CHF 25.60

1-24 hours

Delivery is possible through one of our partner pharmacies after consultation.

Swissmedic Nr.: 55731004
Index: 07.06.20

Pharmacode: 2495980
GTIN/EAN: 7680557310048
Markteintritt: 27.09.2001

Kategorie: B Mehrmalige Abgabe auf eine ärztliche Verschreibung hin.


Glucovance®/- mite (250 mg)

Metformin und Sulfonamide (A10BD02)

120 Stk

(0/5 , 724)

Um Glucovance®/- mite (250 mg) kaufen zu können, benötigen Sie zunächst ein Rezept. Bei Deindoktor.ch können Sie im Rahmen einer Online-Sprechstunde per Webcam, mit dem Artz Ihrer Wahl, ein elektronische Rezept erhalten.

Das mit DeinDoktor.ch erhaltene Rezept kann in einer der 1400 Schweizer Apotheken verwendet werden. Wir organisieren mit einer unserer Partner-Apotheken eine Sendung Ihres Glucovance®/- mite (250 mg)'s gegen Unterschrift (24h) oder dem Medikamenten-Taxi nach einer Online Sprechstunde, falls gewünscht.

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Dr. David Herren, Einigen (BE)
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Internist


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Dr. Ueli Krebs, Thun (BE)
Generalist
Internist


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+-Medicaments
Your received prescription through DeinDoktor.ch is usable to get your medicaments in any of the 1400 Swiss pharmacies or in the Swiss online pharmacies. We can arrange with one of our pharmacy-partners a delivery against signature (24h) or medicament-taxi after an online-consultation.
+-Was ist Glucovance/- mite und wann wird es angewendet?

Glucovance/- mite ist ein oral einzunehmendes Mittel zur Behandlung des Typ 2-Diabetes (nicht-insulinabhängiger Diabetes mellitus) bei Erwachsenen, das unter Berücksichtigung einer strengen Diät angewendet wird. Glucovance/- mite ist eine Kombination von zwei sich ergänzenden oralen blutzuckersenkenden Mitteln (dem Metformin, einem Biguanid und dem Glibenclamid, einem Sulfonylharnstoff). Es senkt den Zuckergehalt des Blutes, indem es die Bildung von Glucose in der Leber hemmt, die Aufnahme von Glucose in die Muskelzellen und den Glucoseverbrauch verbessert, die Glucoseaufnahme im Darm verzögert sowie die Insulinfreisetzung in der Bauchspeicheldrüse im Anschluss an eine Mahlzeit steigert. Glucovance/- mite trägt ausserdem dazu bei, den Gehalt des Blutes an Cholesterin und Triglyceriden (Blutfetten) zu senken.

Das Arzneimittel darf nur auf Verschreibung des Arztes oder der Ärztin und unter dessen bzw. deren sorgfältiger Aufsicht verwendet werden.

+-Was sollte dazu beachtet werden?

Auch wenn Sie Glucovance/- mite einnehmen, ist es unerlässlich, dass Sie die Diätvorschriften befolgen und die vom Arzt oder der Ärztin verordneten Kontrolltests konsequent durchführen. Diät ist die wichtigste Massnahme gegen Zuckerkrankheit. Wenn Sie übergewichtig sind, sollten Sie Ihre Kalorienzufuhr vermindern und Ihr Körpergewicht reduzieren. Es wäre ein Irrtum zu glauben, dass Sie die Diät weniger streng befolgen müssten, weil Sie ein blutzuckersenkendes Mittel einnehmen.

+-Wann darf Glucovance/- mite nicht eingenommen werden?

Glucovance/- mite darf nicht eingenommen werden bei:

