Tablets Maninil (1.75, 3.5 and 5 mg) for the treatment of type 2 diabetes mellitus

Maninil is designed for control of type 2 diabetes (non-insulin-dependent form).

Tablets are prescribed to diabetics in addition in the absence of planned effect after lifestyle modification (low-carbohydrate diet, adequate physical activity, weight management, emotional control, compliance with sleep and recreation).

Prescribes the medicine endocrinologist, calculating the treatment regimen taking into account the diet, age patient, stage of the disease, concomitant pathologies, general health and the body's response to a drug. The exact dosage of the drug is determined by targeting the glycemic profile of the patient.

Clinical and pharmacological group

Oral hypoglycemic drug.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Maninil cost? The average price in pharmacies is at the level of175 rubles.

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Form of issue and composition

"Maninil" comes in the form of round tablets of pink or pale pink color, packaged in bottles from a medical glass on 120 pieces in everyone or in cardboard packs (in one blister contains 20 tablets). Depending on the content of the active substance, three forms of the drug are distinguished:

• "Maninil, 5" (, 5 mg of glibenclamide);
• "Maninil (mg glibenclamide);
• "Maninil 5" (5 mg of glibenclamide).

As lapids in the form of monohydrate, lactose in the form of monohydrate is used as an auxiliary ingredient, so patients with lactase deficiency should take the drug with caution. In the composition of tablets also present: potato starch, talc, gelatin, silicon dioxide. Pink color is achieved by adding food additive E124, which is a food color.

Pharmacological effect

The active substance of the drug belongs to the category of sulfonylurea derivatives. It has a hypoglycemic effect, due to which it is convenient to use for the treatment of diabetes mellitus. Glibenclamide comes into contact with beta-cells of the pancreas, which increases the production of insulin in the body.

In addition, when taking these tablets, sensitivity to insulin increases. This promotes faster absorption of glucose by muscle tissues. A very important feature of Glibenclamide is its ability to slow down lipolysis, which avoids the development of atherosclerosis. Also, this drug prevents the formation of blood clots. The assimilation of Glibenclamide occurs from the digestive system. Activate this substance begins about 2 hours later. The drug actively comes into contact with proteins contained in the blood plasma. Metabolism is carried out in the liver, with the formation of two metabolites, which are considered inactive. One of them excretes the kidneys, the other is eliminated along with the bile.

To withdraw half of the substance in the body, it takes from 3 to 16 hours (this depends on the individual characteristics of the patient). The duration of exposure to the drug is at least 20 hours, while its effect is characterized by softness and physiology.

Indications for use

The drug is prescribed in cases where additional measures, such as moderate exercise, a reduced diet sugar content, weight loss does not affect the level of glucose in the blood, leading to normal physiological indicators.

The drug Maninil from diabetes is indicated for use by non-insulin dependent individuals with type 2 diabetes.

Contraindications

Medication can not be administered in the following situations:

• Diabetes mellitus type 1;
• Leukopenia;
• Diabetic coma and precoma, diabetic ketoacidosis;
• Condition after removal of the pancreas;
• Paresis of the stomach, intestinal obstruction;
• Deficiency of glucose-6-phosphate dehydrogenase;
• Pregnancy and the period of breastfeeding (lactation);
• Severe hepatic and renal insufficiency (with creatinine clearance less than 30 ml per minute);
• Hereditary lactose intolerance, lactase deficiency or lactose and glucose malabsorption syndrome;
• Age to 18 years (efficacy and safety of the use of Maninil in this age group of patients have not been studied);
• Hypersensitivity to the components of the drug, as well as to other derivatives of sulfonylurea, sulfonamides, probenecid, diuretic (diuretic) drugs with a sulfonamide group in the molecule (due to the possibility of developing cross reactions);
• Decompensation of carbohydrate metabolism in infectious diseases, injuries, burns, or after major surgical operations, when insulin therapy is indicated.

Maninil should be taken with caution to patients with acute alcohol intoxication, chronic alcoholism, febrile syndrome, thyroid diseases gland (with impaired function), hypofunction of the adrenal cortex or anterior pituitary gland, as well as to patients aged 70 years (because of the danger of hypoglycemia).

Use in pregnancy and lactation

Medication can not be administered to patients during breastfeeding and pregnancy.

In the case when pregnancy has come during therapy, the medicine is canceled.

Dosage and route of administration

The instructions for use indicate that the dose of Maninil depends on the age, the severity of the course of diabetes mellitus, the concentration of glucose in the blood on an empty stomach and 2 hours after ingestion.

Maninil should be taken before meals, without chewing and washing down with a small amount of liquid. Daily doses of the drug, up to 2 tab., Usually should be taken 1 time / day - in the morning, just before breakfast. Higher doses are divided into morning and evening reception.

