SUGUAN ® a drug based on Fenformin hydrochloride and glibenclamide
THERAPEUTIC GROUP: Oral hypoglycemic agents - combined therapy
IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects
Indications SUGUAN ® - Fenformin + Glibenclamide
SUGUAN ® is used in the second type of diabetic patient, to improve glycemic control in case of primary or secondary resistance to sulfonylureas.
Mechanism of action SUGUAN ® - Phenformin + Glibenclamide
SUGUAN ® owes its therapeutic efficacy to the presence of complementary active ingredients such as phenformin and glibenclamide.
The synergistic action of these two compounds allows on the one hand to improve insulin secretion by pancreatic beta cells, facilitating depolarization of the plasma membrane and the entry of calcium ions useful for release into the circulation of the hormone (effect of sulfonylureas) glibenclamide) and on the other hand to improve glucose uptake by peripheral tissues by increasing GLUT4 exposure, and at the same time reducing the activation of those biochemical processes, such as gluconeogenesis and glycogenolysis, able to increase concentrations blood glucose (effect of biguanides - phenformin).
The effectiveness of the therapy is also supported by the ease of taking the drug, which predisposes the patient to follow medical recommendations.
In fact, both active ingredients can be easily administered orally.
Studies carried out and clinical efficacy
1. SECONDARY FAILURE OF THERAPY WITH ORAL HYPOGLYCEMISANTS
Even when the combined therapy between glibenclamide and phenformin does not produce the expected results, the control of glycaemia in the second type of diabetic patient is entrusted to the administration of insulin alone, which seems to guarantee good glycemic control even in the long run.
2. EFFECTIVENESS OF COMBINED THERAPY
The combined therapy between sulfonylureas and biguanides, ie glibenclamide and phenformin, has proved particularly effective, in this study conducted about 500 patients suffering from type II diabetes, in ensuring a good glycemic control, without the onset of serious side effects.
3. OVERDOSE
The overdose of oral hypoglycemic agents was very frequent, especially in adolescence, resulting in hypoglycemia, sometimes with a dangerous course. Fortunately, despite the symptomatology, the number of deaths from hypoglycemic overdoses is still not significant.
Method of use and dosage
SUGUAN ® phenophormia 25 mg tablets and glibenclamide 2.5 mg:
SUGUAN ® therapy should start with taking ½ tablet a day, to increase it later following poor glycemic control.
It is therefore important for the doctor to carefully evaluate the glycemic profile of the patient and also establish based on this, the best dosage within the 3 tablets per day.
Warnings SUGUAN ® - Phenformin + Glibenclamide
The entire period of treatment with SUGUAN ® must be accompanied by a balanced diet and a healthy lifestyle marked by periodic monitoring of liver, kidney, heart and metabolic function, to avoid the occurrence of serious side effects and at the same time guarantee maximum therapeutic efficacy.
The success of the therapy also derives from the correct management of the doctor-patient relationship that must clarify the disease, the management of the disease and those warning signs, which may precede the appearance of serious side effects such as hypoglycemic crises and lactic acidosis.
Before surgery, during infectious diseases and febrile states, traumas or serious pathologies, it would be advisable to shift hypoglycemic therapy towards insulin, in order to maintain good glycemic control.
SUGUAN ® contains lactose, therefore it could be associated with the appearance of unpleasant side effects in patients with lactase deficiency, lactose intolerance or galactose / glucose malabsorption.
PREGNANCY AND BREASTFEEDING
Gestational diabetes, is a fairly frequent condition in pregnancy, which can have serious repercussions on the health of the fetus, and therefore should be treated in the best way.
In this regard, therefore, it is preferred in these cases to intervene with well-characterized drugs such as insulin, and with the best safety profile, without compromising the development of the fetus.
Interactions
The interactions described for SUGUAN ® are evidently associated with the presence of glibenclamide and phenformin.
Consequently the intake of dicumarol and derivatives, MAO inhibitors, phenylbutazone and derivatives, chloramphenicol, probenecid, cyclophosphamide, salicylates, adrenals, corticosteroids, oral contraceptives and thiazide diuretics could alter the normal pharmacokinetic properties of glibenclamide, while alcohol, glucorticoids, betagonists, diuretics and ACE inhibitors could alter the therapeutic capacity of phenformin.
It is also important to remember that the administration of iodinated contrast agents could reduce renal function, resulting in a potentially toxic accumulation of phenformin for the patient's health.
Contraindications SUGUAN ® - Fenformin + Glibenclamide
SUGUAN ® contraindicated in cases of impaired hepatic and renal function, fasting, diabetic keto acidosis, diabetic pre-coma, alcoholism, cardiovascular diseases, dystrophic diseases, acute bleeding and gangrene.
SUGUAN ® is contraindicated in case of hypersensitivity to the active ingredients or excipients, and during the period of pregnancy and lactation.
Undesirable effects - Side effects
Several clinical trials and careful post-marketing monitoring seem to agree on the good tolerability of SUGUAN ® therapy .
In fact, the most common side effects have been described as gastrointestinal reactions such as nausea, vomiting, diarrhea, dermatological reactions due to hypersensitivity to the active ingredient and headache.
Clinically relevant adverse reactions such as hypoglycemia or lactic acidosis have only been observed in a few cases, in patients predisposed or following excessive doses of the drug or inadequate diets.
Note
SUGUAN ® sold only under medical prescription.
