Gluconorm Plus is a multicomponent hypoglycemic agent. Due to the presence in the composition of several active substances a positive result during therapy can be obtained faster. The considered agent differs from the analogue of the same name (Gluconorm) in a higher dosage. And both drugs are in the same price category.
International non-proprietary name
Metformin + glibenclamide.
Gluconorm Plus is a multicomponent hypoglycemic agent.
Forms of release and composition
The drug is available only in pill form. Contains active ingredients: glibenclamide and metformin hydrochloride. Dosage in 1 tablet, respectively: 2.5 and 5 mg; 500 mg. In addition to this combination of substances, the composition also includes standard auxiliary components for this release form:
- microcrystalline cellulose;
- croscarmellose sodium;
- magnesium stearate.
Tablets are coated with a special coating that reduces the rate of release of active substances. This reduces the level of aggressive influence on the mucous membranes of the stomach. You can buy the product in packages containing 30 tablets.
The drug is available only in pill form. Contains active ingredients: glibenclamide and metformin hydrochloride.
The mechanism of work of Gluconorm Plus is based on the combined influence of different substances. Each component acts on its own principle, but at the same time enhances the effect of the other. Due to the complex effect, various biochemical processes in the body are covered, which contributes to a rapid decrease in the glucose content. So, metformin refers to biguanides. It is a hypoglycemic agent that simultaneously performs different functions:
- normalizes the ratio of insulin to proinsulin and bound insulin to free, but this process is not activated by Gluconorm, but is a consequence of other reactions of the body provoked by this medicine;
- reduces the concentration of glucose in the blood, which is caused by inhibition of the synthesis of metformin, at the same time it starts the process of its transformation in the cells.
Against the background of increasing glucose uptake, tissue sensitivity to insulin increases. At the same time, the process of release of free fatty acids is slowed down. Oxidation of fats, too, is much slower. The amount of triglycerides, low-density lipoproteins is also reduced. This reduces the rate of formation of fat deposits, which directly affects the weight of a person. Against the background of proper nutrition, low-calorie diet and moderate physical exertion, the development of obesity stops, which is especially important for diabetics.
The indirect effect of the drug on the ratio of different forms of insulin is due to other reactions. Thus, during therapy with metformin, there is no effect on the process of insulin production, since this substance exhibits hypoglycemic properties, bypassing pancreatic cells. Despite the fact that this component violates the metabolism of cholesterol, reduces the concentration of LDL, during therapy does not decrease the content of HDL. Due to these reactions, the weight not only ceases to increase, but its decline is observed when a number of conditions are met.
Another property of metformin is the ability to influence blood clots. So, in the process of therapy with Gluconorm Plus, the fibrinolytic properties of the blood normalize. As a result, formed blood clots are destroyed. This process is based on blocking tissue type plasminogen activator.
Another property of metformin is the ability to influence blood clots.
The second active component (glibenclamide) belongs to the group of sulfonylurea derivatives. Means of this type are the most effective of all existing hypoglycemic drugs. The mechanism of action of glibenclamide is based on its ability to influence the beta cells of the pancreas. When interacting with their receptors, potassium closure and the opening of calcium channels are noted.
The result of these reactions is the activation of the insulin release process. This is due to the penetration of calcium into the cells. At the last stage, there is a powerful release of insulin into the blood, which contributes to a decrease in the glucose content. Given the mechanism of action of this substance, it is advisable to use it only in the treatment of patients with functioning beta cells of the pancreas. Otherwise, the effectiveness of glibenclamide is reduced.
Metformin is absorbed rapidly. The level of its concentration in serum increases to the limit value after 2 hours. The disadvantage of the substance is a short action. After 6 hours, the plasma concentration of metformin begins to decrease, which is caused by the end of the absorption process in the gastrointestinal tract organs. The half-life of the substance is also reduced. Its duration varies from 1.5 to 5 hours.
In addition, metformin does not bind to plasma proteins. This substance tends to accumulate in the tissues of the kidneys, liver, salivary glands. Impaired kidney function is the main factor contributing to the accumulation of metformin in the body, which leads to an increase in the concentration of this component and increase its effectiveness.
Impaired kidney function is a major factor contributing to the accumulation of metformin in the body, which leads to an increase in its effectiveness.
Glybenclamide lasts longer - for 8-12 hours. The peak of efficiency comes in 1-2 hours. This substance is fully associated with blood proteins. The process of transformation of glibenclamide occurs in the liver, where 2 compounds are formed that do not exhibit hypoglycemic activity.
Indications for use
The drug is allowed to be used in the treatment of patients with type 2 diabetes in some cases:
- lack of results in the previously prescribed treatment of obesity, if any of the drugs were used: Metformin or Glibenclamide;
- replacement therapy, provided that the blood glucose level is stable and well controlled.
Note many restrictions under which they do not use the tool in question:
- intolerance to any component in the composition (active and inactive);
- type 1 diabetes;
- violation of carbohydrate metabolism in diabetes;
- the initial stage of development of coma;
- a significant decrease in blood glucose;
- various pathological conditions that contribute to the disruption of the kidneys, it may be slowing down the process of fluid discharge, infection, shock;
- any diseases involving oxygen deficiency, among them note myocardial infarction;
- lactic acidosis;
- a number of pathological conditions that are the basis for the appointment of insulin therapy, in this case, additional stimulation of this substance can lead to the development of complications.
How to take Glukonorm Plus?
The frequency of taking the pills and the number of active ingredients is determined individually. The choice of treatment regimen is influenced by the patient's condition in case of diabetes mellitus, the presence of other diseases, age. The drug is taken with food.
