Medication Description: Carbutamide (Carbutamide)
N (pair-aminobenzenesulfonyl) -N-butylurea.
Synonyms: Bukarban, Oranil, Bucarban, Diabecid, Diaboral, Glucidoral, Hypoglyсamid, Invenol, Midosal, Nadisan, Orabetic, Oranil, Sulfadiabet, etc.
White crystalline powder slightly bitter taste. Practically insoluble in water, soluble in alcohol.
Rapidly absorbed in the digestive tract, C max is 1 h, T 1/2 - 36 h; undergoes biotransformation in the liver, excreted by the kidneys.
The sugar-reducing effect of carbutamide is most pronounced in the first 5-7 hours after administration and lasts up to 12 hours (after a single dose).
Like other drugs of this group, it is used mainly in diabetes mellitus type II.
Assign inside (1 hour before meals). At the beginning of treatment they 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.
After 2 weeks after the elimination of glycosuria and the normalization of glucose in the blood, the dose can be reduced to 1 g in the morning and 0.5 g in the second half of the day, while maintaining good results after the same period - up to 0.5 g in the morning and 0.5 g in the evening. The drug in this dose is continued for at least 1 month, and later, with good indicators, the daily dose is reduced to 0.5 or 0.25 g or less (depending on the results of the research).
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 carbohydrate metabolism disorders are compensated by insulin at doses of less than 40 U per day), the latter is prescribed for carbutamide at a dose of 1 g 2 times per day, and the dose of insulin is reduced by half. Further clarification of the dose of insulin, its reduction or cancellation of the drug produced under the control of urine tests (glucose and acetone) and blood (glucose). If less than 10 U of insulin per day is required to compensate for diabetic disorders, it can be canceled immediately and you can assign 1 g of carbutamide 2 times a day.
In those cases when hyperglycemia and glycosuria are not eliminated in the first weeks of treatment with carbutamide, they usually switch to a more active drug or combine a sulfanilamide drug with a biguanidine medication, but it is not possible to achieve compensation of metabolic disorders using insulin.
Treatment with carbutamide, as well as 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 during the first time of treatment, these studies are carried out daily. In the process of treatment should be regularly carried out a complete blood count.
Possible side effects: hypoglycemia, dyspeptic symptoms (due to the suppression of intestinal microflora), impaired function of the liver and thyroid gland, leukopenia, atranulocytosis, hemolytic anemia, allergic reactions. If side effects do not pass, the drug is canceled.