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Gliformin is a hypoglycemic agent for oral administration of the biguanide group. Gliformin inhibits gluconeogenesis in the liver, reduces the absorption of glucose from the intestines, increases peripheral glucose utilization, and also increases the insulin sensitivity of tissues. It does not have an effect on insulin secretion by pancreatic beta cells. It lowers triglycerides and low density lipoproteins in the blood. Stabilizes or reduces body weight. It has a fibrinolytic effect due to the suppression of a tissue-type plasminogen activator inhibitor.
Type 2 diabetes mellitus (especially in obese patients) with the ineffectiveness of diet therapy.
Use during pregnancy and lactation
Contraindicated use during pregnancy and lactation (breastfeeding). When planning pregnancy, as well as in the event of pregnancy on the background of taking Gliformin, the drug should be canceled and insulin therapy prescribed. It is not known whether metformin is excreted in breast milk, therefore Gliformin® is contraindicated in breastfeeding. If you need to use the drug Gliformin® during lactation, breastfeeding should be stopped.
- diabetic ketoacidosis, diabetic precoma, coma,
- severe renal impairment,
- heart and respiratory failure, acute phase of myocardial infarction, acute cerebrovascular accident, dehydration, chronic alcoholism and other conditions that may contribute to the development of lactic acidosis,
- pregnancy and breastfeeding,
- hypersensitivity to the drug,
- serious surgery and injuries when insulin therapy is indicated,
- abnormal liver function, acute alcohol poisoning,
- lactic acidosis (including history),
- use for at least 2 days before and within 2 days after conducting radioisotope or x-ray studies with the introduction of iodine-containing contrast material,
- adherence to a low-calorie diet (less than 1000 calories / day).
It is not recommended to use the drug in persons older than 60 years who perform heavy physical work, which is associated with an increased risk of developing lactic acidosis in them.
On the part of the digestive system: nausea, vomiting, "metallic" taste in the mouth, lack of appetite, diarrhea, flatulence, abdominal pain.
On the part of the metabolism: in rare cases - lactic acidosis (requires discontinuation of treatment), with long-term treatment - hypovitaminosis B12 (impaired absorption).
From the side of blood-forming organs: in some cases - megaloblastic anemia.
On the part of the endocrine system: hypoglycemia (when used in inadequate doses).
Allergic reactions: skin rash.
With simultaneous use with sulfonylurea derivatives, acarbose, insulin, nonsteroidal anti-inflammatory drugs, monoamine oxidase inhibitors, oxytetracycline, angiotensin-converting enzyme inhibitors, clofibrate derivatives, cyclophosphamide, beta-adrenergic blockers, asymptomatric, asymptotrophritic With simultaneous use with glucocorticosteroids, oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and "loop" diuretics, phenothiazine derivatives, derivatives of nicotinic acid, the hypoglycemic action of Glyformin® may be reduced.
Cimetidine slows down the excretion of Gliformin®, resulting in an increased risk of developing lactic acidosis.
Gliformin® can weaken the effect of anticoagulants (coumarin derivatives). With the simultaneous use of alcohol may develop lactic acidosis.
How to take, the course of administration and dosage
The dose of the drug is set by the doctor individually, depending on the level of glucose in the blood.
The initial dose is 0.5-1 g / day. After 10-15 days, a further gradual increase in dose is possible depending on the level of glycemia. Maintenance dose of the drug is usually 1.5-2 g / day. The maximum dose - 3 g / day. To reduce the side effects of the gastrointestinal tract, the daily dose should be divided into 2-3 doses. In elderly patients, the recommended daily dose should not exceed 1 g. Gliformin® tablets should be taken whole or directly after meals with a small amount of liquid (a glass of water). Due to the increased risk of lactic acidosis, the dose of Gliformin® must be reduced in case of severe metabolic disorders.
With an overdose of Gliformin® lactic acidosis may develop. The cause of the development of lactic acidosis may also be the accumulation of the drug due to renal dysfunction. Early symptoms of lactic acidosis are nausea, vomiting, diarrhea, fever, abdominal pain, muscle pain, and there may be an increase in breathing, dizziness, impaired consciousness, and coma.
Treatment: In case of signs of lactic acidosis, treatment with Gliformin® should be stopped immediately, the patient should be hospitalized immediately and, after determining the concentration of lactate, the diagnosis should be confirmed. The most effective measure for the removal of lactate and Glyformin® from the body is hemodialysis. Symptomatic treatment is also performed. Hypoglycemia may develop with the combination therapy of Gliformin® with sulfonylurea drugs.
During the period of treatment, it is necessary to monitor renal function. At least 2 times a year, as well as the appearance of myalgia should determine the content of lactate in the plasma.
Gliformin® may be used in combination with sulfonylurea derivatives. In this case, especially careful control of blood glucose level is necessary.