  • Überempfindlichkeit gegenüber den Wirkstoffen Metformin und Glibenclamid oder anderen Sulfonylharnstoffen oder Sulfonamiden oder einem der Hilfsstoffe,
  • insulinabhängigem Diabetes (Typ 1-Diabetes),
  • Diabetes mit Stoffwechselentgleisungen (Ketoazidose, diabetisches Präkoma oder Koma),
  • mittelschweren oder schweren Nierenfunktionsstörungen,
  • Entwässerung des Körpers infolge von anhaltendem Durchfall, wiederholtem Erbrechen, hohem Fieber, schweren Infektionskrankheiten (z.B. der Harnwege),
  • Röntgenuntersuchungen mit iodhaltigen Kontrastmitteln (z.B. Urographie, Angiographie): Ihr Arzt bzw. Ihre Ärztin wird Ihnen eine vorübergehende Einnahmepause verordnen; bei einer Angiographie der Netzhaut unter Verwendung von Fluorescein ist kein Behandlungsunterbruch notwendig,
  • Störungen der Herz-Kreislauffunktion (Herzschwäche) und der Atmung,
  • geplante grössere chirurgische Eingriffe,
  • Leberfunktionsstörungen,
  • Alkoholvergiftung, akutem, übermässigem Alkoholkonsum oder Alkoholismus,
  • Entzündung der Bauchspeicheldrüse (Pankreatitis),
  • Stoffwechselstörung mit Pigmentansammlung (Porphyrine) im Organismus (Porphyrie),
  • während Schwangerschaft und Stillzeit (vgl. «Darf Glucovance/- mite während einer Schwangerschaft oder in der Stillzeit eingenommen werden?»).
+-Wann ist bei der Einnahme von Glucovance/- mite Vorsicht geboten?

Informieren Sie Ihren Arzt bzw. Ihre Ärztin über die Einnahme dieses Arzneimittels, wenn Sie sich im Spital einer Untersuchung, einer Operation oder der Behandlung einer zusätzlichen Erkrankung (z.B. Herzkrankheit, Infektionskrankheit) unterziehen müssen.

Laktatazidose

In sehr seltenen Fällen kann es während der Behandlung zur sogenannten Laktatazidose, einer schweren Stoffwechselentgleisung, kommen, die tödlich ausgehen kann, wenn sie nicht unverzüglich behandelt wird. Beim Auftreten von Symptomen wie Erbrechen, Durchfällen, Bauchschmerzen mit Muskelkrämpfen, allgemeinem Unwohlsein mit ausgeprägtem Schwächezustand oder starker Beschleunigung der Atmung, müssen Sie sofort Ihren Arzt bzw. Ihre Ärztin konsultieren und die Einnahme des Arzneimittels bis zum Arzttermin aussetzen.

In den bis jetzt bekannten Fällen von Laktatazidose, die während einer Behandlung mit Metformin aufgetreten sind, litten die betroffenen Patienten an einer eingeschränkten Nierenfunktion. Weitere Risikofaktoren für das Auftreten von Laktatazidose sind: komplizierte oder schlecht eingestellte Zuckerkrankheit, längeres Fasten, Alkoholismus, eingeschränkte Leberfunktion und Sauerstoffmangel im Gewebe (z.B. bei Störungen der Blutzirkulation, Herzinfarkt oder anderen Herz-Kreislauf-Erkrankungen).

Unterzuckerung (Hypoglykämie)

Während der Behandlung können Episoden von Unterzuckerung auftreten. In schwerwiegenden Fällen kann eine Hospitalisierung zur Wiedereinstellung des Blutzuckers nötig sein. Nach einer Unterzuckerung ist es möglich, dass Ihr Arzt bzw. Ihre Ärztin Ihren Zustand während mindestens 24 Stunden überwacht.

Durch Beachtung der folgenden Punkte kann eine Unterzuckerung vermieden werden:

  • Es ist wichtig, die Mahlzeiten, einschliesslich des Frühstücks, in regelmässigen Abständen einzunehmen, da das Risiko für eine Unterzuckerung beim Auslassen einer Mahlzeit, bei mangelnder resp. unausgewogener Ernährung oder unzureichendem Zucker- bzw. Kohlehydratgehalt steigt. Falls Sie wiederholt unter schwerer Unterzuckerung leiden, müssen Sie Ihren Arzt resp. Ihre Ärztin unbedingt informieren.
  • Höheres Alter, schlechter Ernährungs- oder Allgemeinzustand, Nieren- und Leberfunktionsstörungen sowie gewisse Störungen der Nebenniere, der Schilddrüse oder der Hypophyse können eine Unterzuckerung fördern.
  • Eine zu strenge oder zu einseitige Diät, eine zu starke oder zu lange andauernde körperliche Anstrengung, Alkohol oder die Einnahme anderer blutzuckersenkender Arzneimittel (vgl. «Wechselwirkungen mit anderen Arzneimitteln») können eine Unterzuckerung hervorrufen.

Ihr Arzt bzw. Ihre Ärztin wird Ihnen und Ihren Angehörigen erklären, wie Sie eine Unterzuckerung vermeiden und wie Sie die ersten Symptome erkennen und behandeln können. Es ist zu beachten, dass gewisse blutdrucksenkende Arzneimittel wie Betablocker die Warnzeichen einer Unterzuckerung verschleiern können.

