Premil 1 mg Tablet is an oral antidiabetic medicine belonging to the Meglitinide Analogues class. It is used as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus (NIDDM) when blood glucose levels are not adequately controlled by lifestyle modification alone. Premil 1 mg may also be used in combination with Metformin to achieve better blood glucose control in suitable patients.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Indications

Premil 1 mg is indicated for:

• Adjunctive treatment with diet and exercise to lower blood glucose levels in patients with type 2 diabetes mellitus

• Combination therapy with Metformin in patients whose hyperglycemia cannot be adequately controlled by diet, exercise, and either Premil 1 mg or Metformin alone

Pharmacology and Mode of Action

Premil 1 mg stimulates insulin secretion from pancreatic beta cells. It works by closing ATP-regulated potassium channels in the beta-cell membrane, leading to cell depolarization. This opens voltage-dependent calcium channels, increasing intracellular calcium levels and triggering insulin release. Its rapid onset and short duration of action help control postprandial blood glucose levels effectively.

Dosage and Administration

Premil 1 mg should be taken immediately before or up to 30 minutes before meals. The dosing frequency depends on the number of meals taken per day.

• Initial dose:

  • HbA1c <8%: 0.5 mg before each meal

  • HbA1c >8%: 1–2 mg before each meal

• Dose range: 0.5 mg to 4 mg before each meal

• Maximum dose: 16 mg per day

If a meal is skipped, the corresponding dose should be omitted. If an extra meal is consumed, an additional dose should be taken with that meal. Dose adjustments should be made at intervals of 1–2 weeks based on glycemic response.

Drug Interactions

Premil 1 mg may interact with several medications:

• CYP450 inhibitors such as azole antifungals and macrolides may increase Premil levels

• CYP450 inducers like rifampicin, carbamazepine, and phenobarbital may reduce its effectiveness

• Highly protein-bound drugs, including NSAIDs, may increase the risk of hypoglycemia

• Concomitant use with other hypoglycemic agents or drugs such as salicylates, sulphonamides, MAO inhibitors, and beta-blockers may enhance hypoglycemic effects

Contraindications

Premil 1 mg is contraindicated in patients with:

• Type 1 diabetes mellitus

• Diabetic ketoacidosis, with or without coma

• Known hypersensitivity to the drug or its components

Side Effects

The most common adverse effect is hypoglycemia. Other possible side effects include upper respiratory tract infections, nausea, vomiting, diarrhea, constipation, and hypersensitivity reactions such as rash and urticaria.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions and Warnings

• Premil 1 mg should be taken with meals to reduce the risk of hypoglycemia

• Insulin therapy should be considered during periods of severe illness, trauma, surgery, or stress

• All oral antidiabetic drugs carry a risk of hypoglycemia; careful monitoring is advised

Pregnancy and Lactation

The safety of Premil 1 mg during pregnancy has not been established. It should be used during pregnancy only if clearly needed. It is not known whether Premil 1 mg is excreted in human milk; therefore, caution is advised when administered to nursing mothers.

Overdose

Overdose may lead to excessive lowering of blood glucose. Severe hypoglycemia with neurological symptoms is rare and usually occurs in the absence of adequate food intake. Management is supportive and focused on correcting hypoglycemia.

Storage Conditions

Store below 30°C, protected from light. Keep out of the reach of children.