Glibomet

Glibomet is a combination drug containing two active components: glibenclamide and metformin hydrochloride. Glibenclamide belongs to the sulfonylurea class and helps lower blood sugar levels by stimulating the release of insulin from the pancreas. Metformin hydrochloride belongs to the biguanide class and reduces glucose production in the liver, increases tissue sensitivity to insulin and improves glucose absorption. Glibomet is used to treat type 2 diabetes mellitus, especially in patients who do not respond well to monotherapy with glibenclamide or metformin.

Indications Glibometa

Glibomet (glibenclamide, metformin hydrochloride) is used to treat type 2 diabetes mellitus in adults. Indications for its use include cases where diet, exercise and lifestyle changes are not effective enough to control blood sugar levels. This combination drug may also be recommended for patients who do not achieve target glycemic levels with glibenclamide or metformin monotherapy.

Release form

Glibomet is usually available in the form of tablets for oral administration.

Pharmacodynamics

1. Glibenclamide:

   • Glibenclamide belongs to a class of drugs called sulfonylureas. It is a stimulator of insulin secretion.
   • The mechanism of action of glibenclamide is that it increases the release of insulin from pancreatic beta cells by closing potassium channels in the beta cells, which leads to depolarization of the membrane and the subsequent entry of calcium into the cell, causing the release of insulin.
   • Glibenclamide also increases tissue sensitivity to insulin.

2. Metformin hydrochloride:

   • Metformin is a drug from the biguanide class. Its mechanism of action is associated with a decrease in hepatic glucose production and improvement in peripheral insulin sensitivity.
   • It reduces the absorption of glucose from food in the intestines and increases the use of glucose by muscles.

3. Combined effect:

   • Combining glibenclamide with metformin allows you to achieve more complete and balanced control of blood glucose levels in patients with type 2 diabetes.
   • The combination of these two drugs reduces blood glucose by stimulating insulin secretion and improving tissue sensitivity to insulin, as well as reducing the absorption of glucose from food and reducing glucose production in the liver.

Pharmacokinetics

1. Glibenclamide:

   • Absorption: Glibenclamide is usually rapidly and completely absorbed from the gastrointestinal tract after oral administration.
   • Metabolism: Glibenclamide is metabolized in the liver to form active metabolites. They also have a hypoglycemic effect.
   • Excretion: Glibenclamide and its metabolites are excreted primarily in the urine.
   • Duration of action: The duration of action of glibenclamide is about 12-24 hours, so it is usually taken once or twice a day.

2. Metformin hydrochloride:

   • Absorption: Metformin hydrochloride is usually absorbed slowly and incompletely from the gastrointestinal tract.
   • Metabolism: Metformin is practically not metabolized in the body. It remains unchanged and is excreted in the urine.
   • Excretion: About 90% of metformin is excreted unchanged by the kidneys.
   • Duration of action: The duration of action of metformin is usually about 12 hours and is often taken two or three times a day.

Dosing and administration

1. Method of application:

   • Glibomet tablets are usually taken orally, i.e. Through the mouth.
   • They are swallowed whole with a small amount of water.
   • The tablets should be taken during or immediately after meals.

2. Dosage:

   • The dosage of Glibomet is determined by the doctor and may vary depending on the individual needs of the patient and the characteristics of the disease.
   • The usual starting dose for adults is one tablet containing a combination of glibenclamide and metformin, taken once or twice daily.
   • The dosage may be changed according to the doctor's recommendations depending on the patient's blood glucose level.

3. Duration of treatment:

   • The duration of taking Glibomet is usually determined by the doctor depending on the nature and severity of diabetes.
   • The drug is usually taken for a long time to control blood glucose levels.

