Glucophage Long extended-release tablets 500 mg 60 pcs.

There are a lot of drugs to lower blood sugar levels, from cheap tablets to modern insulins in special devices. Sometimes you want to understand the doctor's prescriptions. What if there is a better drug?

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Diabetes

Nobody takes glucose-lowering drugs for nothing. This is the most important point in the treatment of diabetes mellitus, a disease that is associated with hyperglycemia. In a healthy person, blood sugar levels are fairly constant and should not go beyond certain limits, regardless of periods of eating or fasting. It is believed that it can range from 2.5 mmol/l to 8 mmol/l.

Previously, when there was no treatment for diabetes mellitus, after a few years of illness a ketoacidotic coma could develop and the person would die. Today there are fewer and fewer such cases; medications help prevent sugar levels from rising to life-critical levels. Doctors and patients are faced with a new task - to delay the development of complications and prolong life as much as possible.

Hyperglycemia leads to the development of atherosclerosis, damage to blood vessels and nerves, coronary heart disease, and impaired sensitivity of the limbs. Blindness, gangrene, chronic renal failure, heart attack, and stroke may develop. All these changes accumulate day after day due to high blood sugar levels.

In type 1 diabetes, the pancreatic cells that produce insulin gradually die, so there is only one treatment - regular administration of insulin.

For type 2 diabetes mellitus, both medications and various forms of insulin can be used. Typically, the introduction of insulin on a regular basis occurs when all the possibilities of drug combinations have been used, but there is no effect. It is on an ongoing basis, because insulin can be administered temporarily to relieve the toxic effect of hyperglycemia.

Only for type 2 diabetes can medications be used, not insulin.

Now more about drugs other than insulin.

Contraindications for use are also general.

• serious disruption of the functioning of internal organs and systems (diabetic precomas, comas, increased acetone levels)

• renal failure

• severe nervous system disorders

• infectious diseases

• respiratory, heart failure, myocardial infarction

• conditions after abdominal surgery and trauma, when the use of insulin is indicated

• before and after radioisotope and x-ray studies (two days before and after manipulations)

• pregnancy, lactation period

• children under 10 years old

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Drugs

The purpose of taking medications is to maintain glucose levels within a certain range of values. At the same time, too little sugar can be just as “harmful” as high sugar. The threshold of digital values ​​is determined by the endocrinologist. After the start of treatment, there may be a long way to select the optimal therapy, since the results are assessed not the next day according to glucometer readings, but only after 3 months according to the analysis of glycated hemoglobin.

Drugs affecting insulin resistance

This group increases the sensitivity of body cells to insulin, body cells (muscle, fat, etc.) begin to more actively capture glucose from the blood.

Biguanides. The most famous drug is Metformin (Glucophage) and its extended-release form (Glucophage Long). Metformin remains the drug of choice, despite the fact that the history of its use goes back more than 60 years. It is usually prescribed first if there are no contraindications.

Flaws:

• long-term use of metformin can lead to B12-deficiency anemia, so periodic monitoring of B12 in the blood is necessary;
• possible discomfort in the gastrointestinal tract.

The advantages include:

• low risk of hypoglycemia;
• no effect on weight;
• positive effect on lipid profile;
• affordable price;
• reducing the risk of diabetes with low glucose tolerance.

Glitazones (Thiazolidinediones). Used since 1996. Pioglitazone is the most widely used active substance from this group.

Flaws:

• swelling of the limbs;
• weight gain;
• reduce bone mineral density and increase the risk of fractures, more so in women;
• slow onset of action;
• high cost.

Advantages:

• reducing the risk of problems with large vessels;
• low risk of a critical drop in sugar levels;
• normalization of biochemical blood parameters for fats;
• potential protective effect on pancreatic cells;
• reducing the risk of transition of low glucose tolerance to diabetes mellitus.

Among the disadvantages of glitazones is weight gain.

Drugs that enhance insulin secretion

Sulfonylurea derivatives (SUM):

• Chlorpropamide, Tolbutamide (“old” drugs, practically not used);
• Glibenclamide, Diabeton MB, Amaryl (more modern).

This group stimulates the release of insulin from the pancreas. On the one hand, there is a rapid decrease in blood glucose levels, on the other, there is a risk of developing hypoglycemia. The affordable price and possible positive effect on small vessels make the drug often prescribed, but the negative effects include rapid addiction, which can negate the effect of taking it, as well as a possible increase in body weight.

Drugs with incretin activity

These substances help restore sufficient insulin synthesis by the pancreas in response to food intake.

