Avandamet is a combination drug of hypoglycemic action.
International non-proprietary name
Metformin in combination with rosiglitazone.
Avandamet is a combination drug of hypoglycemic action.
ATC means - A10BD03.
Forms of release and composition
The drug is available in tablet form. The tablets contain 2 active ingredients - metformin and rosiglitazone. The first in the form of hydrochloride, the second - maleate.
The amount of metformin in 1 tablet is 500 mg. The content of rosiglitazone is 1 mg.
The drug is available in cardboard packs, each of which contains 1, 2, 4 or 8 blisters. Each of them includes 14 film-coated tablets.
On sale is Avandamet containing rosiglitazone 2 mg.
The drug belongs to the oral sugar-reducing agents of the combined type. It combines 2 active ingredients whose action allows for optimal control of sugar levels in patients with non-insulin-dependent diabetes.
Rosiglitazone belongs to the thiazolidinedione group, metformin is a substance from the biguanide group. They complement each other, acting simultaneously on the cells of peripheral tissues and gluconeogenesis in the liver.
When rosiglitazone is used, the growth of pancreatic cells is noted.
Rosiglitazone increases the level of susceptibility of peripheral tissues to the action of insulin. Thanks to this, it becomes possible to utilize the excess sugar in the bloodstream.
The substance acts on one of the main pathogenesis of insulin-dependent diabetes mellitus. Insulin resistance of tissues does not allow the hormone to adequately regulate sugar levels. Under the influence of rosiglitazone, the content of insulin in the blood, sugars and fatty acids decreases.
When it is used, there is a proliferation of pancreatic cells responsible for the synthesis of insulin. It also prevents the occurrence of target organ complications. The substance does not affect the rate of insulin release from cells and does not lead to an abnormal decrease in glucose level.
Studies have noted a decrease in the level of insulin and its predecessors in the bloodstream. There is evidence that these compounds in large quantities adversely affect the cardiovascular system.
Metformin reduces the activity of glucose synthesis by the liver cells. Under his influence, both the basal glucose concentration and its level after eating are normalized. The substance does not activate insulin production by cells of the islets of Langerhans.
In addition to inhibiting gluconeogenesis in the liver, the active ingredient increases the susceptibility of peripheral tissues to insulin, accelerates the utilization of free sugar, and slows glucose absorption through the mucous membrane of the gastrointestinal tract.
Metformin reduces the activity of glucose synthesis by the liver cells.
Metformin promotes the acceleration of glycogen production in cells. It activates the transport channels-carriers of glucose, located on the cell membranes. It regulates the metabolism of fatty acids, reducing the amount of cholesterol and other harmful lipids.
The combination of rosiglitazone and metformin helps to achieve optimal treatment efficacy. Substances affect all parts of the pathogenesis of insulin-dependent diabetes mellitus, thereby providing the best control of glucose levels.
Taking the drug with food reduces the maximum effective concentration of both active substances. Their half-life is also increasing.
When taken orally, Rosiglitazone is actively absorbed by the intestinal mucosa. The acidity of the stomach does not affect the degree of absorption. Bioavailability is almost 100%. The substance is almost completely bound to transport peptides. Not cumulated. The maximum effective concentration is observed in the bloodstream 60 minutes after administration.
Changes in the concentration of a substance depending on food intake do not have much clinical significance. This fact allows you to take the tool, regardless of meal times.
Rosiglitazone undergoes metabolic transformations under the influence of liver enzymes. The main isoenzyme that is responsible for the chemical conversion of a substance is CYP2C8. The resulting metabolites are inactive.
The acidity of the stomach does not affect the degree of absorption.
The half-life of the component is up to 130 hours with normal kidney function. 75% of the dose taken is excreted in the urine, about 25% leaves the body in the composition of feces. Excretion occurs in the form of inactive metabolites, so a long half-life does not lead to increased side effects as a result of cumulation.
The maximum effective concentration of metformin is observed in plasma 2-3 hours after taking the pill. The bioavailability of this substance does not exceed 60%. Up to 1/3 of the dose taken is excreted unchanged through the intestines. The active ingredient is practically not associated with transport peptides. It can penetrate into red blood cells.
Pharmacokinetic properties of metformin change under the influence of food. The clinical significance of these changes is not fully understood.
The excretion of the active substance occurs in its original form. The half-life is 6-7 hours. Excreted by the kidneys.
Indications for use
The drug is prescribed for the treatment of non-insulin-dependent diabetes mellitus, both as monotherapy and in combination with other hypoglycemic drugs.
The drug is prescribed for the treatment of insulin-dependent diabetes mellitus.
Contraindications to the use of Avandamet are:
- individual hypersensitivity to the active ingredients or other substances in the composition;
- chronic heart failure;
- respiratory failure;
- shock conditions;
- alcohol abuse;
- renal failure with creatinine clearance below 70 ml / min;
- dehydration with the possibility of the development of acute renal failure;
- the use of contrast agents containing iodine;
- simultaneous insulin therapy.
With care, the tool is used in combination with diuretics and beta-adrenomimetics. Such combinations can lead to the development of hyperglycemia. This can be avoided by more frequent monitoring of blood sugar levels.
How to take Avandamet
It is advisable to take the drug during or after eating food. This reduces the risk of side effects from the gastrointestinal tract. The dosage is selected individually.
Avandamet is prescribed if diet therapy and exercise do not allow for adequate control of blood glucose levels.
The initial daily dosage is 4 mg of rosiglitazone and 1000 mg of metformin. Later it can be adjusted for efficiency. The maximum daily dosage is 8 mg / 2000 mg.
