Метформин-Канон Таблетки, 30 шт, 1 г, в пленочной оболочке

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При одновременном приеме пищи абсорбция метформина снижается и задерживается. Абсолютная био доступность составляет 50-60 %. Максимальная концентрация в крови (Сmax) - 2 мкг/мл время достижения максимальной концентрации (ТСmax) - 181-269 ч. Метформин быстро распределяется в ткани. Проникает в эритроциты. Накапливается в слюнных железах печени и почках. Объем распределения (для дозы 850 мг) составляет 296-1012 л. Связь с белками плазмы - незначительная. Подвергается метаболизму в очень слабой степени. Выводится почками преимущественно в неизмененном виде. Клиренс метформина у здоровых лиц составляет 400 мл/мин. Период полувыведения (Т1/2) - 62 ч (начальный Т1/2 - от 17 до 3 ч терминальный - от 9 до 17 ч). При почечной недостаточности он возрастает появляется риск кумуляции препарата."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Сахарный диабет 2 типа у взрослых (особенно у пациентов с ожирением) при неэффективности диетотерапии и физических нагрузок в качестве монотерапии или в комбинации с другими пероральными гипогликемическими средствами или инсулином. Сахарный диабет 2 типа у детей с 10-летнего возраста - как в качестве монотерапии так и в комбинации с инсулином."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"\n\n- Повышенная чувствительность к метформину или к любому вспомогательному веществу."}},{"type":"paragraph","data":{"text":"- Диабетический кетоацидоз диабетическая прекома кома."}},{"type":"paragraph","data":{"text":"- Почечная недостаточность или нарушение функции почек (клиренс креатинина (КК) менее 60 мл/мин)."}},{"type":"paragraph","data":{"text":"- Острые состояния протекающие с риском развития нарушений функции почек:"}},{"type":"paragraph","data":{"text":"- дегидратация (при диарее рвоте) лихорадка тяжелые инфекционные заболевания"}},{"type":"paragraph","data":{"text":"- состояния гипоксии (шок сепсис инфекции почек бронхо-легочные заболевания)."}},{"type":"paragraph","data":{"text":"- Клинически выраженные проявления острых и хронических заболеваний которые могут приводить к развитию тканевой гипоксии (в том числе - сердечная или дыхательная недостаточность острый инфаркт миокарда)."}},{"type":"paragraph","data":{"text":"- Обширные хирургические операции и травмы когда показано проведение инсулинотерапии (см. раздел \"Особые указания\")."}},{"type":"paragraph","data":{"text":"- Печеночная недостаточность нарушение функции печени."}},{"type":"paragraph","data":{"text":"- Хронический алкоголизм острое отравление алкоголем."}},{"type":"paragraph","data":{"text":"- Лактоацидоз в том числе в анамнезе."}},{"type":"paragraph","data":{"text":"- Применение в течение не менее 48 ч до и 48 ч после проведения радиоизотопных или рентгенологических исследований с введением йодсодержащего контрастного вещества (см. раздел \"Взаимодействие с другими лекарственными средствами\")."}},{"type":"paragraph","data":{"text":"- Период не менее 48 ч до и 48 ч после хирургических вмешательств под общим наркозом спинномозговой или перидуральной анестезией."}},{"type":"paragraph","data":{"text":"- Соблюдение гипокалорийной диеты (менее 1000 ккал/сут)."}},{"type":"paragraph","data":{"text":"- Детский возраст до 10 лет.\n\n"}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"У лиц в возрасте старше 60 лет выполняющих тяжелую физическую работу (повышенная опасность развития лактоацидоза)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"\n\nПрепарат противопоказан к применению при беременности и в период грудного вскармливания."}},{"type":"paragraph","data":{"text":"При планировании или возникновении беременности Метформин Канон следует отменить и применить инсулинотерапию. Пациентку следует предупредить о необходимости поставить в известность врача в случае возникновения беременности. За матерью и ребенком следует установить наблюдение."}},{"type":"paragraph","data":{"text":"Неизвестно выделяется ли метформин с грудным молоком. При необходимости применения препарата в период лактации грудное вскармливание следует прекратить.