Dipeptidyl peptidase-4 (DPP-4) inhibitors:

• Januvia;
• Galvus;
• Ongliza;
• Tragenta.

These drugs have a fairly high price, and are also expected to influence the development of pancreatitis, but this data has not yet been confirmed. Positive actions:

• do not affect weight;
• have a low risk of hypoglycemia;
• have a potential protective effect on pancreatic B cells.

Ready-made combination drugs with metformin are convenient:

• Janumet;
• Galvus Met;
• Comboglise Prolong;
• Vipdomet.

Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists):

• Baeta, Baeta Long;
• Victoza, Saxenda;
• Lyxumia;
• Trulicity.

Glucagon-like peptide-1 receptor agonists are injected into the subcutaneous fat of the abdomen, thigh, or upper arm once daily.
These drugs are injectable and come in the form of syringe pens, but they are not insulin. The medicine is injected into the subcutaneous fat on the abdomen, thigh or shoulder once a day, preferably at the same time. Treatment requires certain skills of use, conditions; consumables (needles) are needed. After using a syringe pen, needles must be removed and thrown away; not everyone follows these rules, which can lead to infection at the injection sites and damage to the device. Another possible problem is the syringe pen falling and failing. Compared to tablet forms, these drugs have an impressive list of positive effects:

• low risk of excessive drop in glucose levels;
• reduce weight, blood pressure;
• a decrease in mortality from cardiovascular diseases was recorded;
• possible protective effect on pancreatic cells.

The disadvantages include:

• discomfort in the digestive tract;
• possible formation of antibodies;
• unproven risk of pancreatitis;
• high price.

Drugs that block the absorption of glucose in the intestine

Alpha-glucosidase inhibitors. The drug on the market is Acarbose. It blocks the absorption of carbohydrates from the digestive tract. Despite the advantages of:

• low likelihood of hypoglycemia;
• reducing the risk of transition of low glucose tolerance to diabetes mellitus;
• lack of weight gain from the drug.

Its effectiveness is quite low , the dosage regimen is inconvenient - 3 times a day.

Drugs that inhibit renal glucose reabsorption

Gliflozins (NGLT-2 inhibitors):

• Forxiga;
• Jardines;
• Canagliflozin.

Taking these drugs causes glucosuria, that is, the excretion of glucose in the urine, which helps reduce hyperglycemia in diabetes mellitus. In addition, when you lose glucose in the urine, you also lose calories, which is how the drugs help you lose weight. Also, their use has a low risk of developing hypoglycemia, reduces mortality, and reduces the frequency of hospitalizations for chronic heart failure. The effect of the drugs does not depend on the presence of insulin in the blood.

Gliflozins reduce the incidence of hospitalization in chronic heart failure.

But there are also development risks:

• urinary tract infections;
• lack of circulating blood volume;
• ketoacidosis.

The price is also quite high.

Glucophage and alcohol: compatibility

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Glucophage and alcohol: compatibility

Doctors consider diabetes mellitus to be a real scourge of the modern age. More and more patients are being diagnosed with this disease, and recently there has been an increase in the number of patients with type 2 diabetes. In such a situation, patients cannot do without the use of medications. If at the initial stages of the development of the disease it is still possible to manage and stabilize the condition by adjusting the diet and physical exercise, then with consistently high sugar levels, you have to undergo a course of drug treatment.

Doctors often prescribe medications for diabetics that contain metformin hydrochloride. One of the most common tablets in this category is Glucophage. And, of course, especially on the eve of various holidays, patients begin to wonder whether it is possible to take Glucophage and alcohol together, and whether such a tandem will lead to a worsening of the condition.

More information about the drug

This medication belongs to the hypoglycemic drugs of the biguanide group. The main task of the medicine is to normalize sugar levels in diabetics. The main active compound of the drug is metmorphine hydrochloride. In addition to it, the product also contains additional elements: povidone and magnesium stearate.

Metformin is an active substance that stabilizes the level of glucose in human blood; when its readings are elevated, under the influence of metformin it decreases to normal levels.

This medicine is prescribed for long-term use in patients diagnosed with type 2 diabetes, if diet and normalization of living standards have not brought the expected results. Glucophage can also be used as a component of complex therapy. Reviews from patients speak of this drug as a rather mild and well-tolerated remedy.

Unlike a number of analogues, Glucophage does not have a targeted effect on insulin and does not change its level in the blood of a person who does not have diabetes. Modern pharmacies offer this medication in the form of a prolonged-acting (longer-acting) medication called Glucophage-Long. During treatment, only one Glucophage Long tablet per day is used.

