39．克尿糖

出处：按学科分类—医药、卫生 军事医学科学出版社《临床常用进口药物手册》第206页（5435字）

【中文释文】：

口服抗糖尿病剂

〔成分〕

克尿糖每片含25mg有效成分的格列波脲。

〔特性〕

克尿糖耐受性好，剂量小，效果大。像其他磺酰脲的作用一样，使胰腺的β细胞释放胰岛素。

〔适应证〕

糖尿病。克尿糖适用于治疗成年性糖尿病——这种糖尿病不需胰岛素治疗，而单独食物疗法又不足以控制代谢。

〔剂量〕

根据个人的代谢情况而使用，以下是一般用法：

初疗剂量：(病人以前未曾口服抗糖尿病剂治疗，及单独使用食物疗法无效者)开始治疗日服半片克尿糖。此量足以控制代谢情况，但大多数病人需增量至1～2片／d(早餐时服用)。剂量至2片／d时，早晚各服1片，需于早晚餐时服用。

〔耐受量〕

上述克尿糖剂量，耐受性极其良好，低糖情形很少发生。胰腺反应及肠胃不适现象极少发生。

〔注意〕

克尿糖治疗时间是很长的，即使病人口服降糖药，也要注意特别饮食。需经医师指导及多做检查。

如系幼年性糖尿病，即胰岛素完全缺乏，则必须以胰岛素治疗。

尚无临床报告克尿糖对胎儿成长有害，然而患糖尿病的孕妇因代谢情况不定，宜使用胰岛素治疗。

〔禁忌证〕

禁用于严重肾功能不全的病人和对磺酰脲不耐受的病人，糖尿病昏迷等。

〔包装〕

25mg30片、100片、500片等粒硬锡纸包装。

将药品保存在儿童不能触及的地方。

〔生产厂家〕

瑞士霍夫曼罗氏制药厂

(附本品别名：甲磺冰脲，克糖利，格拉出尔，Glibornuridum，Glitrim，Glitrin，Gluborid，Ro6-4563)

【外文释文】：

Oral antidiabetic agent

Composition．

Each tablet contains an active ingredient 25 mg of 1-[(I R)-2-endo-hydroxy-3-endobomyl]-3-(p-tolylsulfonyl)ures(glibornurid)．

Properties

Glutril is a well-tolerated oral antidiabetic agent that is effective in low doses．Like other sulfonylureas，it acts by stimulating the release of endogenous insulin from the β-cells of the pancreas．

Indication

Diabetes mellitus：Glutril is indicated for the treatment of maturity-onset diabetes that does not require insulin therapy and that is not adequately controllable by dietary measures alone．

Dosage

The dosage of Glutril should be adapted by the doctor to the metabolic requirements of the individual patient．The following dosage schemes are presented as general guidelines：

Initial therapy．This scheme is intended for patients for whom diet alone is not sufficient to bring about appropriate control as well as for those who have not previously been treated with oral antidiabetic drugs．

Treatment should begin with 1／2 tablet daily．This dosage may be adequate but，in most patients，it will have to be increased to 1-2 tablets(to be taken with breakfast)．If a higher dosage is needed，2 tablets should be given in the morning and the remainder of the dose in the evening．

In general，the maximal daily dosage of Glutril is 3 tablets since higher doses usually do not lead to better results．

Transfer(This scheme is indicated for patinets previously treated with other oral antidiabetic drugs．)

If a patient is transferred to Glutril，the dosage should be based on that of the drug previously used；e．g．25mg of Glutril are equivalent to approximately 1000 mg tolbutamide，250mg chlorpropamide or 5 mg glibenclamide．

N．B．Transfer from insulin to Glutil can be tried in obese patients with maturity-onset diabetes．If this is done，the dosage for Glutril must be established by appropriate controls of blood sugar．

Side effects

In the recommended doses Glutril is very well tolerated．Hypoglycemic incidents the first symptoms of which are hunger，sweating，nausea and confusion-are rarely encountered．In such cases，the patient should take a little sugar dissolved in water．In such episodes，the treating physician must，in any case，be consulted as quickly as possible．Allergic dermatitis and gastrointestinal disturbances are extremely rare．

Note

Treatment with Glutil is life-long．Patients should keep to a special diet even when taking oral antidiabetic agents．Glutril patients should therefore be under regular supervision(as with any other antidiabetic drug)．Any alterations of dosage required-should a patient have to make unavoidable changes in his diet or physical activities or should an additional illness supervene-must be determined by the patient’s physician．

Treatment with insulin is indicated both in juvenile diabetics，i．e．when there is a severe or absolute deficiency of endogenous insulin，and in patients showing evidence of ketoacidosis．

There is no experimental evidence to suggest that Glutril has a harmful influence on embryonic development；in female diabetic patients whose metabolic status is altered by pregnancy，however，insulin is the drug of choice．

The simultaneous administration of sulfonamides(sulfaphenazole)，salicylates，phenylbutazone，tuberculostatics(ethionamide)，chloramphenicol，tetracyclines，coumarin derivatives，cyclo phosphamide(cytostatic agent)or monoamine oxidase inhibitors may enhance the effect of oral antidiabetic agents．In patients taking(Glutril)，intolerance to alcohol may occur but very rarely．

Contraindieations

Glutril is contraindicated in severe renal insufficiency and in patients with known intolerance to sulfonylureas，in diabetic coma and precoma，in juenile diabetes(including prophylaxis in mild nonketotic forms)，in any patient with ketoacidosis，in pregnancy．

Packs

Tablets(scored)25mg，30，100，500

Medicine：keep out of reach of children

Manufacturer

Made in switzerland by F．Hoffmann-La Roche & Co．Ltd Basle