taking fast sources of carbohydrates, such as fruit juice, glucose, or a sweet drink, followed by long-term carbohydrates 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 attention: If you suspect an overdose of gliquidone, seek immediate medical attention. Your doctor may do necessary medical treatments, such as intensive glucose or insulin therapy, to return your blood glucose levels to normal.

Interactions with other drugs

1. Salicylates: Increased hypoglycemic effect of gluquidone.
2. Sulfonylurea (SU) and their derivatives: May increase the hypoglycemic effect of gluquidone.
3. Antimicrobials: Certain antibiotics (e.g. Sulfonamides, tetracyclines) and antifungals may increase 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 that affect kidney function: Increased half-life of gluquidone, which may require dose adjustment.
7. Drugs that affect liver function: Impaired metabolism of gluquidone and increased blood levels.
8. Other hypoglycemic drugs: Increased risk of hypoglycemia when used together.