\n\n"}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nТаблетки следует принимать внутрь проглатывая целиком не разжевывая во время или непосредственно после еды запивая достаточным количеством воды."}},{"type":"paragraph","data":{"text":"Взрослые"}},{"type":"paragraph","data":{"text":"Монотерапия и комбинированная терапия с другими пероральными гипогликемическими средствами"}},{"type":"paragraph","data":{"text":"Рекомендуемая начальная доза составляет 1000-1500 мг/сут. Для уменьшения побочных явлений со стороны ЖКТ дозу следует разделить на 2-3 приема. Через 10-15 дней при отсутствии неблагоприятных эффектов со стороны ЖКТ возможно дальнейшее постепенное увеличение дозы в зависимости от концентрации глюкозы в крови. Медленное увеличение дозы может способствовать улучшению желудочно-кишечной переносимости препарата."}},{"type":"paragraph","data":{"text":"Поддерживающая суточная доза составляет 1500-2000 мг. Максимальная суточная доза составляет 3000 мг разделенная на 3 приема."}},{"type":"paragraph","data":{"text":"При планировании перехода с приема другого перорального гипогликемического средства на препарат Метформин Канон необходимо прекратить прием другого гипогликемического средства и начать прием Метформин Канон в вышеуказанных дозах."}},{"type":"paragraph","data":{"text":"Комбинированная терапия с инсулином"}},{"type":"paragraph","data":{"text":"Рекомендуемая начальная доза препарата Метформин Канон 500 мг и 850 мг - 1 таблетка 2-3 раза в сутки Метформин Канон 1000 мг - 1 таблетка 1 раз в сутки дозу инсулина при этом подбирают на основании показателей концентрации глюкозы в крови."}},{"type":"paragraph","data":{"text":"Дети старше 10 лет"}},{"type":"paragraph","data":{"text":"Метформин Канон применяется при монотерапии и в комбинированной терапии с инсулином."}},{"type":"paragraph","data":{"text":"Рекомендуемая начальная доза препарата Метформин Канон - 500 мг 1 раз в сутки вечером во время еды. Через 10-15 дней дозу препарата необходимо скорректировать на основании концентрации глюкозы в крови. Поддерживающая доза составляет 1000-1500 мг/сут в 2-3 приема. Максимальная суточная доза - 2000 мг в 3 приема."}},{"type":"paragraph","data":{"text":"Пациенты пожилого возраста"}},{"type":"paragraph","data":{"text":"Из-за возможного снижения функции почек дозу препарата Метформин Канон следует подбирать под регулярным контролем показателей функции почек (контроль концентрации креатинина в сыворотке крови не реже 2-4 раз в год)."}},{"type":"paragraph","data":{"text":"Длительность лечения определяет врач. Не рекомендуется прерывание приема препарата без указания лечащего врача.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\n\nСо стороны центральной нервной системы: нарушение вкуса (\"металлический\" привкус во рту)."}},{"type":"paragraph","data":{"text":"Со стороны ЖКТ: тошнота рвота диарея боли в животе и отсутствие аппетита."}},{"type":"paragraph","data":{"text":"Возникновение данных побочных эффектов наиболее вероятно в начальный период лечения и в. большинстве случаев они спонтанно проходят. Для предотвращения симптомов рекомендуется принимать метформин во время или после приема пищи. Медленное увеличение дозы может улучшить желудочно-кишечную переносимость."}},{"type":"paragraph","data":{"text":"Со стороны гепатобилиарной системы: нарушение показателей функции печени гепатит. После отмены метформина нежелательные явления как правило полностью исчезают."}},{"type":"paragraph","data":{"text":"Аллергические реакции: очень редко - эритема кожный зуд сыпь крапивница."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ: очень редко - лактоацидоз (требует отмены препарата)."}},{"type":"paragraph","data":{"text":"Прочие: очень редко - при длительном применении развивается гиповитаминоз В12 (в том числе мегалобластная анемия) и фолиевой кислоты (нарушение всасывания). Опубликованные данные показывают что в ограниченной детской популяции в возрасте от 10 до 16 лет побочные эффекты по характеру и тяжести схожи с таковыми у взрослых пациентов.\n\n"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\n\nСимптомы: при применении метформина в дозе 85 г не наблюдалось гипогликемии однако отмечалось развитие лактоацидоза. Ранними симптомами лактоацидоза являются тошнота рвота диарея снижение температуры тела боли в животе боли в мышцах в дальнейшем может отмечаться учащение дыхания головокружение нарушение сознания и развитие комы."