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Nuzide is brand name for the generic drug Gliclazide and is manufactured by Intas Biopharmaceuticals, Ltd, one of the leading biotechnology companies in Asia headquartered in Moraiya, Ahmedebad in India. Nuzide's main active ingredient is Gliclazide and like most other brands, Nuzide is formulated with 30 mg to extra-strength 60 mg and 80 mg content in capsule and tablet forms.
The Gliclazide ingredient in Nuzide is an oral anti-diabetic (hypoglycemic) drug classified as a sulfonylyrea, though it remains unknown in medical literature if the drug is first or second generation. Nuzide is indicated to treat Type 2 diabetes or non-insulin dependent Diabetes Mellitus. Its Gliclazide ingredient controls hyperglycemia in mild, stable, adult type non-ketosis prone, and Gliclazide-responsive diabetes where the right diet and exercise cannot treat the condition or when insulin therapy is not appropriate.
Nuzide helps control blood sugar content by stimulating the pancreas to release insulin to keep blood sugar levels down after each meal, while protecting pancreatic beta cells from cellular apoptosis caused by hyperglycemia.
Nuzide has also been to shown to prevent accumulation of fat in the arteries or antiatherogenic effects in Type 2 diabetes.
Because it works best to control spikes in sugar levels that often occur after each meal, Nuzide should be taken with food and is best done during or after a meal. Nuzide is also recommended to be taken as part of a complete diabetes treatment regimen that includes a nutritious diet, regular workouts, and routine monitoring of blood sugar levels.
Action or Pharmacokinetics of Glilazide in Nuzide
As a hypoglycemic, the Gliclazide in Nuzide has selective protein biding properties. It binds to SUR-1 sulfonylurea receptors on pancreatic beta-cell surface to stimulate insulin secretion. Nuzide's binding action closes the K+ ion channels that effectively decreases potassium eflux from the cell that leads to the depolarization of the cell. This results in Calcium ion channels to open which allows increased Calcium influx. This activates calmodulin production which leads to exocystosis of insulin vesicles that in turn leads to insulin release.
Nuzide's selective binding will bypass SUR-2A sulfonylurea receptors located in the heart. This allows Nuzide to provide cardiovascular protection in its administration. Nuzide also reduces hepatic gluconeogenesis as well as lowers blood glucose concentrations. It also inhibits aggregation of platelet at therapeutic doses.
Nuzide is readily absorbed in the gastrointestinal tract and takes 12 hours or more for the body to benefit from its action. Its metabolic action is extensively hepatic and has a half-life of 10-12 hours with 60% to 70% inactive metabolites passing through as urine with small amounts of Nuzide unchanged, while 10% to 12% are eliminated as fecal content.
Known side effects
Nuzide has been documented to cause nausea, skin reaction or rashes, vomiting, gastrointestinal problems such as gastritis, vomiting, cholestatic jaundice and diarrhea, thrombocytompenia, leucopenia, hemolytic anemia, and increased transaminases.
Precautions when using Nuzide
If you are taking any prescriptive or over-the-counter medication, it is best to inform your doctor what these drugs are prior to taking Nuzide as there may be adverse side effects in the interaction or that discontinuing some drugs before taking Nuzide may have adverse effects. In addition, if you are pregnant or lactating, have known allergies to certain drugs, or have other other ailments or health conditions apart from type 2 diabetes, be sure to alert your doctor before taking Nuzide. Refrain from taking alcoholic drinks while being treated with Nuzide as an intolerance may develop that can cause rapid heart rates, nausea, giddiness, and flushing.
When taking Nuzide, it is important that blood glucose concentration is routinely monitored. Nuzide may also required insulin administration when there is metabolic stress. Moreover, the patient may need to be monitored when shifting from a combination drug therapy to Nuzide to arrest any possible adverse effect.
Nuzide is contraindicated for Type 1 Diabetes Mellitus complicated with ketoacidosis. It is also contraindicated for persons with severe hepatic and renal impairment, as well as pregnant and lactating women. There is as yet no information to contraindicate Nuzide for children, though the drug is meant for diabetic adults. There is also incomplete information to contraindicate Nuzide among geriatrics, though some risk may be present when treating elderly debilitated patients. There is also some risk of hypoglycemia in patients with deficient caloric intake, in people after a strenuous workout, and when Nuzide is taken with ethanol or with more than one anti-diabetic drug is administered.
Nuzide Interactions with other drugs
Gliclazide's action in Nuzide have been shown to interact with oral contraceptives and steroids, antidepressants, blood thinners, sulfonamide antibiotics, aspirin, cimetidine, disopyramide, rifampin, propranolol, phenylbutazone, propranolol, and chlofibrate, to mention some. Rifampin/Rifampicin has been found to increase gliclazide metabolism in humans when tested in vivo and should not be taken with Nuzide.
Nuzide's hypoglycemic action is enhanced by a co-administration of oral anticoagulants, beta2 agonists, clofibrate, chlorpromazine, salicylates, glucocorticoids phenylbutazone, progestogens, sulphonamides, and MAOIs. On the other hand, Nuzide's hypoglycemic efficacy can be diminished by a co-intake of alcohol, barbiturates, corticosteroids, diuretics, beta blockers, estrogens, rifampicin, diazoxide, fluconazole, phenylbutazone, sympathomimetic drugs and possibly high blood pressure drugs like ACE inhibitors If you are taking any of these as may be prescribed by your doctor, some dosage adjustment may be needed either for Nuzide or your other drugs.
Recommended dosage of Nuzide
Nuzide tablets with the 80 mg formulation is recommended to be taken from 40 mg (half tablet) to 320 mg (4 tablets) daily with doses greater than 160 mg spread in two separate intakes, one during breakfast or lunch, and another during or after dinner. Nuzide tablets formulated with 30 mg -60 mg Gliclazide in modified release form may be taken 1-2 tablets daily during breakfast with higher dose spread over two separate intakes at different times of the day.
Nuzide overdose may result in severe hypoglycemia, requiring immediate intravenous administration of glucose and subsequent monitoring of sugar levels.
Other brands equivalent to Nuzide
Apart from the Nuzide brand, Gliclazide is marketed under various brands such as Diamicron in India with a modified release formulation marketed as Remicron MR, Diabeton MR, Dianormaz MR, Diaprel MR, Dimicron MR and Uni Diamicron, to mention some. It is also marketed as Reclide, Glyloc and Glizid in Australia and Canada, Pharylinde in Japan, Reclide MR in Vietnam, Reclide in Sir Langka and Venezuela, and Diamicron MR in the Philippines, just to mention a few.
Nuzide and other brands of Gliclazide are not yet marketed in the US as it has yet to undergo FDA testing and clearance. Gliclazide based anti-diabetic drugs was been cleared in China just last May, 2011. Online, each Nuzide capsule or tablet formulated with 30 mg Gliclazide costs $0.30 while the 80 mg formulation cost $0.54.
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