Use Glibometa during pregnancy

The use of a combination of glibenclamide and metformin (Glibomet) during pregnancy is associated with a number of potential risks and requires careful medical supervision. Here are some key points based on research:

1. Metformin: Considered relatively safe for use during pregnancy and can be used as an alternative to insulin for the treatment of gestational diabetes mellitus (GDM). Metformin does not cause birth defects and may reduce the risk of miscarriage, preeclampsia and subsequent development of gestational diabetes. However, approximately 46% of women taking metformin may require additional insulin to achieve glucose control (Holt & Lambert, 2014).
2. Glibenclamide: Effectively lowers blood glucose levels in women with gestational diabetes, possibly with less treatment failure than metformin. However, its use may be associated with an increased risk of preeclampsia, neonatal jaundice, prolonged neonatal intensive care unit stay, macrosomia, and neonatal hypoglycemia (Holt & Lambert, 2014).

It should be noted that the long-term effects of oral hypoglycemic agents in utero are not fully understood, and more research is needed to evaluate their safety and effectiveness. The use of Glibomet during pregnancy should only be done after careful discussion with your doctor, who can evaluate all potential risks and benefits.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to glibenclamide, metformin or any of the ingredients of the drug should not take Glibomet.
2. Type 1 diabetes mellitus: Glibomet is not recommended for the treatment of type 1 diabetes mellitus, which is characterized by absolute insulin deficiency.
3. Antidiabetic agents: The use of glibenclamide may be contraindicated in patients taking certain antihyperglycemic agents or insulin, especially if they may cause hypoglycemia.
4. Liver failure: In patients with severe liver failure, Glibomet should be used with caution and under medical supervision, as changes in drug metabolism may require dosage adjustment.
5. Pregnancy and breastfeeding: Data on the safety of glibenclamide and metformin during pregnancy and breastfeeding are limited, so their use during this period should only be done on the advice of a physician.
6. Children: The effectiveness and safety of Glibomet in children have not been established, so its use in children may require consultation with a doctor.
7. Older age: Elderly patients may require more careful prescribing and regular monitoring when using Glibomet.

Side effects Glibometa

1. Hypoglycemia (low blood sugar), especially when taken incorrectly or taken together with other antidiabetic drugs.
2. Gastrointestinal disorders such as nausea, vomiting, diarrhea, constipation.
3. Uretic dysfunction (problems with urination).
4. Metallic taste in the mouth.
5. Increased levels of lactic acid in the blood (lactic acidosis), especially in patients with impaired renal function.
6. Increased levels of urea and creatinine in the blood.
7. Allergic reactions such as skin rash, itching, hives.
8. Increased sensitivity to sunlight (photosensitivity).

Overdose

1. Hypoglycemia: This is the most serious and common side effect of overdose of sulfonylureas, including glibenclamide. Symptoms may include fasting, trembling, loss of consciousness, irregular heartbeat, nervousness and even seizures.
2. Acid-dependent metabolic acidosis: This is a potentially dangerous complication of metformin overdose. Symptoms include deep and rapid respiratory failure, drowsiness, weakness, abdominal pain and vomiting.
3. Other side effects: May include headache, dizziness, nausea, vomiting, diarrhea, and various problems with the heart and central nervous system.

Interactions with other drugs

1. Drugs that increase hypoglycemic effect:

   • Drugs that lower blood glucose levels (for example, insulin, other sulfonylureas) may enhance the hypoglycemic effect of glibenclamide. This can lead to the development of hypoglycemia (low blood sugar).
   • Medicines that also lower blood glucose levels, such as other antidiabetic drugs or drugs containing alpha-glucosidase, may also enhance the hypoglycemic effect of glibenclamide.

2. Medicines that increase the risk of lactic acidosis:

   • Medicines that may increase the risk of lactic acidosis, such as certain antibiotics (e.g. Macrolides), certain X-ray contrast agents, or alcohol, may increase the side effects of metformin such as metabolic acidosis.

3. Medicines that affect kidney function:

   • Since metformin is eliminated primarily via the kidneys, drugs that also affect kidney function (e.g. Certain nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics) may increase the risk of metformin accumulation in the body and increase its side effects.

4. Drugs that affect liver function:

   • Since glibenclamide is metabolized in the liver, drugs that affect liver function (e.g., liver enzyme inhibitors or inducers) may alter its pharmacokinetics.

5. Drugs that affect the gastrointestinal tract:

   • Some drugs, such as antiacids, may slow or reduce the absorption of metformin from the gastrointestinal tract.