}},{"type":"paragraph","data":{"text":"Лечение: В случае появления признаков лактоацидоза лечение препаратом необходимо немедленно прекратить больного срочно госпитализировать и определив концентрацию лактата уточнить диагноз. Наиболее эффективным мероприятием по выведению из организма лактата и метформина является гемодиализ. Проводят также симптоматическое лечение.\n\n"}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nПротивопоказанные комбинации"}},{"type":"paragraph","data":{"text":"Радиологические исследования с применением йодсодержащих рентгеноконтрастных препаратов может вызвать развитие лактоацидоза у больных сахарным диабетом на фоне функциональной почечной недостаточности. Применение метформина следует отменить за 48 ч до и не возобновлять ранее 48 ч после рентгенологического исследования с использованием рентгеноконтрастных препаратов."}},{"type":"paragraph","data":{"text":"Нерекомендуемые комбинации"}},{"type":"paragraph","data":{"text":"При одновременном применении метформина с алкоголем и этанолсодержащими препаратами во время острой алкогольной интоксикации при голодании или соблюдении низкокалорийной диеты а также при печеночной недостаточности повышается риск развития лактоацидоза."}},{"type":"paragraph","data":{"text":"Комбинации требующие особой осторожности"}},{"type":"paragraph","data":{"text":"При одновременном применении метформина с даназолом возможно развитие гипергликемического эффекта. При необходимости лечения даназолом и после прекращения его приема требуется коррекция дозы метформина под контролем концентрации глюкозы в крови."}},{"type":"paragraph","data":{"text":"Хлорпромазин в высоких дозах (100 мг/сут) уменьшает высвобождение инсулина и повышает концентрацию глюкозы в крови. При одновременном применении с нейролептиками и после прекращения их приема требуется коррекция дозы метформина под контролем концентрации глюкозы в крови."}},{"type":"paragraph","data":{"text":"Глюкокортикостероиды (ГКС) при парентеральном и местном применении снижают толерантность к глюкозе и повышают концентрацию глюкозы в крови в некоторых случаях вызывая кетоз. При необходимости применения такой комбинации и после прекращения приема ГКС требуется коррекция дозы метформина под контролем концентрации глюкозы в крови."}},{"type":"paragraph","data":{"text":"При одновременном применении \"петлевых\" диуретиков и метформина имеется риск развития лактоацидоза из-за возможного появления функциональной почечной недостаточности."}},{"type":"paragraph","data":{"text":"Применение в виде инъекций бета2-адреномиметиков снижает гипогликемическое действие метформина вследствие стимуляции бета2-адренорецепторов. В этом случае следует контролировать концентрацию глюкозы в крови и при необходимости применять инсулин."}},{"type":"paragraph","data":{"text":"Ингибиторы ангиотензинпревращающего фермента и другие антигипертензивные препараты могут снижать концентрацию глюкозы в крови. При необходимости следует скорректировать дозу метформина."}},{"type":"paragraph","data":{"text":"При одновременном применении метформина с производными сульфонилмочевины инсулином акарбозой и салицилатами возможно усиление гипогликемического действия. Нифедипин повышает абсорбцию и Сmax метформина что необходимо учитывать при их одновременном применении."}},{"type":"paragraph","data":{"text":"\"Петлевые\" диуретики и нестероидные противовоспалительные препараты (НПВП) повышают риск снижения функции почек. В этом случае необходимо соблюдать осторожность при применении метформина.\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nВ период лечения метформином необходимо регулярно контролировать концентрацию глюкозы в крови натощак и после еды."}},{"type":"paragraph","data":{"text":"Пациента следует предупредить о необходимости прекратить прием препарата и обратиться к врачу при появлении рвоты болей в животе мышечных болей общей слабости и сильного недомогания. Данные симптомы могут быть признаком начинающегося лактоацидоза."