Imagin

Indications

Imeglimin Hydrochloride is a tablet used to lower blood sugar in adults with type 2 diabetes, together with diet and exercise. It can be used alone or with some other diabetes medicines.

How It Works

Imeglimin is the first of a newer group of diabetes medicines called glimins. It improves how the mitochondria (the energy centres of cells) work. This helps the pancreas release more insulin when blood sugar is high, helps the liver make less sugar, and helps muscles use sugar better.

Dosage and Administration

The usual adult dose is 1,000 mg twice a day, morning and evening, as prescribed by your doctor. It can be taken with or without food. Swallow the tablet whole with water. It is not recommended when kidney function is severely reduced. Keep taking it even if you feel well and check your blood sugar as advised.

Interactions

When used with insulin or sulfonylureas (such as Gliclazide or Glimepiride), blood sugar may drop too low, so the doctor may lower those doses. Some reports suggest stomach upset is more common when used with Metformin. Steroids such as Prednisolone, thiazide diuretics and some other medicines can raise blood sugar and reduce its effect.

Contraindications

• Allergy to Imeglimin or any ingredient of the tablet.
• Type 1 diabetes or diabetic ketoacidosis (a serious complication with high ketones).
• Severe kidney disease or dialysis.
• Severe infection, major surgery or serious injury, where insulin is needed instead.

Side Effects

The most common effects are nausea, diarrhoea, constipation and stomach discomfort, which often settle. Low blood sugar (sweating, shaking, hunger, confusion) may happen, mainly when used with insulin or sulfonylureas.

Get urgent medical help if you have signs of a severe low blood sugar that does not improve after taking sugar, fainting, a severe allergic reaction with swelling of the face or difficulty breathing, or persistent vomiting with abdominal pain.

Pregnancy and Lactation

There is no safety information for pregnancy or breastfeeding. Insulin is normally preferred for diabetes in pregnancy. Do not use Imeglimin if you are pregnant, planning pregnancy or breastfeeding unless your doctor advises it.

Precautions and Warnings

Your doctor will check kidney function before and during treatment. Learn the signs of low blood sugar and carry sugar or glucose with you. It has been studied mostly in Asian adults and long term experience is still limited. It is not for children. Take care with driving if you are prone to low blood sugar.

Overdose

Overdose may cause stomach upset and possibly low blood sugar. Take sugar if you have symptoms of low blood sugar and contact a doctor or hospital.

Therapeutic Class

Oral antidiabetic agent; glimin (mitochondrial function enhancer).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.