Classification of undesirable adverse reactions (NDP) according to the frequency of development: Often: ≥1/10; often: ≥1 / 100 and <1/10; infrequently: ≥1 / 1000 and <1/100; rarely: ≥1 / 10000 and <1/1000; very rarely: < 1/10000 assignments or frequency is not known (can not be calculated based on available data).
Disorders from the metabolism and nutrition: often - hypoglycemia, weight gain.
The most common undesirable effect of the drug is hypoglycemia. It can take a protracted character and promote the development of severe conditions up to a comatose, life-threatening patient or ending lethally.With diabetic polyneuropathy or with concomitant treatment with sympatholytic drugs (see section "Interaction with other drugs"), typical precursors of hypoglycemia may be mild or absent altogether. The reasons for the development of hypoglycemia can be: drug overdose; application is not according to the indication; irregular eating; elderly patient; 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 drugs.
Symptoms of hypoglycemia are: a strong feeling of hunger, sudden profuse sweating, palpitations, pale skin, paresthesia in the mouth, tremors, general anxiety, headache, pathological drowsiness, sleep disorders, feelings of fear, impaired coordination of movements, temporary neurological disorders (eg, visual and speech disorders, 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.
Violations of the blood and lymphatic system: rarely - thrombocytopenia; rarely - leukocytopenia, erythrocytopenia, granulocytopenia (up to agranulocytosis); in isolated cases - hemolytic anemia, pancytopenia.
Disturbances on the part of the organ of sight: rarely - visual impairment and accommodation (these phenomena are more often observed at the beginning of treatment due to changes in blood glucose level).
Disorders from the gastrointestinal tract: infrequently - nausea, discomfort in the stomach, a feeling of heaviness and overflow in the stomach, vomiting, abdominal pain, diarrhea, belching, "metallic" taste in the mouth.
Disturbances from the skin and subcutaneous tissues: not often - itching, urticaria, skin rash (including flaky), photosensitization, skin hyperemia, Quincke's edema, purpura; rarely - generalized allergic reactions with skin rash, pain in the joints, fever, the appearance of protein in the urine and jaundice; rarely - life-threatening allergic vasculitis.
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.
Disturbances from the liver and bile ducts: rarely - a temporary increase in the activity of "hepatic" enzymes (alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase), drug hepatitis, intrahepatic cholestasis.
Other: rarely - increased diuresis, transient proteinuria, hyponatremia, acute reaction of alcohol intolerance after its use, expressed by complications from the circulatory and respiratory organs (disulfiramoid-like reaction: vomiting, sensation of fever of the face and upper body, tachycardia, dizziness, headache).