Lao Hu has been suffering from diabetes for more than 20 years, and it has become more and more difficult to control blood sugar in recent years, from the beginning to eat only metformin to control blood sugar at about 6mmol /L, to change to insulin, blood sugar is still controlled at about 7mmol/L. Since last year, he has also taken glimepiride and migliglisol while using insulin, but his fasting blood sugar has been around 8 mmol/L, and he occasionally has dizziness.
He was in a hurry, went to the hospital for examination, the doctor added empagliflozin, used it for more than 1 month, found that blood sugar control can also be, around 6mmol / L, very happy. However, when he went to the hospital again to get the medicine, the doctor prescribed dapagliflozin, and when he got the medicine, he found that it was not the same as the medicine he took last time. Although I was not at ease, I saw that there were many people queuing up for medical treatment, and I did not ask the doctor again. Later, the consultation asked, what is the difference between the two drugs, can they be exchanged?
Since we say that we have reached platyflozin and empagliflozin, we have to say that cagliflozin, both are legagins, what are the similarities and differences?
1. Similarities
(1) Mechanism of action: dapagliflozin, empagliflozin, and kapogliflozin all belong to sodium-glucose synergistic transporter-2 (SGLT-2) inhibitors, which is a new type of oral hypoglycemic drug, which inhibits the reabsorption of glucose by the renal tubules, so that glucose is excreted from the urine, and finally achieves the purpose of hypoglycemic. But specifically, there is still a certain difference, dapagliflozin mainly acts on SGLT-2, while carbagliflozin acts on the two transporters SGLT-2 and SGLT-1, of course, 90% of which act on SGLT-2.
(2) Weight loss: As we all know, overweight or obesity is a high risk factor for diabetes, and these three new hypoglycemic drugs of dapagliflozin, empagliflozin and kapagliflozin can increase urinary glucose excretion and increase calorie loss, thereby achieving the purpose of weight loss. Clinical trials have confirmed that the average weight reduction of caspagliflozin is about 2.81 kg, the average weight reduction of dapagliflozin is about 2.10 kg, and the average weight reduction of empagliflozin is 1.84 kg.
(3) Lower blood pressure, cardiovascular protection: Although the main effect of these three column net drugs is to lower blood sugar, but there is also a certain blood pressure lowering effect, blood sugar into the urine will increase urine, promote the excretion of sodium, and the role of diuretics is similar. For normal people, the reduction in systolic blood pressure is about 3-4 mmHg, and the reduction in diastolic blood pressure is about 1-2 mmHg, and for patients with hypertension, the reduction is even greater. It is precisely because these drugs have a series of effects such as blood pressure reduction, hypoglycemic reduction, weight loss, etc., and also have a good protective effect on cardiovascular disease.
(4) Protection of the kidneys: diabetic patients if the blood glucose control is not good, the damage to the kidneys is very large, serious and even appear uremia, the study found that because the list of drugs can reduce 36% of the proteinuria, the proportion of reverse proteinuria up to 70%, reduce the risk of kidney events of 40%, can be a good protection of the kidneys, delay the progression of kidney disease.
2. The difference
(1) The price is different: the price of the original research drug 100mg * 10 tablets imported by kagliflozin is about 42 yuan, the price of 100mg * 30 tablets of generic drugs is about 56 yuan; the price of the original research drug imported by Empagliflozin is about 40 yuan, the price of 10mg * 30 tablets of generic drugs is about 58 yuan; the price of 10mg * 30 tablets of dapagliflozin is about 90 yuan.
(2) The dosage of drugs is different: the recommended starting dose of carbagliflozin is 100mg / day, which can be taken before breakfast every day, and the dose of the drug can be adjusted according to the patient's blood glucose situation, and the maximum can be increased to 300mg / day, which can be used together with metformin, sulfonylureas and other drugs. The initial dose of empagliflozin is 10 mg per day, which can be used on an empty stomach or after eating, and the maximum dose can be increased to 25 mg, which can be used in combination with metformin and sulfonylureas. The starting dose of dapagliflozin is 5 mg, taken in the morning, not affected by eating, and in patients with higher blood glucose, the dose can be increased to 10 mg / time. None of the above three drugs can be used for the treatment of type I diabetes or diabetic ketoacidosis.
In the process of use, if a drug is gone, it is possible to switch to another drug, because its mechanism of action is basically the same, and the role played after entering the body is similar, so do not worry too much, according to the drug instructions or consult a professional doctor, take the drug correctly, and monitor blood sugar to ensure that blood sugar control is within the normal range. Although this is the case, if there is no special reason, try to use a drug as well.
Finally, any drug has adverse reactions, for these 3 drugs, contraindicated people are people with a history of severe allergies, patients with severe renal failure and patients receiving dialysis, and it is not recommended for pregnant women. If you don't know if you can use it, it is best to consult a doctor or a professional person before making a decision!