Unausgeglichener, unstabiler Blutzucker

Gewisse Krankheiten oder die Einnahme von bestimmten Arzneimitteln können den Blutzucker mehr oder weniger stark aus dem Gleichgewicht bringen, so dass eine vorübergehende Anwendung von Insulin notwendig sein kann. Informieren Sie Ihren Arzt bzw. Ihre Ärztin über jede Begleitbehandlung sowie jede Infektionskrankheit wie z.B. Grippe, Infektionen der Lunge und Harnwege.

Besondere Vorsicht ist in Situationen geboten, in denen eine Einschränkung der Nierenfunktion auftreten kann, z.B. bei älteren Patienten, zu Beginn einer Behandlung gegen Bluthochdruck, einer Behandlung mit wasserausschwemmenden Mitteln (Diuretika) oder mit gewissen Schmerz- und Rheumamitteln, z.B. nicht-steroidalen Entzündungshemmern.

Wechselwirkungen mit anderen Arzneimitteln

Das Pilzmittel Miconazol (systemisch sowie Anwendung auf Mundschleimhaut) soll in Kombination mit Glucovance/- mite aufgrund einer möglichen Verstärkung der blutzuckersenkenden Wirkung nicht angewendet werden.

Zahlreiche andere Arzneimittel und Alkohol können bei gleichzeitiger Einnahme mit Glucovance/- mite die blutzuckersenkende Wirkung verstärken oder abschwächen bzw. unerwünschte Wirkungen auslösen oder verstärken:

Arzneimittel, welche die Wirkung von Glucovance/- mite verstärken oder abschwächen

  • Dies sind beispielsweise bestimmte Präparate gegen Infektionskrankheiten wie Antibiotika und Pilzmittel, verschiedene Schmerz- und Rheumamittel, gewisse Substanzen mit Hormonwirkung wie Danazol, hormonale Empfängnisverhütungsmittel (z.B. Pille), Präparate gegen Wechseljahrbeschwerden, gewisse Anabolika, männliche Geschlechtshormone, Schilddrüsenhormone, gewisse wasserausschwemmende Arzneimittel, Arzneimittel zur Behandlung von Herz- und/oder Herz-Kreislauf-Erkrankungen, gewisse Arzneimittel gegen Durchblutungsstörungen, Arzneimittel gegen psychische Erkrankungen und Depressionen, Arzneimittel gegen Epilepsie, Asthmamittel, Arzneimittel zur Regulierung der Blutfettwerte, Azetazolamid zur Behandlung des erhöhten Augendrucks (grüner Star), andere blutzuckersenkende Arzneimittel (Insulin, andere orale Antidiabetika), Glucagon, gewisse Arzneimittel zur Behandlung von Blutgerinnungsstörungen, gewisse Arzneimittel gegen allergische Reaktionen, gewisse Gichtmittel, gewisse Arzneimittel gegen Krebs und Arzneimittel gegen übermässige Säureproduktion im Magen. Falls Sie eines oder mehrere solcher Arzneimittel einnehmen müssen, wird Ihr Arzt bzw. Ihre Ärztin möglicherweise die Dosis von Glucovance/- mite anpassen oder eine Umstellung auf Insulin vornehmen. Auf jeden Fall muss der Blutzucker häufig kontrolliert werden.
  • Vermeiden Sie den Konsum alkoholischer Getränke. Alkohol kann die blutzuckersenkende Wirkung von Glucovance/- mite verstärken oder abschwächen; übermässiger Alkoholkonsum kann die Gefahr einer Laktatazidose erhöhen.

Wechselwirkungen mit folgenden Arzneimitteln können die Nebenwirkungshäufigkeit von Glucovance/- mite erhöhen

  • Dies sind zum Beispiel gewisse wasserausschwemmende Arzneimittel (Diuretika), iodhaltige Kontrastmittel (vgl. «Wann darf Glucovance/- mite nicht eingenommen werden?»), Bosentan (ein Mittel zur Behandlung des Lungenbluthochdrucks) sowie Alkohol.

Arzneimittel, welche durch Glucovance/- mite in ihrer Wirkung beeinflusst werden

  • Dies sind zum Beispiel gewisse wasserausschwemmende Arzneimittel, Arzneimittel zur Behandlung von Blutgerinnungsstörungen und gewisse Substanzen mit Hormonwirkung.

