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DRUGS & SUPPLEMENTS
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Mopaday HS
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Mopaday HS uses
Mopaday HS consists of Metformin, Pioglitazone.Metformin:
Mopaday HS (Metformin) is a biguanide antihyperglycemic agent used for treating non-insulin-dependent diabetes mellitus (NIDDM). It improves glycemic control by decreasing hepatic glucose production, decreasing glucose absorption and increasing insulin-mediated glucose uptake. Mopaday HS (Metformin) is the only oral antihyperglycemic agent that is not associated with weight gain. Mopaday HS (Metformin) may induce weight loss and is the drug of choice for obese NIDDM patients. When used alone, Mopaday HS (Metformin) does not cause hypoglycemia; however, it may potentiate the hypoglycemic effects of sulfonylureas and insulin. Its main side effects are dyspepsia, nausea and diarrhea. Dose titration and/or use of smaller divided doses may decrease side effects. Mopaday HS (Metformin) should be avoided in those with severely compromised renal function (creatinine clearance < 30 ml/min), acute/decompensated heart failure, severe liver disease and for 48 hours after the use of iodinated contrast dyes due to the risk of lactic acidosis. Lower doses should be used in the elderly and those with decreased renal function. Mopaday HS (Metformin) decreases fasting plasma glucose, postprandial blood glucose and glycosolated hemoglobin (HbA1c) levels, which are reflective of the last 8-10 weeks of glucose control. Mopaday HS (Metformin) may also have a positive effect on lipid levels.
Indication: For use as an adjunct to diet and exercise in adult patients (18 years and older) with NIDDM. May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome (PCOS).
Mopaday HS (Metformin) is an oral antihyperglycemic agent that improves glucose tolerance in patients with NIDDM, lowering both basal and postprandial plasma glucose. Mopaday HS (Metformin) is not chemically or pharmacologically related to any other class of oral antihyperglycemic agents. Unlike sulfonylureas, Mopaday HS (Metformin) does not produce hypoglycemia in either patients with NIDDM or healthy subjects and does not cause hyperinsulinemia. Mopaday HS (Metformin) does not affect insulin secretion.
Pioglitazone:
Pharmacological action
Mopaday HS is an oral hypoglycemic agent, series of thiazolidinedione derivatives. Powerful and selective agonist of gamma-receptors, peroxisome proliferator-activated (PPAR-gamma). PPAR-gamma receptors are found in adipose and muscle tissues and liver. Activation of nuclear receptor PPAR-gamma modulates the transcription of several genes that are sensitive to insulin, involved in controlling glucose and lipid metabolism. This medicine reduces insulin resistance in peripheral tissues and liver, as a result of this is increased flow of glucose and insulin reduced glucose production in the liver. Unlike sulfonylureas, Mopaday HS (Pioglitazone) does not stimulate insulin secretion by beta cells of the pancreas.
In diabetes mellitus type 2 (insulin-dependent) decrease in insulin resistance under the action of Mopaday HS (Pioglitazone) reduces blood glucose levels, reduce insulin levels in plasma and hemoglobin A1c (glycated hemoglobin, HbA1c).
In diabetes mellitus type 2 (insulin-dependent) with lipid disorders during treatment with Mopaday HS (Pioglitazone) there is a decrease in triglycerides and increase HDL. The level of LDL and total cholesterol in these patients does not change.
Pharmacokinetics
After oral administration Mopaday HS (Pioglitazone) is found in fasting plasma after 30 minutes. Cmax in plasma is reached after 2 hours. At ingestion there was a slight increase of Cmax to 3-4 hours, but the extent of absorption was not changed.
Protein binding of human serum, mainly to albumin greater than 99%; binding to other serum proteins less pronounced. The metabolites of Mopaday HS (Pioglitazone) M-III and M-IV also significantly associated with serum albumin is more than 98%.
Mopaday HS (Pioglitazone) is extensively metabolized in the liver by hydroxylation and oxidation. Metabolites M-II, M-IV (hydroxy derivatives of Mopaday HS (Pioglitazone)) and M-III (keto derivative of Mopaday HS (Pioglitazone)) exhibit pharmacological activity in models of type 2 diabetes in animals. Metabolites also partly converted into conjugates glucuronic or sulfuric acids.
