Pharmacological properties Pharmacodynamics. Buy primobolan inhibits gluconeogenesis in the liver, reduces glucose absorption from the intestine, increases peripheral glucose disposal, and also increases the sensitivity of tissues to insulin. When this has no effect on insulin secretion of pancreatic beta-cells causes hypoglycemic reactions. It reduces the level of triglycerides and low-density lipoprotein in blood. Stabilizes or reduces body weight. Has fibrinolytic action by inhibiting plasminogen activator inhibitor, tissue-type. Pharmacokinetics. After oral administration Buy primobolan is absorbed slowly from the gastrointestinal tract.The bioavailability after ingestion of standard doses of 50-60%. The maximum plasma concentration is reached 2.5 hours after oral administration. Almost does not bind to plasma proteins. It accumulates in the salivary glands, muscles, liver and kidneys. Provided unchanged by the kidneys. The half-life of 1.5-4.5 h. When renal function is possible accumulation of the drug.
Indications for use of
Type 2 diabetes mellitus with poor diet (especially for patients suffering from obesity) as monotherapy or in combination with other hypoglycemic drugs.
– diabetic ketoacidosis, diabetic precoma, coma;
– renal dysfunction;
– acute conditions with the risk of renal dysfunction:
– dehydration (diarrhea, vomiting), fever, severe infections, a condition of hypoxia (shock, sepsis, renal infections, bronchopulmonary disease);
– symptomatic manifestations of acute and chronic diseases, which may lead to the development of tissue hypoxia (cardiac or respiratory failure, acute myocardial infarction, etc.),
– major surgery and trauma (when shown holding insulin monotherapy);
– abnormal liver function:
– chronic alcoholism, acute alcohol poisoning;
– pregnancy, breast-feeding;
– hypersensitivity to the drug;
– lactic acidosis (including history);
– the application for at least 2 days before and within 2 days after the radioisotope or radiological examinations with administration of iodine-containing contrast material;
– compliance with a reduced-calorie diet (less than 1000 calories / day)
is not recommended to use the drug in patients older than 60 years, performing heavy physical work, which is due with an increased risk of developing lactic acidosis.
Pregnancy and lactation:
When planning a pregnancy, or in the event of pregnancy while taking Gliformina, it should be withdrawn and insulin. Since the data on the penetration into breast milk is not present, the drug is contraindicated in breastfeeding. If necessary, use Gliformina during breast-feeding, breast-feeding should be discontinued.
Dosage and administration
The dose is established by the doctor individually, depending on the level of glucose in the blood.
Take with liquid during or after meals, drinking plenty of water. The initial dose of 0.5 g of 1-2 times per day or 0.85 g 1 day. After 10-15 days may further gradual increase in the dose depending on the level of blood glucose. The maintenance dose is usually 1.5-2 g / day. The maximum daily dose – 3 years to ensure the above dosing regime may be used Gliformin in the dosage form – tablets 0.5 g
In elderly patients the daily dose should not exceed 1 g
Due to the increased risk of lactic acidosis, with severe metabolic disturbances dose necessary reduce.
Side effect On the part of the digestive system organs: . Nausea, vomiting, “metallic” taste in the mouth, loss of appetite, diarrhea, flatulence, abdominal pain These symptoms are particularly common at the beginning of treatment and usually disappear on their own. These symptoms can be reduced by the appointment of antacids, antispasmodics or atropine derivatives. On the part of metabolism: rarely – lactic acidosis (requires discontinuation of treatment); long-term treatment – B12 vitamin deficiencies (malabsorption). From the side of hematopoiesis: . in some cases – megaloblastic anemia From the Endocrine: hypoglycemia, allergic reactions: . rash In cases of side effects dose should be reduced or temporarily stop the drug.
If overdose of Buy primobolan may develop lactic acidosis fatal.
The reason for the development of lactic acidosis may also be the accumulation of the drug due to renal dysfunction. Early symptoms of lactic acidosis are weakness, nausea, vomiting, diarrhea, drop in body temperature, abdominal pain, muscle pain, lower blood pressure, reflex bradyarrhythmia in the future there may be a shortness of breath, dizziness, impaired consciousness and coma develop.Treatment: In case of occurrence of lactic acidosis symptoms, treatment, Buy primobolan should be discontinued immediately, the patient hospitalized immediately and determine the concentration of lactate, to confirm the diagnosis. The most effective measure for the excretion of lactate and Buy primobolan is hemodialysis. Spend as symptomatic treatment.
Interaction with other medicinal products
In an application with sulfonylureas, acarbose, insulin, non-steroidal anti-inflammatory drugs, monoamine oxidase inhibitors, oxytetracycline, angiotensin converting enzyme inhibitors, derivatives of clofibrate, cyclophosphamide, β-blockers may increase the hypoglycemic effect of Buy primobolan.
While the use of corticosteroids, oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and “loop” diuretics, phenothiazine derivatives, derivatives of nicotinic acid may reduce the hypoglycemic action of Buy primobolan.
cimetidine slows the elimination of Buy primobolan, thus increasing the risk of lactic acidosis.
Buy primobolan may weaken the effect of anticoagulants ( coumarin).
Together with the admission of alcohol may develop lactic acidosis.
During treatment 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 plasma.
In addition, 1 every 6 months is necessary to monitor the level of creatinine in serum (especially in patients of advanced age) should be appointed Gliformin if creatinine level in the blood above 135 mmol / l in men and 110 mmol / l in women.
for 48 hours before and 48 hours after the X-ray contrast studies (urography, intravenous angiography) should stop taking Gliformina.
during the treatment should refrain from drinking alcohol and drugs containing ethanol.
Perhaps the use Gliformin drug in combination with sulfonylureas. In this case, needs particularly careful monitoring of blood glucose levels. Effects on ability to drive vehicles and operate machinery: When used as monotherapy Gliformin not affect the ability to drive vehicles and operate machinery. When combined Gliformina with other hypoglycemic agents (sulfonylureas, insulin etc.) may develop hypoglycemic conditions under which deteriorates the ability to manage road and busy with other potentially hazardous activities that require increased attention and rapid psychomotor reactions.