Andere Wechselwirkungen

  • Gewisse blutdrucksenkende Arzneimittel können die Wahrnehmung der Warnzeichen einer Unterzuckerung beeinträchtigen.
  • Glucovance/- mite sollte mindestens 4 Stunden vor einem gallensäurebindenden Arzneimittel eingenommen werden, damit die Wirkung von Glucovance/- mite nicht vermindert wird.

Lenken von Fahrzeugen oder Bedienen von Maschinen

Wegen des durch die Behandlung bedingten Risikos einer Unterzuckerung ist beim Lenken von Fahrzeugen und bei der Bedienung von Maschinen Vorsicht geboten.

Da Glucovance/- mite Laktose enthält, ist bei bestimmten Stoffwechselstörungen wie z.B. Laktasemangel Vorsicht geboten.

Informieren Sie Ihren Arzt, Apotheker bzw. Ihre Ärztin, Apothekerin, wenn Sie an anderen Krankheiten leiden, Allergien haben oder andere Arzneimittel (auch selbstgekaufte!) einnehmen oder äusserlich anwenden.

+-Darf Glucovance/- mite während einer Schwangerschaft oder in der Stillzeit eingenommen werden?

Glucovance/- mite darf während einer Schwangerschaft nicht eingenommen werden. Während der Schwangerschaft wird zur Behandlung des Diabetes Insulin verordnet. Falls Sie während der Behandlung mit diesem Arzneimittel schwanger werden, ist auf Insulin umzustellen. Wenden Sie sich an Ihren Arzt bzw. an Ihre Ärztin, wenn Sie schwanger sind oder schwanger werden möchten. Er bzw. sie wird Sie zur weiteren Behandlung des Diabetes beraten.

In der Stillzeit darf Glucovance/- mite nicht angewendet werden.

+-Wie verwenden Sie Glucovance/- mite?

Allgemeine Dosierungshinweise

Ihr Arzt bzw. Ihre Ärztin wird die Dosierung von Glucovance/- mite angepasst an den Schweregrad Ihrer Zuckerkrankheit und die Ergebnisse der Stoffwechseluntersuchungen festlegen. Üblicherweise wird die Behandlung mit einer niedrigen Dosis begonnen und die Dosis schrittweise erhöht. Die maximale Dosis beträgt 4 Filmtabletten Glucovance pro Tag.

Die Filmtabletten sind zu Beginn der Mahlzeit ganz und mit etwas Wasser einzunehmen. Höhere Tagesdosen sollen auf 2-3 Einzeldosen aufgeteilt werden.

Es ist wichtig, die Mahlzeiten, einschliesslich des Frühstücks, in regelmässigen Abständen einzunehmen, da das Risiko für eine Unterzuckerung beim Auslassen einer Mahlzeit, bei mangelnder resp. unausgewogener Ernährung oder unzureichendem Zucker- bzw. Kohlehydratgehalt steigt.

Ältere Patienten

Bei älteren Patienten muss die Dosis vorsichtig unter Berücksichtigung der Nierenfunktion festgelegt werden.

Kinder und Jugendliche

Glucovance/- mite ist für Kinder und Jugendliche nicht empfohlen.

Behandlungsdauer

Wenn von Ihrem Arzt bzw. von Ihrer Ärztin nicht anders verordnet, muss dieses Arzneimittel täglich ohne Unterbruch eingenommen werden.

Vorgehen bei vergessenen Filmtabletten

Falls Sie die Einnahme von Glucovance/- mite vergessen haben, so dürfen Sie diesen Einnahmefehler nicht durch Einnahme der doppelten Menge Filmtabletten ausgleichen. Nehmen Sie die nächste Dosis zur gewohnten Zeit ein.

Vorgehen bei Überdosierung

Beim Auftreten von Symptomen einer Unterzuckerung wie Schwäche, Schwitzen, Heisshunger, Zittern, Schläfrigkeit, Schwindel, Kopfschmerzen, Sehstörungen, sollten Sie sofort Zucker (z.B. Würfelzucker, Traubenzucker, süsse Fruchtsäfte oder gezuckerten Tee) einnehmen sowie unverzüglich Ihren Arzt bzw. Ihre Ärztin benachrichtigen.

Ändern Sie nicht von sich aus die verschriebene Dosierung. Wenn Sie glauben, das Arzneimittel wirke zu schwach oder zu stark, sprechen Sie mit Ihrem Arzt oder Apotheker bzw. mit Ihrer Ärztin oder Apothekerin.

