制造商: 药理分类: 活性成分(补): 另外: 药理作用:
成人: 儿童: 禁忌(补): 警告/注意事项: 互动(补): 不良反应(补): 如何提供: 最后更新: Manufacturer:Novo Nordisk and Sciele Pharma Pharmacological Class:Antidiabetic agent (meglitinide analogue + biguanide) Active Ingredient(s):Repaglinide 1mg, metformin 500mg; tabs. Also:PRANDIMET 2mg/500mg Indication(s):Adjunct to diet and exercise in type 2 diabetes. Pharmacology:PrandiMet is an oral antidiabetic agent that combines two drugs with different mechanisms of action to improve glycemic control in patients with type 2 diabetes. Repaglinide lowers blood glucose by stimulating the release of insulin from the pancreas. This action is dependent upon functioning beta cells in the pancreatic islets. Metformin is an antihyperglycemic agent that lowers basal and postprandial blood glucose levels. It decreases hepatic glucose production, decreases the intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Legal Classification:Rx Adults:Take within 30mins before food; give in 2–3 divided doses; individualize. Previously on metformin alone: initially one 1mg/500mg tab twice daily. Previously on repaglinide alone: initially add metformin component 500mg twice daily. Previously on both components: switch to similar doses of PrandiMet then titrate. Max 4mg/1000mg per meal, or 10mg/2500mg per day. Withhold drug if meal is skipped. Children:Not recommended. Contraindication(s):Renal impairment. Metabolic acidosis. Diabetic ketoacidosis. Concomitant both gemfibrozil and itraconazole. Warnings/Precautions:Not for treating type 1 diabetes. Avoid in hepatic disease. CHF, renal or hepatic dysfunction, sepsis, dehydration, excessive alcohol intake: increased risk of lactic acidosis. Confirm normal renal function before starting and monitor (esp. in patients ≥80years). Monitor blood glucose, hepatic function, hematology (esp. serum Vit.B12 levels). Discontinue if lactic acidosis, shock, acute MI, sepsis, or hypoxemia occurs. Suspend therapy if dehydration occurs and before surgery. Stress. Uncompensated strenuous exercise, malnourished or caloric deficiency, adrenal or pituitary insufficiency, or acute alcohol intoxication: increased risk of hypoglycemia. Elderly. Debilitated. Pregnancy (Cat.C), nursing mothers: not recommended. Interaction(s):See Contraindications. Not for use with NPH insulin. Suspend therapy during and for 48 hours after the use of intravascular iodinated radiocontrast agents. Repaglinide potentiated by gemfibrozil and itraconazole. Metformin may be potentiated by cationic drugs eliminated by renal tubular secretion (eg, amiloride, digoxin, morphine, procainamide, quinidine, trimethoprim, ranitidine, vancomycin), furosemide, nifedipine. Repaglinide may be potentiated by CYP3A4 inhibitors (eg, ketoconazole, clarithromycin). Repaglinide may be antagonized by CYP3A4 inducers (eg, rifampin). Avoid excessive alcohol. Diuretics, steroids, phenothiazines, phenytoin, sympathomimetics, calcium channel blockers, isoniazid, niacin, others may cause hyperglycemia. Increased risk of hypoglycemia with alcohol, sulfonylureas, insulin. Beta-blockers may mask hypoglycemia. Adverse Reaction(s):Hypoglycemia, headache, GI upset; lactic acidosis (rare, half the cases are fatal). How Supplied:Tabs—20, 100 临床疗效: 一项为期18周的随机、双盲、安慰剂对照试验(包括6周的剂量调节期和随后12周的维持剂量期)的结果显示:在12周的维持剂量期间,瑞格列奈组患者的平均糖基化血红蛋白(HbA1c)值从8.5%下降至7.8%,而安慰剂组患者的平均HbA1c值从8.1%上升至9.3%(P<0.01)。与安慰剂组比较,瑞格列奈组平均空腹和餐后血糖浓度均明显下降(P<0.01),空腹和餐后胰岛素和C肽浓度则有明显上升(P<0.05)。 与格列本脲的临床对比试验表明在餐前每日2~3次口服瑞格列奈0.5~4mg与每日服用格列本脲2.5-15mg的疗效相当。 与二甲双胍对照试验的结果显示,瑞格列奈或二甲双胍单药治疗的效果没有明显差别,HbA1c值分别下降了0.4%和0.3%。两药联合应用,HbA1c值下降了(1.40.2)%,从8.3%下降至6.9%(P=0.0016),空腹血糖下降了2.2mmol/L(P=0.0003)。瑞格列奈单用和(或)与二甲双胍合用,空腹胰岛素水平分别提高了4.04mU/L和4.23mU/L(P<0.02)。 糖尿病是一种常见的内分泌代谢疾病,随着生活方式的改变和老龄化进程的加速,我国糖尿病的患病率正在呈快速上升趋势,成为继心脑血管疾病、肿瘤之后的另一个严重危害人民健康的重要慢性非传染性疾病。它的急、慢性并发症,尤其是慢性病并发症累及多个器官,致残、致死率高,严重影响患者的身心健康,并给个人、家庭和社会带来沉重的负担。 2型糖尿病是糖尿病人群的主体,占糖尿病患者的90%左右,2型糖尿病起病时症状比较隐蔽,很难在初发时即获确诊,但其患病率较高。一般用患病率对2型糖尿病的流行病学特点进行研究。近年来,世界各国2型糖尿病的患病率均有急剧增加的趋势,2型糖尿病患者激增是造成全世界糖尿病患者总数剧增的主要原因。 |
瑞格列奈-二甲双胍复方片-治疗2型糖尿病简介:美国FDA批准PrandiMet上市,治疗第二型糖尿病
Manufacturer:
Novo Nordisk and Sciele Pharma
Pharmacological Class:
Antidiabetic agent (meglitinide analogue + biguanide)
Active Ingredient(s):
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