The most common undesirable action is hypoglycemia. This condition can take a protracted character and contribute to the development of severe conditions up to a comatose, life-threatening patient or ending lethally.In diabetic polyneuropathy or concomitant medication sympatholytic agents (see. The section "Interaction with other drugs") typical precursors of hypoglycemia can be quite weakly expressed or absent. The reasons for the development of hypoglycemia can be: drug overdose; incorrect reading; irregular eating; elderly patients; vomiting, diarrhea; large physical exertion; diseases that reduce the need for insulin (violations of liver and kidney function, hypofunction of the adrenal cortex, pituitary gland or thyroid gland); alcohol abuse, as well as interaction with other medicines (see section "Interaction with other drugs"). Symptoms of hypoglycemia include: strong hunger, sudden sweating, palpitations, pallor, paresthesia in the mouth, trembling, general restlessness, headache, abnormal sleepiness, sleep disturbances, anxiety, impaired motor coordination, temporary neurological disorders (eg, disorders of vision and speech,manifestations of paresis or paralysis or altered perception of sensations). With the progression of hypoglycemia, patients may lose self-control and consciousness. Often such a patient has moist cold skin and a predisposition to convulsions.
Along with hypoglycemia are possible:
Disorders from the digestive system: rare nausea, eructation, vomiting, "metallic" taste in the mouth, a feeling of heaviness and fullness in the stomach, abdominal pain and diarrhea. In some cases, a temporary increase in the activity of "hepatic" enzymes (alkaline phosphatase, glutamic-oxaloacetic aminotransferase, glutamine-pyruvic aminotransferase) in the blood serum was described; drug hepatitis and jaundice.
Rarely appear skin allergic reactions: rash, itching of the skin, urticaria, reddening of the skin, Quincke edema, pinpoint bleeding in the skin, flaky rash on large skin surfaces and increased photosensitivity. Very rarely skin reactions can serve as the beginning of the development of severe conditions, accompanied by shortness of breath and lowering blood pressure until the onset of shock, threatening the life of the patient.Separate cases are described severe generalized allergic reactions with a skin rash, pains in the joints, fever, the appearance of protein in the urine and jaundice.
On the part of the system of hemopoiesis: rarely there is thrombocytopenia or very rarely leukocytopenia, agranulocytosis. In isolated cases, hemolytic anemia or pancytopenia develops.
To other side effects, observed in a few cases, include: a weak diuretic effect, a temporary appearance of protein in the urine, visual and accommodation discomforts, and an acute reaction of alcohol intolerance after its use, expressed by complications from the circulatory and respiratory organs (disulfiram-like reaction: vomiting, fever and the upper part of the trunk, tachycardia, dizziness, headache).
If any of the side effects indicated in the manual are aggravated, or any other side effects not indicated in the instructions are noted, you should inform the doctor immediately.