Begin a course of therapy with minimal doses. Take 1 tablet per day. Moreover, the concentration of the active components may be different: 2.5 mg + 500 mg; 5 mg + 500 mg. Gradually, the amount of metformin and glibenclamide increases, but not more than 5 mg and 500 mg, respectively. The change in the concentration of medicinal substances is made every 2 weeks until the patient's condition stabilizes.
The maximum daily amount of the drug - 4 tablets, with doses of active ingredients in 1 pc: 5 mg and 500 mg. The alternative is 6 tablets, but the amount of glibenclamide and metformin is respectively: 2.5 mg, 500 mg. These doses of the drug are divided into several doses (2 or 3), it all depends on the number of tablets. The exception is when one pill is prescribed per day.
Side Effects of Gluconorm Plus
There is a risk of deterioration of vision against the background of lowering glucose levels.
Vomiting, accompanied by nausea, anorexia, abdominal pain, taste of metal. Rarely noted the occurrence of symptoms of jaundice, hepatitis, increases the activity of hepatic transaminases. This is a consequence of a change in liver function.
Vomiting, accompanied by nausea - one of the side effects of the drug.
A number of disorders accompanied by changes in the composition and properties of blood: thrombocytopenia, leukopenia, anemia, etc.
central nervous system
Fatigue, headache and dizziness, general weakness, impaired sensitivity (rare).
Hypoglycemia, symptoms of which are aggression, confusion, depression, blurred vision, tremor, weakness, etc.
On the part of the skin
Symptoms of increased sensitivity to sunlight.
Hives. The main symptoms: rash, itching, increase in body temperature. Erythema develops.
The drug can provoke an allergy in the form of itching and rash.
Influence on ability to operate mechanisms
Given that the drug provokes a violation of the eyes, sometimes contributes to the development of hypoglycemia, it is recommended to exercise caution during therapy with Gluconorm Plus while driving a car.
The tool is prescribed with caution in cases of pronounced disorders of the thyroid gland, pituitary, fever and adrenal insufficiency.
During treatment, it is recommended to constantly monitor the level of glucose (on an empty stomach and after meals).
You must inform the doctor about developing urinary tract infections. This may require a change in treatment regimen.
Against the background of liver and kidney disorders, the concentration of metformin in the blood increases, which is a consequence of the slowing down of the elimination process of this substance. As a result, lactic acidosis develops.
Use during pregnancy and lactation
Appointment Gluconorm Plus children
Not used, only adult therapy is acceptable.
The drug is not used to treat children.
Use in old age
The drug is taken with caution, especially if the patient is experiencing excessive exercise. In this case, the risk of lactic acidosis increases.
Use in violation of kidney function
Do not prescribe a remedy for severe lesions of this organ. Control of creatinine clearance is required. With its significant reduction in the course of treatment is interrupted.
Use in violation of the liver
The drug is contraindicated in case of insufficiency of the liver.
Gluconorm Plus Overdose
This remedy is dangerous if used in violation of the treatment regimen. At the same time hypoglycemia develops, since the processes of insulin release are activated. At the same time, glyconeogenesis and glucose utilization are more intensely inhibited. As a result, increasing the dose of Gluconorm Plus develops complications.
Therapy involves the normalization of the diet. The patient must take a dose of carbohydrates in any form. If a severe pathological condition develops, accompanied by a coma, the treatment is carried out in a hospital: a dextrose solution is injected intravenously.
When the dose of Gluconorm Plus increases, lactic acidosis may develop. This pathological condition requires treatment in a hospital. Moreover, lactate and metformin are effectively eliminated from the body through hemodialysis. This method is not suitable for the removal of glibenclamide, since this substance is fully associated with blood proteins.
The drug is contraindicated in case of insufficiency of the liver.
Interaction with other drugs
Simultaneous reception of Gluconorm Plus and Miconazole contributes to the development of hypoglycemia.
Iodine-containing drugs are not used along with the considered drug. This should be considered when conducting surveys that require the use of contrast enhancement with substances containing iodine.
Phenylbutazone enhances the action of the considered agent - contributes to a more intensive decrease in the level of glucose.
Bezontan provokes an increase in toxic effects on the liver.
A number of drugs and substances that require caution:
- beta adrenomimetics and adrenoblockers;
- means of depressing the ACE.
Compatibility with alcohol
Alcohol-containing beverages are not combined with Gluconorm Plus.
- Glucophage and others
Pharmacy vacation terms
The drug is a prescription.
Can I buy without a prescription?
Price for Gluconorm Plus
Average price: 160-180 rubles.
Drug storage conditions
Recommended temperature: up to + 25 ° C.
Properties of the drug are stored for 2 years from the date of issue.
JSC Pharmstandard-Tomskhimpharm, Russia.
In the elderly, the drug is taken with caution, especially if the patient is experiencing excessive exercise.
Reviews of Gluconorm Plus
Valiev A. A., endocrinologist, 45 years old, Vladivostok
Effective remedy. The desired result of therapy can be obtained almost immediately, but such indicators are associated with the risk of complications. A rapid decrease in blood glucose levels leads to hypoglycemia, so the drug can be taken only after consulting a doctor.
Shuvalov EG, therapist, 39 years old, Pskov
This tool works great. Only you can take it with type 2 diabetes. I note a large number of side effects, contraindications. I consider it an advantage of an affordable price, which is important, because patients often have to take these pills.
Veronika, 28 years old, Yaroslavl
I have diabetes mellitus recently. While learning to live with him, need a diet and periodic monitoring of glucose. This drug was also taken, it helps quickly, and this is a plus, since my greatest fear is coma against the background of a decrease in the level of glucose.
Anna, 44 years old, Samara
The drug did not fit. Provokes side effects. Headache, nausea, blurred vision - all these signs experienced on myself. The doctor at first believed that it was a dosage, but even the most benign treatment regimen did not eliminate the problem.