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What Glimmegamma is and what it is used for
Glimemagma is a medicine for lowering blood sugar (an antidiabetic medicine for oral administration). This drug belongs to a group of products that lower blood sugar and are called sulphonylureas. Glimmegma works by increasing the amount of insulin released by your pancreas. Insulin then lowers blood sugar levels.
Glimemia is used in type 2 diabetes mellitus when only diet, exercise and weight loss have insufficient effect.
If you do not feel better or your condition gets worse, you should seek medical attention.
2. What you need to know before you take Glimmegma
Do not take Glimmegma:
if you are allergic to glimepiride or other medicinal products of the same group (sulphonamides and sulphonylureas) or to any of the other ingredients of this medicine (listed in section 6);
if you have a serious kidney function disorder;
if you have a serious impairment of liver function;
if you have insulin-dependent diabetes (type 1 diabetes mellitus);
if you have diabetic ketoacidosis (a complication of diabetes that leads to increased levels of acidity in your body.) Symptoms include fatigue, nausea, frequent urination, and muscle stiffness;
if you are in a diabetic coma (somnolence or loss of consciousness due to elevated blood sugar).
Warnings and precautions
Talk to your doctor or pharmacist before taking Glimmegam, especially if:
you recover after trauma, surgery, temperature infections, or other forms of stress. Tell your doctor about this, as a temporary change in treatment may be necessary;
have a severe kidney or liver disorder.
In patients with a lack of glucose-6-phosphate dehydrogenase, a decrease in hemoglobin and a decrease in red blood cell count (haemolytic anemia) may occur.
Important information about hypoglycaemia (low blood sugar)
During the first few weeks of treatment, it is possible to increase the risk of lowering blood sugar (hypoglycaemia) and therefore it is extremely important that you are under close supervision of your doctor. Please see further information on hypoglycaemia, its signs and treatment.
The following factors may increase the risk of hypoglycaemia:
irregular meals or if you miss meals;
changing your diet;
increase your physical activity and intake of carbohydrates not responding to this increase;
alcohol consumption, especially when you miss a meal;
if you are taking other medicines or natural medicines at the same time (see also "Other medicines and Glimmegam");
administration of high doses of glimepiride;
if you suffer from particular hormonal disorders (functional disorders of the thyroid gland, pituitary gland or adrenal gland);
decreased kidney function;
severely impaired liver function.
If you have low blood sugar (hypoglycaemia), you may have the following symptoms: headache, feeling hungry, exhaustion, nausea, vomiting, sluggishness, drowsiness, sleep disturbances, anxiety, aggression, attention deficit disorder, reduced alertness reaction time, depression, confusion, speech and vision disorders, aphasia, tremor, paresis, sensory disturbances, dizziness and helplessness.
The following symptoms may also occur: sweating, sticky skin, anxiety, rapid heartbeat, high blood pressure, palpitations, sudden severe chest pain that may spread to adjacent areas (chest pain) and cardiac arrhythmias.
If your blood glucose levels continue to fall, you may experience serious confusion (seizure), seizures, loss of self-control, your breathing may become superficial and your heart rate may slow down, you may become unconscious .
The clinical picture of severely low blood sugar may resemble the clinical picture of stroke (stroke).
Treatment of hypoglycaemia
In most cases, signs of low blood sugar disappear very quickly when you take sugar in some form, grape sugar, sugar lumps, sweet juice, sweetened tea.
Therefore, you should always carry sugar in any form (for example, lumps of sugar). You should remember that sweeteners are not effective. Please contact your doctor or visit a hospital if the intake of sugar does not help or the symptoms recur.
The level of sugar in the blood or urine should be checked regularly. Your doctor may also perform blood tests to monitor blood cell levels and liver function.
Signs of low blood sugar may be missing, poor or very slow. You do not know in time when your blood sugar level has fallen. This can happen
weight loss medications (fenfluramine);
high cholesterol lowering drugs (fibrates);
medicines for the treatment of cancer (cycl-, tri- and andphosphamides);
medicines for the treatment of allergies, such as hay fever (tritoqualine);
medicines for improving blood flow (pentoxifylline);
gout medicines (probenecid, allopurinol, sulphinpyrazone).
The blood glucose lowering effect of Glimmegma may be diminished and blood sugar levels may increase with some of the following medicines:
medicines containing female sex hormones (estrogens and progestogens);
urine release drugs (saluretics, thiazide diuretics);
Thyroid stimulating drugs (such as levothyroxine);
medicines for the treatment of allergies and inflammations (glucocorticoids);
medicines to treat severe psychiatric disorders (chlorpromazine and phenothiazine derivatives);
medicines for the treatment of epilepsy (phenytoin);
medicines to treat high blood pressure or low blood sugar (diazoxide);
medicines for the treatment of infections and tuberculosis (rifampicin);
medicines for the treatment of very low blood glucose (glucagon);
medicines for anxiety and sleep problems (barbiturates);
medicines used at elevated intraocular pressure (acetazolamide);
medicines used to increase heart rate, treat asthma, nasal congestion, cough and cold, to reduce body weight or to use in emergency life-threatening cases (adrenaline and sympathomimetics);
medicines for the treatment of high cholesterol (nicotinic acid);
medicines to treat constipation when used for a long time (laxative).
The following medicines may increase or decrease the ability of Glimmegma to lower blood sugar:
medicines for the treatment of gastric or duodenal ulcer (H2-receptor antagonists);
medicines to treat high blood pressure or heart failure (beta-blockers, clonidine, guanethidine and reserpine). They may also hide the signs of hypoglycaemia, so it is necessary to apply them with caution.
Glimmegam can potentiate or reduce the effects of blood-clotting drugs (coumarin derivatives such as warfarin).
