HLORPROPAMYD (Chlorpropami-dum; synonym: Bioglumin, Catanil, Chlorpropamide, Diabamide, Diabaryl, Diabet, Diabexan, Diabinese, Mel-linese, Prodiaben; joint venture. B) — nepo-ralny antidiabetic drug from group of derivatives of sulphonylurea: X - (gs-Hlorbenzol-
sulphonyl)-] H '-propilmochevina:
White crystal powder, we will almost not dissolve in water, alcohol, it is dissolved in alkalis.
On a structure, pharmakol. to properties and the mechanism of action it is close to Butamidum (see). Is more active, than Butamidum, bukarban (see) and Cyclamidum (see). Chlorproramidum has gi-poglikemiziruyushchy effect in smaller doses, than the listed above drugs, however its toxicity a little. Does not possess antibacterial action on flora of intestines. It is removed with urine.
As well as other drugs of this group, Chlorproramidum apply to treatment of a diabetes mellitus of «adult» (insulinonezavisimy) type, generally at persons 30 years are more senior (see a diabetes mellitus). At younger age it is effective only at the easy forms of a disease which are especially combined with obesity. Drug is appointed inside. Usually treatment at moderately severe diabetes begin with a dose 0,5 — 0,75 g a day, at easy forms — an initial daily dose of 0,25 g. Action begins to be shown within the first hour after reception, and the maximum concentration in blood is observed in 2 — 4 hours. The Gipoglikemiziruyushchy effect proceeds within a day. In 24 hours concentration of Chlorproramidum in blood makes apprx. 60% of maximum. Drug slowly collects in an organism therefore its maximum effect develops in 1 — 2 week, and in some cases only in
2 — 4 weeks. Further, in process of compensation of carbohydrate metabolism, the dose shall be lowered to 0,25 — 0,125 g. Slow elimination chlorine-nropamida allows to be limited in most cases to a single dose of drug in the morning. In need of addition to morning reception of Chlorproramidum appoint other drugs from group of derivatives of sulphonylurea, napr, Butamidum. The daily dose at prolonged treatment makes 0,1 — 0,5 g the Highest daily dose for adults in 1 g. In the absence of sufficient effect increase in a dose does not improve indicators of carbohydrate metabolism and often leads to loss of appetite, nausea, an eructation, pressure sense in a stomach, to dizziness.
It is better to accept Chlorproramidum after food to avoid irritation of a mucous membrane of a stomach. In case of replacement of insulin with Chlorproramidum it is appointed approximately on 0,25 g instead of 20 PIECES of insulin.
In some cases Chlorproramidum is effective at patients with not diabetes mellitus (see Diabetes not sugar) at a refrakternost to drugs of a back share of a hypophysis (to Adiurecrinum, etc.). At the same time it is applied in the same doses, as at treatment of a diabetes mellitus.
In therapeutic doses Chlorproramidum is usually well transferred. By-effects (allergic reactions, a leukopenia, thrombocytopenia, an agranulocytosis, diarrhea) are observed seldom. Sometimes drug causes the phenomena of cholestatic jaundice (see) in this connection it is absolutely contraindicated at an abnormal liver function. The same other contraindications, as for Butamidum: it is contraindicated to the children
sick with the youthful type of a diabetes mellitus, pregnant, sick inclined to ketoacidosis, at diseases of kidneys and blood. At overdose can cause a hypoglycemia (see).
Form of release: tabletkr! on 0,1 and 0,25 g. Store in well corked container.
See also Gipoglikemiziruyushchy means.
Bibliography: Galler G. and Sh t r and at -
tsenberg S.E. Pero Ral ny therapy of diabetes, the lane with it., M., 1973; M and sh-to about in with to and y M. D. Pharmaceuticals, p.1, page 561, M., 1984; The Guide to clinical endocrinology, under the editorship of V. G. Baranov, L., 1977.
A. G. Mazowiecki, T. L. Kurayeva.