It is recommended to increase the dosage slowly, which will allow the body to adapt to the drug. Expect to change the therapeutic effect is at least 2 weeks after adjusting the dosage.
Side effects Avandameta
On the part of the organ of vision
Swelling of the macula may be observed.
Musculoskeletal and connective tissue
The drug may be accompanied by an increase in brittleness of the bones, pain in the muscles.
You may experience these side effects:
- violation of the chair;
- increased level of liver enzyme activity.
- decreased platelet count;
- decrease in the number of granulocytes;
central nervous system
The following undesirable reactions may occur:
Since the cardiovascular system
You may experience these side effects:
- chronic heart failure;
- myocardial ischemia.
Anaphylactic reactions, angioedema, rash, itching, urticaria, pulmonary edema may occur.
Influence on ability to operate mechanisms
Avandamet does not affect the concentration of attention and speed of reaction, therefore there are no grounds for refusing to control mechanisms or driving a car.
Use in old age
In appointing the drug to older people, it is necessary to consider the possibility of reducing renal function. It should be monitored during therapy. The dosage should also be adjusted to the amount of renal creatinine clearance. This will help avoid some unwanted effects.
Appointment to children
Data on the use of Avandamet for the treatment of patients in this category is not enough for a safe appointment. It is recommended to choose an adequate replacement tool.
Data on the use of Avandamet for treating children is not enough for a safe prescription.
Use during pregnancy and lactation
Data that the drug can penetrate the placental barrier, do not allow it to freely assign it to women during pregnancy. Insulin is most often prescribed to this category of patients, temporarily replacing hypoglycemic agents.
When breastfeeding, the appointment Avandameta is not recommended. Adequate replacement can be insulin therapy. If therapy with this remedy is necessary for a nursing woman, it is desirable to transfer the child to artificial feeding.
Use in violation of the liver
A slight decrease in hepatic function does not require correction of the drug dosage. For more severe dysfunction of the hepatobiliary tract, it is recommended to carry out treatment under the supervision of a doctor. This will help avoid lactic acidosis. Possible selection of another means to control glycemia.
Use in violation of kidney function
Severe renal dysfunction requires constant monitoring of the patient’s condition by the doctor. Before appointing Avandamet, all risk factors must be considered. If monitoring data indicates the presence of lactic acidosis, therapy should be canceled and the patient hospitalized.
If the concentration of serum creatinine exceeds 135 µmol / l (males) and 110 µmol / l (females), you should abandon the purpose of the drug.
Overdose means accompanied by the development of lactic acidosis due to the pharmacological activity of metformin. This pathology requires hospitalization of the patient with emergency medical care.
Lactate and the active component are excreted by hemodialysis. It is necessary to provide the patient with symptomatic therapy, since rosiglitazone remains in the body due to its high degree of binding to transport peptides.
Interaction with other drugs
Avandamet - the combined drug, data on its medicinal interaction are absent. Conducted research drug interaction of active substances separately.
Special care should be exercised at simultaneous use of means with glucocorticosteroids.
Particular caution should be exercised when applying the agent with glucocorticosteroids, diuretics, beta2-agonists. Such combinations can cause an increase in the level of sugar in the blood serum.
Combined use of the drug with nitrates is not recommended. This may lead to aggravation of myocardial ischemia symptoms.
Sulfonylurea combinations can cause a pathological decrease in plasma sugar. In such cases, careful monitoring of blood glucose concentration is recommended.
Compatibility with alcohol
Drinking alcohol during Avandamet treatment increases the risk of lactic acidosis. This pathological condition is a severe violation of homeostasis, which can lead to coma.
Alcoholic beverages in combination with this tool also increase the risk of other side effects that are characteristic of this drug.
Analogs of this drug are:
Pharmacy vacation terms
Depends on the place of purchase.
Drug storage conditions
Must be stored at a temperature not exceeding + 25 ° C.
The tool is suitable for use within 3 years from the date of issue. Further use is not recommended.
The drug is manufactured by Glaxo Wellcom SA, Spain.
Gennady Bulkin, endocrinologist, Ekaterinburg
This drug is not a simple placebo, but an effective remedy for the control of insulin-dependent diabetes mellitus. The combination of 2 active substances allows you to achieve more effective glycemic control. The tool acts on pancreatic tissue and cells of peripheral organs. This provides increased insulin sensitivity.
I recommend this drug to people with type 2 diabetes who cannot maintain a normal blood glucose level with the help of diet therapy, exercise, and other medicines. The tool is potent, so care must be taken during therapy.
Alisa Chekhova, endocrinologist, Moscow
Avandamet is one of the most effective drugs for glycemic control. Often I prescribe it to heavy patients. The combination of active components allows to achieve improvement in the most hopeless cases.
There are downsides. Treatment requires vigilant monitoring by the doctor. Properly selected dosage and continuous monitoring of glucose levels will help avoid side effects.
Leonid, 32 years old, St. Petersburg
I accept Avandamet more than a year. Prior to that, I tried many tools, but all of them eventually ceased to act. Diabetes is a dangerous disease that, if left untreated, affects the entire body.
To maintain health, I went to an experienced endocrinologist. The price for taking a bite, but I got what I was looking for. The doctor has prescribed this remedy. After a week, the glucose level decreased. A month later, he began to stay at a normal level. Grateful to the doctor and Avandameta for bringing me back to normal life.
Victoria, 45, Moscow
The doctor warned that this tool has a strong effect. I would not accept it if I knew what I would encounter during treatment. Somewhere in 2 weeks after I started taking Avandame, unwanted reactions appeared. They began to disturb nausea, constipation. Dizzy, feeling worse. I had to go to the doctor. He found a replacement, after which all the side effects disappeared.