سعر ماجيكنورم 1/500مجم 30اقراص 2022

Magicnorm 1/500 mg film-coated tablets (Medizen / Magic Pharma), pack of 30: a fixed combination of repaglinide 1 mg (meglitinide) and metformin hydrochloride 500 mg (biguanide) for type 2 diabetes.

• Adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus who are already treated with a meglitinide and metformin HCl or who have inadequate glycaemic control on a meglitinide alone or metformin HCl alone. Not for type 1 diabetes or diabetic ketoacidosis.Population: Adults with type 2 diabetesNovo Nordisk (US prescribing information)

• Hypoglycaemia and headache were the most common (10% or more) with repaglinide plus metformin; gastrointestinal reactions (diarrhoea, nausea, vomiting) are the most common with metformin and more frequent at higher doses.International label, same formulation · Novo Nordisk (US prescribing information)

• Renal impairment (e.g. serum creatinine 1.5 mg/dL or more in males, 1.4 mg/dL or more in females, or abnormal creatinine clearance).International label, same formulation · Novo Nordisk (US prescribing information)
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis.International label, same formulation · Novo Nordisk (US prescribing information)
• Concomitant gemfibrozil.International label, same formulation · Novo Nordisk (US prescribing information)

• Boxed warning: lactic acidosis can occur due to metformin accumulation; risk increases with sepsis, dehydration, excess alcohol, hepatic or renal impairment and acute congestive heart failure. If acidosis is suspected, discontinue and hospitalise immediately.International label, same formulation · Novo Nordisk (US prescribing information)
• Temporarily discontinue before and for 48 hours after intravascular iodinated contrast studies and for surgical procedures (restart when renal function is normal and oral intake resumed).International label, same formulation · Novo Nordisk (US prescribing information)
• Hypoglycaemia (repaglinide component): initiate at the lowest dose in meglitinide-naive patients; elderly, debilitated, malnourished patients and those with adrenal, pituitary or hepatic insufficiency are more susceptible; avoid excess alcohol.International label, same formulation · Novo Nordisk (US prescribing information)

• Gemfibrozil (and gemfibrozil plus itraconazole)Gemfibrozil substantially increases repaglinide exposure (more than 20-fold with gemfibrozil plus itraconazole); coadministration is contraindicated.Novo Nordisk (US prescribing information)
• CYP2C8 and CYP3A4 inhibitors or inducers (e.g. trimethoprim, deferasirox, itraconazole, ketoconazole, rifampin)May alter repaglinide pharmacokinetics and effect; use with caution.Novo Nordisk (US prescribing information)
• Cationic drugs eliminated by renal tubular secretion (e.g. amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin)May compete with metformin for renal tubular transport; monitor and adjust doses.Novo Nordisk (US prescribing information)

• No adequate and well-controlled studies in pregnant women; like other antidiabetic medicines, use during pregnancy only if clearly needed.International label, same formulation · Novo Nordisk (US prescribing information)
• Unknown whether repaglinide or metformin is excreted in human milk (both are in rat milk); not recommended in nursing mothers because it may cause hypoglycaemia in nursing infants.International label, same formulation · Novo Nordisk (US prescribing information)

• Repaglinide: Closes ATP-dependent potassium channels in pancreatic beta-cells, depolarising the cell and opening calcium channels, which stimulates insulin release; action depends on functioning beta-cells.
• Metformin: Decreases hepatic glucose production, decreases intestinal glucose absorption and improves insulin sensitivity by increasing peripheral glucose uptake and utilisation.