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Type 2 diabetes is a very common disease today. Therefore, the use of blood sugar control drugs is extremely necessary. Including the drug product Flodilan 4mg.1. Composition and effects of the drug Flodilan 4mg
Flodilan has the main active ingredient Glimepiride, 4mg content. Flodilan 4mg is an oral hypoglycemic agent used in adult non-insulin dependent diabetes mellitus (or type 2 diabetes) when blood glucose levels are not controlled after dietary changes. diet, exercise and weight loss. Glimepiride is a type 2 diabetes medication belonging to the sulfonylurea group. The effect of this active ingredient is to stimulate pancreatic beta cells to release insulin hormone, so Flodilan only works when the pancreas is still able to secrete insulin.
The main mechanism of action of glimepiride is to bind to receptors in the pancreatic beta cell membrane, thereby closing ATP-dependent potassium transport channels. This effect will cause membrane depolarization, opening calcium channels and thereby stimulating the influx of calcium ions into the cell. It is the elevated intracellular calcium concentration that stimulates the release of insulin from the pancreatic cells.
Like other sulfonylurea drugs, Flodilan 4mg lowers blood glucose levels in both diabetic and healthy patients. When taken for a long period of time, Flodilan 4mg has a number of effects other than pancreatic, thereby significantly supporting the hypoglycemic effect, which can be mentioned as increased insulin sensitivity in peripheral tissues and decreased glucose production in the liver.
It should be noted that the active ingredient Glimepiride in Flodilan 4mg has a synergistic effect when used with Metformin or Insulin.
2. Dosage of the drug Flodilan 4mg
Flodilan is usually taken only once a day, maybe before or during breakfast or lunch. The patient needs to swallow the tablet whole with a little water and absolutely do not take a dose if you forget to take it the day before. Cases of taking only 1mg of Glimepiride but showing signs of hypoglycaemia suggestive of diabetes can only be treated with appropriate diet and exercise.
Dosage of Flodilan 4mg:
Starting dose: 1 mg/day. If treatment goal is not achieved, increase by 1 mg/day every 1-2 weeks until blood glucose is controlled. The maximum dose of Flodilan is 6mg/day. However, most patients will respond at doses of 1 - 4 mg/day, very few cases have to take up to 6 mg/day; Patients whose blood glucose levels are not controlled with the maximum dose of Metformin can be added to Flodilan. At that time, the patient remained on the Metformin dose and started Glimepiride at a low dose, then gradually increased until the blood glucose level was satisfactory. This combination treatment should be closely monitored by the doctor, if still not controlled by taking the maximum dose of glimepiride, consider adding insulin; Insulin therapy should be started at a low dose and maintained at the same dose of Glimepiride. The dose of insulin used depends on the degree of glycemic control desired and is often reduced (approximately 40 - 50%) compared with insulin monotherapy. Note that this combination leads to an increased risk of hypoglycemia; Combination therapy of Flodilan and insulin should be closely monitored by a physician. Patients with hepatic impairment, renal impairment should be cautious about the risk of excessive hypoglycaemia when initiating glimepiride, because it is eliminated by the kidneys, after being metabolized in the liver. The dose is started at 1 mg/day and increased when fasting blood glucose remains high. When creatinine clearance is less than 22 mL/min, only 1 mg/day should be used and should not be increased. If renal or hepatic impairment is severe, Flodilan 4mg should be discontinued and insulin therapy should be switched. The goal of treatment for type 2 diabetes depends on each specific patient, but the general goal is to lower fasting blood sugar below 7mmol/L, postprandial blood sugar below 10 mmol/L and HbA1c below 7%. If the patient achieves the goal of fasting blood sugar below 7 mmol/L when using Flodilan, but the HbA1c index is still higher than 7%, then it is necessary to monitor the postprandial blood glucose level.
More stringent treatment goals (eg, HbA1c less than 6%) may be considered in some low-risk patients for hypoglycemia, including those with new diabetes, without concomitant cardiovascular disease. and young age. Less stringent treatment goals are often appropriate for patients with long-standing diabetes, advanced age, and low alertness.
Overdose of Flodilan 4mg and treatment:
Overdosage of Flodilan can cause hypoglycemia (less than 60 mg/dL or 3.5 mmol/L) with symptoms of headache, fatigue, tremors, sweating, cold skin, anxiety, restlessness, increased or irregular heart rate, low blood pressure, nervousness, chest pain, extreme hunger, drowsiness, decreased concentration, impaired flexibility and responsiveness, drowsiness , depression, decreased consciousness or loss of consciousness leading to coma... Manifestations of severe hypoglycemia can be confused with a stroke. It should be noted that hypoglycemia may occur 24 hours after taking Flodilan 4mg; Treatment: Mild cases: Drink sugar water, then monitor blood sugar and drink once every 15 minutes until blood glucose returns to normal; Severe cases: If the patient is comatose or unable to drink, 50ml of 50% glucose solution should be administered intravenously quickly. After that, maintain slow intravenous glucose infusion of 10-20% to normalize blood glucose. In addition, patients should be monitored continuously for 24-48 hours because of the risk of recurrent hypoglycemia.