How does the medicine work?

The use of Glucophage is designed for a fairly long time, and should be taken 2-3 pills daily. The peculiarity of the medication is its effect on the body. Unlike other drugs, this medication does not have a direct effect on insulin; the task of the drug is to directly influence the process of glucose production in hepatocytes (liver cells).

During a course of therapy using Glucophage, patients experience an increase in tissue sensitivity to insulin over time, which improves the absorption of glucose.

Before starting treatment, the patient should consult with the attending physician and under no circumstances self-medicate. The drug is taken according to the developed therapeutic regimen. Reception begins with small doses of the drug (400–500 mg), then the volume gradually increases to 2,000 mg per day. Moreover, it is prohibited to change the prescribed regimen; if suddenly for some reason the patient forgot to take the pill, you should not increase the subsequent dose, but take the medicine according to the regimen.

Indications

The main indications for prescribing this medication are a number of situations. Namely:

• established type 2 diabetes in adults and children over 10 years of age;
• obesity and overweight due to illness.

Contraindications and side effects

Even after consultation, the patient should carefully study the instructions for the drug, especially the contraindications. The instructions for Glucophage state that this medication has a number of strict contraindications. Namely:

• chronic alcoholism;
• ethanol intoxication;
• liver and kidney pathologies;
• problems with the cardiovascular and pulmonary systems.

Before prescribing this medication, patients undergo a specialized tolerance test, which reveals disorders in the body’s perception (absorption) of glucose. In the absence of tolerance, the drug is not prescribed.

Glucophage and alcohol: compatibility

For any kind of disorders associated with carbohydrate metabolism, doctors strongly advise you to completely forget about taking even a small dose of alcohol. Moreover, during treatment with Glucophage, additional intake of alcohol-based medications is prohibited. When taking this medication, do not forget that this is a rather serious drug, and not a simple dietary supplement. After all, after using the medicine, patients experience a drop in glucose levels by 15–20%, and glycosylated hemoglobin levels drop by 1.5–1.7%.

Consequences of joint use

But, despite all the assurances and warnings of doctors, many patients wonder why they should not drink alcohol during treatment. By the way, doctors warn not only about the inadmissibility of combining alcohol and drugs, Glucophage is also incompatible with some products and many medications. Such as:

• Valerian;
• Valocordin;
• Barboval.

It is strictly forbidden to combine Glucophage with drinks containing ethanol; this is indicated in a separate paragraph in the annotation for the drug.

By the way, such a ban is a common reason for patients refusing to undergo treatment using this drug. After all, the tandem: Glucophage and alcohol has extremely serious and sometimes fatal consequences, becoming dangerous not only to the health, but also to the life of the patient.

Hypoglycemic coma

Ethanol has a pronounced effect on glucose levels in the human body. Alcohol consumption leads to a drop in its level, which can give rise to the development of a condition such as hypoglycemia. If after drinking alcohol (even in small quantities) a person takes a Glucophage tablet, he risks experiencing a hypoglycemic coma. This condition is extremely life-threatening and is expressed by the following symptoms:

• cardiac arrhythmia;
• inappropriate behavior;
• tremor of the limbs;
• severe dizziness;
• double vision and spots in the eyes;
• paleness of the skin;
• hypertension;
• attacks of nausea up to vomiting;
• increased appetite;
• pronounced drowsiness;
• memory losses;
• semi-fainting state;
• feeling of lack of air, suffocation;
• development of a coma.

Lactic acidosis

When taking the drug and alcohol together, ethanol reacts actively with metformin, which directly affects the functioning of the liver. The liver organ begins intensive activity, as against the background of the interaction of alcohol and Glucophage, the production of toxic substances increases. In turn, excessive liver activity provokes an increase in lactate (lactic acid) levels in the body.

Hepatocides (liver cells) cannot cope with the sharply increased concentration of lactic acid, stop producing it and abundantly “throw” lactate into the blood. With the rapid accumulation of this substance in the body, lactic acidosis develops, a life-threatening condition.

The danger of the tandem of alcohol and Glucophage lies in the very rapid development of lactic acidosis, sometimes it is enough to take one pill of the drug and wash it down with 2-3 sips of light alcohol (beer or wine).

Against the background of lactic acidosis, the patient experiences a number of characteristic symptoms. They are:

• sharp stabbing pain in the stomach;
• severe nausea and profuse vomiting;
• decrease in all reflexes;
• paresis.