}},{"type":"paragraph","data":{"text":"Метформин следует отменить за 48 ч до и 48 ч после проведения рентгенологического исследования (в том числе урографии внутривенной ангиографии) с использованием рентгеноконтрастных препаратов."}},{"type":"paragraph","data":{"text":"Поскольку метформин выводится почками перед началом лечения и регулярно в последующем следует определять концентрацию креатинина: у пациентов с сохраненной функцией почек 1 раз в год; у пациентов с пониженным КК и у пожилых пациентов -2-4 раза в год."}},{"type":"paragraph","data":{"text":"Особую осторожность следует проявлять при нарушении функции почек например в начальный период терапии антигипертензивными средствами диуретиками НПВП. Следует проинформировать пациента о необходимости обращения к врачу при появлении симптомов бронхо-легочной инфекции или инфекционного заболевания мочеполовых органов."}},{"type":"paragraph","data":{"text":"На фоне применения метформина следует воздерживаться от приема алкоголя в связи с повышенным риском развития гипогликемии и дисульфирамоподобного эффекта. Гиповитаминоз В12 при приеме метформина обусловлен нарушением всасывания и'имеет обратимый характер. При отмене препарата признаки гиповитаминоза В12 быстро исчезают.\n\n"}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nМонотерапия метформином не вызывает гипогликемии и поэтому не влияет на способность управлять автотранспортом и работать с механизмами."}},{"type":"paragraph","data":{"text":"При применении метформина с другими гипогликемическими средствами (производными сульфонилмочевины - инсулином и т.д.) возможно развитие гипогликемических состояний при которых ухудшается способность к управлению автотранспортом и занятиям другими потенциально опасными видами деятельности требующими повышенного внимания и быстрых психомоторных реакций.\n\n"}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки покрытые пленочной оболочкой 500 мг 850 мг 1000 мг."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"\n\nВ сухом защищенном от света месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте.\n\n"}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не применять по истечении срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Закрытое акционерное общество \"Канонфарма продакшн\" (ЗАО \"Канонфарма продакшн\")"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ЗАО \"Канонфарма продакшн\""}}]}],"source":null},"description_toggle":false,"short_description":"Метформин - пероральное гипогликемическое средство из группы бигуанидов. У больных сахарным диабетом снижает концентрацию глюкозы в крови путем угнетения глюконеогенеза в печени уменьшения всасывания глюкозы из желудочно-кишечного тракта (ЖКТ) и повышения ее утилизации в тканях за счет повышения их чувствительности к инсулину (преимущественно поперечно-полосатой мускулатуры в меньшей степени - -жировой ткани). Стимулирует внутриклеточный гликогенез активируя гликогенсинтазу. В отличие от производных сульфонилмочевины не стимулирует секрецию инсулина и не оказывает гипогликемического эффекта у здоровых лиц. Оказывает влияние на липидный обмен - снижает концентрацию в сыворотке крови триглицеридов холестерина и липопротеинов низкой плотности. Стабилизирует или снижает массу тела. Оказывает фибринолитическое действие за счет подавления ингибитора активатора плазминогена тканевого типа. После приема внутрь абсорбция метформина из ЖКТ составляет 48-52%. При одновременном приеме пищи абсорбция метформина снижается и задерживается. Абсолютная био доступность составляет 50-60 %. Максимальная концентрация в крови (Сmax) - 2 мкг/мл время достижения максимальной концентрации (ТСmax) - 181-269 ч. Метформин быстро распределяется в ткани. Проникает в эритроциты. Накапливается в слюнных железах печени и почках. Объем распределения (для дозы 850 мг) составляет 296-1012 л. Связь с белками плазмы - незначительная. Подвергается метаболизму в очень слабой степени. Выводится почками преимущественно в неизмененном виде. Клиренс метформина у здоровых лиц составляет 400 мл/мин. Период полувыведения (Т1/2) - 62 ч (начальный Т1/2 - от 17 до 3 ч терминальный - от 9 до 17 ч). 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