Description of the medicine: Carbutamide (Carbutamide)
N (para-Aminobenzenesulfonyl) -N-butylurea.
Synonyms: Bukarban, Oranil, Bucarban, Diabecid, Diaboral, Glucidoral, Hypoglyсamid, Invenol, Midosal, Nadisan, Orabetic, Oranil, Sulfadiabet, etc.
White crystalline powder with a slightly bitter taste. Almost insoluble in water, soluble in alcohol.
Quickly absorbed in the digestive tract, C max is 1 hour, T 1/2 - 36 hours; subjected to biotransformation in the liver, excreted by the kidneys.
Sugar-lowering effect of carbamide is most pronounced in the first 5-7 hours after administration and lasts up to 12 hours (after a single dose).
Like other drugs in this group, it is mainly used for type II diabetes.
Assign inside (1 hour before meals). At the beginning of treatment, take 2 g per day - 1 g (2 tablets of 0.5 g) in the morning (usually at 7-8 hours) and 1 g - in the evening (at 17-18 hours). Increasing the dose over 2 g does not usually lead to an increase in the effect.
2 weeks after the elimination of glucosuria and the normalization of blood glucose, the dose can be reduced to 1 g in the morning and 0.5 g in the afternoon, and while maintaining good performance after the same period, to 0.5 g in the morning and 0.5 g in the evening. Taking the drug in this dose is continued for at least 1 month, and later, with good performance, reduce the daily dose to 0.5 or 0.25 g or less (depending on the results of the studies).
In mild cases, treatment can begin with a dose of 0.5 g 2 times a day, followed by an increase with insufficient effect.
When transferring patients receiving insulin (when disorders of carbohydrate metabolism are compensated by insulin in doses of less than 40 units per day), the latter is prescribed to carbamide at a dose of 1 g 2 times a day, and the dose of insulin is reduced by half. Further clarification of the dose of insulin, its reduction or discontinuation of the drug is carried out under the control of tests of urine (glucose and acetone) and blood (glucose). If less than 10 IU of insulin per day is required to compensate for diabetic disorders, it can be canceled immediately and 1 g of carbamide 2 times a day can be prescribed.
In those cases when hyperglycemia and glucosuria are not eliminated in the first weeks of treatment with carbamide, they usually switch to a more active drug or combine a sulfanilamide drug with biguanidine, if insulin metabolism cannot be compensated, it can be achieved.
Treatment with carbamide, like other similar drugs, is carried out under medical supervision. Patients must follow a diet. It is necessary to systematically monitor the content of glucose in the blood (in the morning on an empty stomach) and in daily urine; Before and at the beginning of treatment, these studies are carried out daily. In the course of treatment, a general blood test should be performed regularly.
Possible side effects: hypoglycemia, dyspeptic symptoms (due to the suppression of intestinal microflora), impaired liver and thyroid function, leukopenia, atranulocytosis, hemolytic anemia, allergic reactions. If side effects do not go away, the drug is canceled.