• Initial dose of Maninil 1.75is 1-2 tab. (1.75-3.5 mg) 1 time / day. With insufficient effectiveness under the supervision of a doctor, the dose of the drug is gradually increased to the daily dose necessary to stabilize the carbohydrate metabolism. Increase the dose should be made at intervals of several days to 1 week, until the required therapeutic dose, which should not exceed the maximum. The maximum daily dose of Maninil 1.75 is 6 tablets. (10.5 mg).

If the daily dose of glibenclamide exceeds 3 tab. preparation Maninil 1.75, it is recommended to use the preparation Maninil 3.5.

The transition from other hypoglycemic drugs to Maninil 1.75 should be started under the supervision of a doctor with 1-2 tablets. Preparation Maninil 1.75 per day (1.75-3.5 mg), gradually increasing the dose to the required therapeutic.

• Initial dose of Maninil 3.5is 1 / 2-1 tab. (1.75-3 mg) 1 time / day. With insufficient effectiveness under the supervision of a doctor, the dose of the drug is gradually increased to the daily dose necessary to stabilize the carbohydrate metabolism. Increase the dose should be made at intervals of several days to 1 week, until the required therapeutic dose, which should not exceed the maximum. The maximum daily dose of Maninil 3.5 is 3 tab. (10.5 mg).

The transition from other hypoglycemic drugs to Maninil 3.5 should be started under the supervision of a doctor with 1 / 2-1 tab. Preparation Maninil 3.5 per day (1.75-3.5 mg), gradually increasing the dose to the required therapeutic.

• Initial dose of Maninil 5is 1 / 2-1 tab. (2.5-5 mg) 1 time / day. With insufficient effectiveness under the supervision of a doctor, the dose of the drug is gradually increased to the daily dose necessary to stabilize the carbohydrate metabolism. Increase the dose should be made at intervals of several days to 1 week, until the required therapeutic dose, which should not exceed the maximum. The maximum daily dose of Maninil 5 is 3 tab. (15 mg).

The transition from other hypoglycemic drugs to Maninil 5 should be started under the supervision of a doctor with 1 / 2-1 tab. drug Maninil 5 per day (2.5-5 mg), gradually increasing the dose to the required therapeutic.

In elderly patients, weakened patients, patients with reduced diet, in patients with severe impairment function of the kidney or liver initial and maintenance dose of the drug Maninil will reduce because of the danger of development hypoglycemia.

If you miss one dose of the drug, the next pill should be taken at the usual time, while a higher dose is not allowed.

Side effects

According to the patients' reviews, Maninil may have side effects, such as:

1. Hepatitis, intrahepatic cholestasis, a temporary increase in the activity of liver enzymes (from the bile duct and liver).
2. Nausea, eructation, a feeling of heaviness in the stomach, abdominal pain, vomiting, metallic taste in the mouth, diarrhea (from the digestive system);
3. Hyperthermia, hunger, drowsiness, tachycardia, weakness, impaired coordination of movements, headache, damp skin integuments, tremors, feelings of fear, general anxiety, transient neurological disorders, weight gain (on the part of the exchange substances).
4. Thrombocytopenia, pancytopenia, agranulocytosis, leukopenia, hemolytic anemia, erythropenia (from the hemopoietic system).
5. Itching, petechiae, urticaria, photosensitization, allergic vasculitis, purpura, anaphylactic shock, generalized allergic reactions accompanied by fever, skin rash, proteinuria, arthralgia and jaundice (from the immune side system).

In addition, Maninil may cause increased diuresis, visual impairment, accommodation disorder, hyponatremia, transient proteinuria, cross-allergies to probenecis, sulfonamides, sulfonylureas and diuretic preparations containing a sulfonamide group.

Overdose

Symptoms with an overdose of the drug manifest themselves in the form of hypoglycemia, hunger, hyperthermia, tachycardia, drowsiness, weakness, moisture of the skin, impaired coordination of movements, tremor, general anxiety, fear, headache, transient neurological disorders (eg, visual and speech disorders, manifestations of paresis or paralysis, or altered perceptions sensations). With the progression of hypoglycemia, patients may lose self-control and consciousness, the development of hypoglycemic coma.

