Novonorm – a medicinal product of the group of oral hypoglycemic agents. Novonorm contains the active substance repaglinide. The mechanism of action of the drug is based on its ability to block ATP-dependent potassium channels located in the membranes of beta cells, resulting in the depolarization of the membrane and the opening of calcium channels, increases the influx of calcium ions into the beta-cell, which ultimately stimulates the secretion of insulin beta cells . The drug helps to lower blood glucose levels, due to the short half-life of Novonorm, patients who take it can take a more free diet than with other oral hypoglycemic agents.
Clinically significant increase in insulin level in blood plasma is observed after 10-30 minutes after oral administration of the drug, a decrease in plasma concentrations of the active substance is observed 4 hours after the administration of the drug. The drug is characterized by a dose-dependent decrease in the level of glucose in the blood plasma.
After oral administration, repaglinide is well absorbed in the gastrointestinal tract, the peak concentration of the active substance is noted 60 minutes after oral administration. Bioavailability of the drug reaches 63%, for repaglinide characterized by a high degree of communication with plasma proteins (up to 98%). Metabolised in the liver with the formation of pharmacologically inactive metabolites. The drug is quickly excreted from the body (the total elimination time is 4-6 hours), the elimination half-life reaches 1 hour. It is excreted mainly with bile and in an insignificant quantity with urine (no more than 7%) both in unchanged form and in the form of pharmacologically inactive metabolites.
In patients with severe renal dysfunction, there were some changes in the pharmacokinetics of the drug.
In patients with severe impairment of liver function there is an increase in plasma concentrations and an increase in the half-life of the drug.
Dosing and Administration
Novonorm is taken inside. It is prescribed as an adjunct to diet and exercise to reduce blood glucose levels; The intake of the drug should be timed to meals.
The recommended initial single dose of NovoNorm before the main meal is 0.5 mg. Correction of the dose is carried out once a week or once in 2 weeks (while being guided by the level of glucose in the blood as an indicator of response to therapy). If the patient passes from taking another oral hypoglycemic agent to Novonorm treatment, then the recommended initial dose before each main meal should be 1 mg.
From the side of metabolism: the effect on carbohydrate metabolism – hypoglycemic conditions (pallor, increased sweating, palpitations, sleep disorders, tremor); Fluctuations in blood glucose levels can cause temporary visual impairment, especially at the beginning of treatment (noted in a small number of patients and did not require drug withdrawal).
On the part of the digestive system: abdominal pain, diarrhea, nausea, vomiting, constipation; In some cases – increased activity of liver enzymes.
Allergic reactions: itching, erythema, urticaria.