The metabolism of Mopaday HS (Pioglitazone) in the liver occurs with the participation of isoenzymes CYP2C8 and CYP3A4.
T1/2 of unchanged Mopaday HS (Pioglitazone) is 3-7 hours, total Mopaday HS (Pioglitazone) (pioglitazone and active metabolites) is 16-24 hours. The clearance of Mopaday HS (Pioglitazone) is 5-7 L / h.
After oral administration about 15-30% of the dose of Mopaday HS (Pioglitazone) is found in urine. Kidneys displayed a negligible amount of Mopaday HS (Pioglitazone), mainly in the form of metabolites and their conjugates.
It is believed that the ingestion of large doses is excreted in bile as unchanged and as metabolites and excreted in the feces.
The concentrations of Mopaday HS (Pioglitazone) and active metabolites in serum remained at a high level 24 h after a single daily dose.
Why is Mopaday HS prescribed?
Type 2 diabetes (insulin independent).
Dosage and administration
Mopaday HS is taken orally in dose 30 mg 1 time / day. The duration of treatment is determined individually.
The maximum dose in combination therapy is 30 mg / day.
Mopaday HS (Pioglitazone) side effects, adverse reactions
Metabolism: a possible development of hypoglycaemia (mild to severe).
Hematopoietic system: possible anemia, decreased hemoglobin and hematocrit.
Digestive system: rarely - increased ALT.
Mopaday HS contraindications
Diabetes mellitus type 1 (insulin-dependent), diabetic ketoacidosis, pregnancy, lactation, hypersensitivity to Mopaday HS (Pioglitazone).
Using during pregnancy and breastfeeding
Mopaday HS is contraindicated during pregnancy and lactation. In patients with insulin resistance and anovulatory cycles in pre menopausal period the treatment with thiazolidinediones, including Mopaday HS (Pioglitazone), can cause ovulation. This increases the risk of pregnancy if you do not use adequate contraception.
In experimental studies in animals showed that Mopaday HS (Pioglitazone) has no teratogenic effects and adverse effects on fertility.
Category of the fetus by FDA - C.
Special instructions
Mopaday HS (Pioglitazone) should not be used in the presence of clinical presentations of liver disease in the active phase or an increase in ALT is 2.5 times above ULN.
During treatment for suspected development of liver dysfunction (nausea, vomiting, abdominal pain, fatigue, lack of appetite, dark urine) should define indicators of liver function tests. In the case of jaundice Mopaday HS (Pioglitazone) should be discontinued.
Mopaday HS (Pioglitazone) should be used with caution in patients with edema.
Anemia, decreased hemoglobin and hematocrit decrease may be associated with increased plasma volume and do not show any clinically significant hematological effects.
If necessary to usee Mopaday HS (Pioglitazone) simultaneously with ketoconazole should be more regular follow-up blood glucose levels.
There have been rare cases of a temporary increase in the activity level of CPK during treatment with this drug, which had no clinical consequences. The relationship of these reactions from taking Mopaday HS (Pioglitazone) is unknown.
The average values of bilirubin, AST, ALT, ALP and GGT decreased in the survey at the end of treatment by this medicine compared with those of before treatment.
Before treatment and during the first year of treatment (every 2 months) and then periodically monitor the activity of ALT should be.
Experimental studies have shown that Mopaday HS (Pioglitazone) is not mutagenic.
The use of Mopaday HS (Pioglitazone) in children is not recommended.
Mopaday HS drug interactions
In another thiazolidinedione derivative simultaneously observed with oral contraceptives decrease the concentration of ethinyl estradiol and norethindrone in plasma by approximately 30%. Therefore, while the use of Mopaday HS (Pioglitazone) and oral contraceptives may decrease contraceptive efficacy.
Ketoconazole inhibits the metabolism of Mopaday HS (Pioglitazone) in the liver in vitro.
Sulfonamides derivatives, metformin and insulin potentiate (relatively) hypoglycemia.
Mopaday HS in case of emergency / overdose
Treatment: symptomatic therapy.
Mopaday HS pharmaceutical active ingredients containing related brand and generic drugs:
Mopaday HS available forms, composition, doses:
Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.