The main feature of this deadly pathology is its rapid development. Lactic acidosis has extremely dangerous consequences. These include collapse of the lungs and heart, thrombosis, hypothermia, urinary disturbances, coma and subsequent death. According to experts, people at particular risk include those suffering from diabetes:

• cardiovascular diseases;
• respiratory diseases;
• problems in the functioning of the kidneys and liver.

In such patients, taking even a sip of weak alcohol during treatment with Glucophage can lead to irreversible consequences. Sometimes the development of a fatal situation is provoked by taking medication with prohibited medications (containing an alcohol base).

Reduced efficiency

Doctors also resort to prescribing the drug to stabilize the patient’s weight. The mildest consequences of drinking alcohol in tandem with this medicine are the complete ineffectiveness of the therapeutic course. But usually such milder consequences are observed in patients with prediabetes; as a rule, patients have to deal with much more serious reactions of the body.

Other consequences

Ethanol, especially taken in large quantities, leads to global intoxication of internal organs, which entails the development of various pathological processes. Important organs that may be most affected are:

• liver;
• nervous system;
• kidneys;
• heart.

When prescribing Glucophage, doctors are required to warn patients about the prohibition of drinking. Moreover, you will have to forget about alcohol during the entire period of the course of therapy. And, given that the course of taking pills is quite long, doctors do not prescribe the drug if the patient has chronic alcoholism.

Combination rules

As already mentioned, during the entire course of taking the drug, the consumption of strong drinks (regardless of the degree of temperature) is prohibited. But, if there is a feast ahead and the patient cannot refuse the holiday, it is worth minimizing the risk of complications. To do this, you should drink light alcohol no earlier than 9–10 hours after taking the last Glucophage tablet. It is allowed to resume treatment 2–4 days after drinking (depending on the individual characteristics of the body).

conclusions

Alcohol rarely becomes compatible with medications. Every patient should know all the nuances about the specific treatment of their disease. In some cases, during the entire duration of the therapeutic course, taking even low-proof alcohol is strictly prohibited. This taboo directly relates to Glucophage, an effective medicine often prescribed to diabetics. And patients should approach their health extremely responsibly and seriously, because such a tandem not only leads to significant deterioration in health, but also threatens human life.

Reply to post

Replies to post: 1

Arina
25.11.2021

Good afternoon. New Year's holidays are coming soon. Of course, it’s difficult to give up going to see friends) If you stop taking it 3-4 days before and resume after partying 3-4 days later, then nothing critical should happen? Thank you.

Difficult choice

It is impossible to determine the best drug; they are all just building blocks in an integrated approach. Success in treating diabetes mellitus largely depends on the patient. In order to get the effect of taking drugs, not only the doctor must choose the right regimen and combine drugs, taking into account the risks from the kidneys, heart, and concomitant diseases. A person is required to change their lifestyle, eating habits, exercise, monitor glucose levels daily, keep a diary, and follow a diet. Only together can we achieve stable blood glucose levels.

Conservative treatment by an endocrinologist

With PCOS, tissue sensitivity to insulin decreases, which is characteristic of type II diabetes. To increase the sensitivity of cells to insulin, metformin (MF) is prescribed.

The drug normalizes carbohydrate metabolism, reduces the production of male sexual hormones, and stabilizes ovarian function. Taking into account the individual characteristics of the body, any methods of contraception are possible.

The goal of conservative treatment of PCOS is to restore the ovulatory menstrual cycle, eliminating the causes of infertility in women.

How to normalize the menstrual cycle?

To prevent the progression of the disease, combined oral contraceptives (COCs) are used. The drugs contain antiandrogens. They reduce the production of male sex hormones, which causes ovulation and the possibility of pregnancy.

If the COC course is completed and the ovulatory function is not normalized, hormonal drugs are prescribed to stimulate ovulation with a gradual increase in dosage. Additionally, drugs with an antiandrogenic effect (cyproterone acetate, spironolactone) can be used.

Patients note a decrease in skin oiliness and acne, and the intensity of hair growth increases. As an addition to drug therapy for hirsutism, it is recommended to use cosmetic methods for removing unwanted hair, for example, photoepilation.

What to do if after 3-6 months of treatment there is no ovulation?

If hormonal therapy does not have the desired effect, surgical intervention is required, in particular laparoscopy:

• decortication of the ovaries - the follicles are pierced with a needle;
• endothermocoagulation – targeted cauterization of the ovaries.

After laparoscopy, 50% of patients require ovulation induction. If there is no ovulation within 12 weeks, clomiphene citrate is prescribed. Another 6 months have passed and there is no result? The use of gonadotropins is recommended.