+-Welche Nebenwirkungen kann Glucovance/- mite haben?

Sehr häufig:

Beschwerden des Magen-Darm-Traktes wie Übelkeit, Erbrechen, Durchfall, Bauchschmerzen, Appetitverlust.

Diese Symptome treten meist zu Beginn der Behandlung auf und verschwinden dann von alleine, ohne dass die Behandlung abgebrochen werden muss. Um solche unerwünschte Wirkungen auf ein Minimum zu beschränken, wird empfohlen, Glucovance/- mite zu Beginn der Mahlzeiten einzunehmen. Falls diese Nebenwirkungen nicht verschwinden, sollten Sie Ihren Arzt bzw. Ihre Ärztin benachrichtigen. Er bzw. sie wird darüber entscheiden, ob und wie die Behandlung fortgesetzt werden soll.

Häufig:

Veränderung des Geschmacksinns (metallischer Geschmack).

Gelegentlich:

Porphyrie Schübe (eine Stoffwechselstörung mit Pigmentansammlung im Organismus), Veränderungen von Blutwerten.

Selten:

Abnahme der weissen Blutkörperchen sowie der Blutplättchen, allergische Hautveränderungen (wie Nesselfieber, Juckreiz, Hautausschlag, Lichtempfindlichkeit), Gefässentzündungen.

Sehr selten:

Abnahme der roten Blutkörperchen, Blutarmut, Leberfunktionsstörungen (Gelbsucht, Hepatitis), Alkohol-Unverträglichkeit, sehr schwere allergische Reaktionen, Senkung des Vitamin B12- und Natriumspiegels im Blut, Laktatazidose. Das Risiko einer Laktatazidose soll durch strikte Beachtung der Vorsichtsmassnahmen reduziert werden (vgl. «Wann ist bei der Einnahme von Glucovance/- mite Vorsicht geboten?»).

Falls Sie über längere Zeit mit Glucovance/- mite behandelt werden, wird Ihr Arzt bzw. Ihre Ärztin regelmässig Ihr Blut untersuchen, da es sehr selten zu einer Verminderung von Vitamin B12 kommen kann.

Weitere Nebenwirkungen:

Unterzuckerung (Hypoglykämie, vgl. «Wann ist bei der Einnahme von Glucovance/- mite Vorsicht geboten?»), vorübergehende Sehstörungen zu Beginn der Therapie.

Wenn Sie Nebenwirkungen bemerken, die hier nicht beschrieben sind, sollten Sie Ihren Arzt oder Apotheker bzw. Ihre Ärztin oder Apothekerin informieren.

+-Was ist ferner zu beachten?

Stoffwechselkontrollen

Ihr Arzt bzw. Ihre Ärztin wird in regelmässigen Abständen die Nierenfunktion, den Blutzucker und andere Blutwerte überprüfen. Die Nierenfunktion muss ausreichend sein, weil die Ausscheidung der Wirkstoffe von Glucovance/- mite zum grössten Teil über die Nieren erfolgt.

Sonstiges

Glucovance/- mite soll bei Temperaturen nicht über 30 °C und ausserhalb der Reichweite von Kindern aufbewahrt werden. Die Filmtabletten dürfen nur bis zu dem auf der Verpackung mit «EXP» bezeichneten Datum verwendet werden.

Weitere Auskünfte erteilt Ihnen Ihr Arzt oder Apotheker bzw. Ihre Ärztin oder Apothekerin. Diese Personen verfügen über die ausführliche Fachinformation.

+-Was ist in Glucovance/- mite enthalten?

Eine Filmtablette enthält:

Glucovance: 500 mg Metforminhydrochlorid und 2.5 mg Glibenclamid, Laktose sowie weitere Hilfsstoffe.

Glucovance mite: 250 mg Metforminhydrochlorid und 1.25 mg Glibenclamid, Laktose sowie weitere Hilfsstoffe.

+-Zulassungsnummer

55731 (Swissmedic).

+-Wo erhalten Sie Glucovance/- mite? Welche Packungen sind erhältlich?

Glucovance/- mite erhalten Sie in Apotheken nur gegen ärztliche Verschreibung.

Es sind jeweils Packungen mit 60 oder 120 Filmtabletten erhältlich.

+-Zulassungsinhaberin

Merck (Schweiz) AG, Zug.

Diese Packungsbeilage wurde im Juli 2014 letztmals durch die Arzneimittelbehörde (Swissmedic) geprüft.

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