Glimmegamma with food, beverages and alcohol
Glimmegamma should be taken as a single dose just before or during breakfast or at the first main meal of the day, and the tablet should be swallowed whole with water (at least half a cup).
Alcohol may increase or reduce in an unpredictable way the ability of Glimmegma to lower blood sugar.
Pregnancy and breastfeeding
If you are pregnant or breast-feeding, think you may be pregnant or planning to become pregnant, ask your doctor or pharmacist for advice before taking this medicine.
Glimmegamma should not be taken during pregnancy.
It is possible for Glimmegma to pass into breast milk. Glimmegamma should not be taken during breast-feeding.
Driving and using machines
Your ability to concentrate or react may be reduced if your blood sugar is lowered (hypoglycaemia) or increased (hyperglycaemia) or if you experience vision problems as a consequence of these conditions. Keep in mind that you may endanger yourself or others (eg when driving or using machines). Please ask your doctor if you can drive if:
have frequent episodes of hypoglycaemia;
you have less or have no warning signs of hypoglycaemia.
Glimmegamma contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
3. How to take Glimmegma
Always take this medicine exactly as your doctor has told you. If you are not sure, ask your doctor or pharmacist.
Glimmegam should be taken orally (orally) just before or during the first meal of the day (usually breakfast). If you do not have breakfast, you should take Glimem Gamma on the schedule prescribed by your doctor. It is important that you do not miss a meal when you are treated with Glimmegma.
Glimmegma tablets should be swallowed with at least half a glass of water. Do not chew or break the tablets.
How much to take
The starting dose depends on your needs, condition and results of your blood sugar and urine tests and is determined by your doctor.
Do not take more tablets than your doctor prescribed.
The usual starting dose is 1 mg glimepiride per day. If you achieve good control of your blood sugar, you can stay at this dose. If 1 mg does not control your blood sugar well, your doctor may increase the dose after 1-2 weeks of treatment to 2, 3 or 4 mg of glimepiride per day:
If good blood glucose control is achieved, the dose will be used for maintenance treatment.
The maximum recommended dose is 6 mg glimepiride
If you forget to take Glimmegma
Do not take a double dose to make up for missed individual doses. Take your next tablet (s) and, as usual, continue your treatment.
If you stop using Glimmegma
If you stop or stop treatment, you should know that the desired blood glucose lowering effect is not achieved or that the illness will worsen again. If any change is necessary, it is essential to first contact your doctor.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everyone gets them.
Tell your doctor immediately if you experience any of the following symptoms:
Allergic reactions (including inflammation of the blood vessels, often accompanied by skin rash), which may develop into serious reactions with difficulty in breathing, lowering of blood pressure and sometimes progressing to shock;
Hepatic dysfunction including yellowing of the skin and eyes (jaundice), problems with bile duct drainage (cholestasis), liver inflammation (hepatitis) or hepatic insufficiency;
Allergy (hypersensitivity) of the skin such as itching, rash, hives and increased sensitivity to the sun. Some mild allergic reactions may develop into severe reactions;
Severe hypoglycaemia, including loss of consciousness, convulsions and coma.
Some patients have experienced the following side effects while taking Glimmegam:
Rare side effects (may affect up to 1 in 1,000 patients):
Blood sugar level lower than normal (hypoglycaemia) (see section 2 "Warnings and Precautions");
Decrease in blood counts:
platelets (which increases the risk of bleeding or bruising);
white blood cells (which makes the occurrence of infections more likely);
red blood cells (which can cause skin pallor, and cause weakness or shortness of breath).
These problems usually resolve after stopping Glimmegma.
Very rare side effects (may affect up to 1 in 10,000 patients):
Allergic reactions (including inflammation of the blood vessels, often accompanied by skin rash), which may develop into severe reactions with difficulty in breathing, lowering of blood pressure and sometimes progressing to shock. If any of these symptoms occur to you, tell your doctor immediately.
Hepatic function disorders including yellowing of the skin and eyes (jaundice), problems with bile duct drainage (cholestasis), liver inflammation (hepatitis) or hepatic insufficiency. If any of these symptoms occur to you, tell your doctor immediately.
Nausea, vomiting, diarrhea, feeling full or swollen and abdominal pain;
Decrease in blood sodium (shown by blood tests).
Not known (can not be estimated from available data):
Allergy (hypersensitivity) of the skin, which may be as itching, rash, hives and increased sensitivity to the sun. Some mild allergic reactions may develop into serious reactions with swallowing or breathing problems, swelling of the lips, throat or tongue. If you experience one of these side effects, tell your doctor immediately.
Allergic reactions to sulphonylureas, sulphonamides or related (similar) medicinal products may occur;
Ear problems with vision may occur at the start of treatment with Glimmegamma. This is due to changes in blood sugar levels and should soon be improved;
Increased levels of liver enzymes;
Severely unusual bleeding or bruising under the skin.
How to store Glimmegma
Keep out of the reach and sight of children.
This medicine does not require any special storage conditions.
Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.
Do not use this medicine if you notice any visible changes in the appearance of the product.
Do not dispose of medicines in the sewer or in the household waste container. Ask your pharmacist how to dispose of medicines you no longer use. These measures will help to protect the environment.
6. Package Contents and Additional Information
What Glimmegma contains
The active substance is glimepiride.
The other ingredients are: lactose monohydrate, sodium starch glycolate type A, microcrystalline cellulose, povidone K30, magnesium stearate, indigo carmine (E132).
What Glimmegamma looks like and contents of the pack
Glimmegam 4 mg tablets are light blue, oblong, scored on both sides.
Glimmega 4 mg tablets are available in transparent PVC / aluminum blisters.
Packs: containing 30, 60 and 120 tablets.
Not all pack sizes may be marketed.
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