To eliminate symptoms of overdose and mild hypoglycemia, the patient should take inside a piece of sugar, food or drinks high in sugar (jam, honey, a glass of sweet tea). In case of unconsciousness, 40-80 ml of 40% dextrose (glucose) solution should be injected into / from glucose, then infusion of 5-10% dextrose solution. Then you can additionally enter 1 mg glucagon IV, IM or SC. If the patient does not regain consciousness, then this measure can be repeated; further intensive care may be required.

special instructions

Before you start using the drug, read the special instructions:

1. During treatment, prolonged exposure to the sun is not recommended.
2. Long-term abstinence from eating, insufficient provision of carbohydrates, intense physical activity, diarrhea or vomiting are a risk of developing hypoglycemia.
3. During treatment with Maninil it is necessary to strictly follow the doctor's recommendations for diet compliance and self-monitoring of blood glucose concentration.
4. In elderly patients, the risk of developing hypoglycemia is somewhat higher, so a more careful selection is needed dose of the drug and regular monitoring of fasting blood glucose and post-prandial blood glucose, especially at the beginning treatment.
5. Simultaneous administration of drugs that have an effect on the central nervous system, lowering blood pressure (including beta-blockers), as well as peripheral neuropathy can mask symptoms of hypoglycemia.
6. Large surgical interventions and injuries, extensive burns, infectious diseases with febrile syndrome may require the abolition of oral hypoglycemic drugs and prescription insulin.
7. Alcohol can provoke the development of hypoglycemia, as well as the development of a disulfiram-like reaction (nausea, vomiting, abdominal pain, a feeling of fever in the skin of the face and the upper part of the trunk, tachycardia, dizziness, headache), so you should refrain from drinking alcohol during treatment with the drug Maninil.

Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

1. Urine acidifying agents (ammonium chloride, calcium chloride) enhance the effect of Maninil by decreasing the degree of its dissociation and increasing its reabsorption.
2. Pentamidine in a few cases can cause a strong decrease or increase in the concentration of glucose in the blood.
3. H2-receptor antagonists can on one side weaken, and on the other increase the hypoglycemic effect of Maninil.
4. With simultaneous application with the drug, Maninil may intensify or weaken the effect of coumarin derivatives.
5. Along with the increase in hypoglycemic action, beta-blockers, clonidine, guanethidine and reserpine, as well as medicines with a central mechanism of action, can weaken the sensation of precursors of symptoms hypoglycemia.
6. The hypoglycemic effect of the drug Maninil may decrease with the simultaneous use of barbiturates, isoniazid, diazoxide, GCS, glucagon, nicotinates (in high doses), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, oral contraceptives and estrogens, drugs of thyroid hormones, sympathomimetic drugs, slow calcium blockers channels, lithium salts.

An increase in the hypoglycemic effect of the drug Maninil is possible with simultaneous administration with ACE inhibitors, anabolic agents and male sex hormones, other oral hypoglycemic agents (eg, acarbose, biguanides) and insulin, azapropion, NSAIDs, beta-blockers, quinolone derivatives, chloramphenicol, clofibrate and its analogs, coumarin derivatives, disopyramide, fenfluramine, antifungal drugs (miconazole, fluconazole), fluoxetine, MAO inhibitors, PASC, pentoxifylline (at high doses at parenteral administration), perhexylamine, pyrazolone derivatives, phosphamides (e.g., cyclophosphamide, ifosfamide, trophosphamide), probenecid, salicylates, sulfonamides, tetracyclines and tritvaline.

Reviews

We picked up some reviews of people taking the drug Maninil:

1. Victor. I drink 4 tablets, 2 in the morning, 2 in the evening the sugar fell to, before that on the glyidiab reached 1,. In short it helps perfectly, but you need to monitor the diet, a couple of times because of this sugar fell before,.
2. Andrei. It is necessary to know that diabetes mellitus is of the first type and the second. At the first type of diabetes from birth, at the second type - acquired throughout life. Also, diabetes is insulin dependent and insulin independent. Maninil is used in the second type, insulin is independent. Assigned by an endocrinologist, with strict adherence to diet for correcting body weight. The dosage depends on the amount of glucose in the urine. The use of simple - to wash down tablets with water on an empty stomach. The drug is good and effective. My grandmother took it when they discovered diabetes.
3. Natalia. Maninil tablets prescribed to my grandfather, suffering from diabetes for more than 5 years. I buy him this drug for the second year. Side effects of the drug did not cause, the only thing that at first we acted according to the doctor's instructions - took 1 tablet daily for six months, then, due to stress, switched to 2.

Analogues

With the same active component of Glibenclamide, Maninil can be replaced with Glibenclamide and Glybamide. Indications, contraindications, side effects they are absolutely identical. According to the 4th-level ATC code for Maninil analogues can be Gliadab, Gliklazid, Diabeton, Gljurenorm, which have a similar therapeutic effect.

Before using analogues, consult your doctor.

Storage conditions and shelf life

Keep out of the reach of children. Maninil, 5 and, mg at a temperature of not more than + 30 ° C. Maninil 5 mg at a temperature of not more than + 25 ° C.

Shelf life - 3 years.

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