3. Side effects of the drug Flodilan 4mg
When using Flodilan, patients may experience some unwanted effects (ADRs). Among them, the most important ADR is the hypoglycemia mentioned above. Some other common ADRs:
Dizziness, dizziness, headache; Nausea, vomiting, feeling of fullness in the epigastrium, abdominal pain, diarrhea; Transient visual changes due to changes in blood glucose levels. Uncommon side effects of Flodilan 4mg:
Allergic or pseudo-allergic reactions, rash, urticaria, itching; Increased liver enzymes, jaundice, liver failure; Mild or severe decrease in platelet count, hemolytic anemia, leukopenia or agranulocytosis; Allergic vasculitis; Increased sensitivity to light.
4. Contraindications of Flodilan 4mg
People with a history of hypersensitivity to Glimepiride or the components of the drug Flodilan 4mg; Allergy to other drugs of the sulfonylurea group or sulphonamide derivatives; Type 1 diabetes is insulin dependent; Ketoacidosis ; Severe infection or trauma, preparation for major surgery; Coma due to hyperglycemia; Severe kidney or liver failure; Pregnant or lactating women.
5. Some cautions when using Flodilan
Patients should be fully counseled about the nature of diabetes, as well as measures to prevent and detect complications; Hypoglycemia can occur when using Flodilan 4mg drug overdose, inadequate diet, or skipping meals erratically, prolonged heavy exercise or drinking a lot of alcohol... In which the risk of hypoglycemia blood will be higher in the elderly, kidney failure, liver failure; If you are taking Flodilan 4mg and your blood sugar is stable, you may suddenly lose control when you are exposed to severe physical stress (such as trauma, surgery, infection, high fever). At this time, it is necessary to switch to insulin treatment, which can be combined with or replaced with Flodilan 4mg; Caution should be exercised in people with a deficiency of the enzyme glucose-6 phosphate dehydrogenase; Flodilan 4mg contains lactose monohydrate, therefore patients with galactose intolerance, Lapp lactase deficiency or hereditary glucose-galactose malabsorption should not use this product; The effects of Flodilan 4mg on the ability to drive and use machines have not been studied. However, due to the risk of high or low blood sugar, it can affect the ability to concentrate and thereby adversely affect the ability to drive or operate machines; Pregnant patients on Flodilan 4mg should immediately notify their doctor to switch to insulin therapy at the appropriate dose to maintain blood sugar within the normal range. Some animal studies have shown that Glimepiride causes embryotoxic, fetal and teratogenic effects, so it is absolutely contraindicated for pregnant women; Flodilan 4mg is excreted in human milk, therefore it is contraindicated for use in nursing women and a switch to insulin is mandatory.
6. Flodilan 4mg . Drug Interactions
Glimepiride is metabolised in the liver by the cytochrome P450 system (CYP2C9), the extent of which will be altered when co-administered with inducers or inhibitors of CYP2C9.
Some interactions increase the hypoglycemic effect of Flodilan 4mg:
Phenylbutazone, Azapropazon, Oxyphenbutazone; Insulin and oral antidiabetic drugs; Quinolone antibiotics such as Ciprofloxacin or Pefloxacin...; Salicylates and para-aminosalicylic acid; Some NSAIDs; Chloramphenicol, a tetracycline antibiotic; Coumarin anticoagulant; Fibrates; Allopurinol, Probenecid; Cyclophosphamide, Trofosfamide and Ifosfamide; An azole group such as Miconazole or Fluconazole. Some interactions reduce the hypoglycemic effect of Flodilan 4mg:
Estrogen and progestatif; Salt and thiazide diuretics; Thyroid hormone analogues; Glucocorticoids; Chlorpromazine; Adrenaline and sympathomimetic drugs; nicotinic acid; Laxatives (when used long-term); Glucagon; Rifampicin; Acetazolamide. Flodilan, whose active ingredient is Glimepiride, is an oral hypoglycemic agent used for non-insulin dependent diabetes mellitus (or type 2 diabetes mellitus) in adults after uncontrolled blood sugar levels. after changing the diet, exercising and losing weight. To ensure the effectiveness of treatment and avoid unwanted side effects, patients need to take drugs according to prescription or consult a doctor, professional pharmacist.
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