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This medicine is used for managing maturity onset diabetes

Some patients might experience Nausea. Pease consult your doctor if you experience any of these symptoms.

Please consult your doctor before taking this medicine if you have any of these conditions; Juvenile diabetes with Ketosis (type of diabetes), impairment of renal function (kidney disorder), stress, diabetic coma.

This medicine should be taken with food.

Avoid this medication if:

  • You are allergic to this medicine or it's contents, (Sulfa, etc.)

Consult your doctor if:

  • You are pregnant, planning to have a child, or breastfeeding.
  • You have any sort of digestive problems
  • You have a medical history of: Liver diseases, kidney diseases, thyroid problems, blood disorders, etc.
  • You are considered an elderly patient, since this medicine may cause low blood sugar in such patients.
  • Inform your physician about any other medication you are taking.

Be careful about:

  • Having your meals on time to maintain blood sugar levels
  • Taking the medicine timely, in the way that your physician has prescribed (with food)
  • Following the lifestyle changes that your physician has suggested.
Type II Diabetes

This medicine is indicated in maturity onset diabetes either alone or with sulphonylureas. It is also used as adjuvant therapy in insulin dependent diabetes, particularly in obese patients.

GI upset, taste disturbance, abnormal liver function tests, hepatitis (inflammatory condition of liver), skin reactions, reduced B12 absorption are some of its side effects. Rarely it may cause lactic acidosis (buildup of lactate causing acidic pH of blood stream).

This medicine is contraindicated in patients with diabetic ketoacidosis (life threatening condition in which liver breaks down fats into ketones for energy) or precoma (a state of near unconsciousness), renal (kidney) or hepatic (liver) impairment, acute conditions predisposing to renal impairment, cardiac or respiratory failure, recent myocardial infarction (heart attack), alcoholism and in patients with administration of iodinated contrast materials.

This medicine should be taken with food.

Avoid this medication if:

  • You are allergic to this medicine or its contents 

Consult your doctor if:

  • You are pregnant, planning to have a child, or breastfeeding.
  • If you are avoiding unwanted pregnancy, so that your doctor may suggest a suitable form of birth control. Due to Metformin's effects on ovulation and pregnancy.
  • You have any sort of digestive problems after taking this medicine: Nausea, vomiting, diarrhea, etc.
  • You have a medical history of: Liver diseases, kidney diseases, congestive heart failure, or lung disease.
  • If you are about to undergo any medical or surgical treatment. 
  • If you are about to undergo any CT scan, or X-ray, as it may interact with the dyes used in some pf these procedures.
  • If you have a B12 deficiency, are anemic, or are developing symptoms of anemia, Such as: lethargy, aches and pains,  or a pale appearance to the skin. 

Be careful about:

  • Having your meals on time to maintain blood sugar levels.
  • Taking the medicine timely, in the way that your physician has prescribed (with food), this will help avoid digestive disturbances.
  • Alcohol consumption.
  • Avoiding dehydration in any form.
Type II diabetes
It belongs to a class of drugs known as sulfonylureas. These drugs are used in the treatment of diabetes.
This is a possible side effect, but can be avoided if meals are taken regularly.
If it has not been too long, have the skipped dose with your next meal. If it is almost time to take your next dose, do not take two doses, simply return to the prescribed routine.
If you are not regular with your meals, you may experience symptoms of low blood sugar: Such as palpitation, sweating, dizziness, light headedness etc. In this case, taking sugar can relieve your symptoms.
Kindly avoid taking any medication beyond the mentioned date of expiry.
No. Please consult your doctor if you suffer from a liver or a kidney disease.
No. This drug is not recommended for use in pregnancy. Please consult your doctor before using it during pregnancy.
No. The use of this medication is not recommended for use during lactation. Please consult your doctor before using this drug during breast feeding.
Some of the blood pressure lowering drugs may enhance the effect of glibenclamide causing hypoglycemia. Please consult your doctor for further assistance.
If your doctor has recommended using this drug with insulin then it should be added to your treatment. However, it is advised to strictly follow the prescribed doses , as failure to do may cause symptoms of hypoglycemia (low blood sugar) such as; dizziness, light headedness, palpitations etc.
No. This medicine is only for use in type 2 diabetes.
Yes, this medicine can be given to elderly patients but regular dose monitoring is important because older patients are more prone to the development of low blood sugar. Please consult your doctor for further guidance.
Metformin belongs to a class of drugs known as biguanides. It is used to improve insulin activity, and control weight in diabetic patients. It is also known to regulate menstrual cycles (periods) and is used in the treatment of PCOs (Poly Cystic Ovarian Disease.)
No, this drug does not contain hormones, or insulin,. It enhances the effect of insulin, which helps patients with diabetes or PCOs, since their bodies tend to develop a resistance to the actions of insulin.
Though there is no dangerous drug interaction, an adjustment in doses of both anti thyroid drugs, and steroids (eg: prednisone) may be required. It should be noted that patients taking steroids sometimes develop diabetes as a side effect. Please consult your physician, and discuss all the medicines you are taking, including their doses.
Lactic acidosis is a very rare, and potentially fatal side effect of this medication. It occurs when there is an excessive buildup of lactic acid in the body. It may occur in patients who have overdosed. Symptoms include stomach problems, dizziness, breathing difficulty, muscle aches, irregular heartbeat, etc. Patients who experience these symptoms should go to a doctor immediately.
Please use this medicine for the time that has been prescribed, and in the dose prescribed by your physician. Using it for longer than prescribed can cause side effects such as Vitamin B12 deficiency.
Low blood sugar is rare with Metformin, but it is a possible side effect, especially if you are taking other anti-diabetic drugs. Please maintain regularity in meals, dosage, and exercise to maintain blood sugar levels, and continue monitoring sugar levels. Also carry sugar or a sugary drink in case you feel dizzy, or develop any other sign of low blood sugar.
You can take the missed dose as soon as you remember. If you remember when it is almost time for your next dose, then skip the missed dose entirely. Do not double your dose to catch up for missed doses.
It is important to maintain regularity in meals, and exercise. Low blood sugar is rare, but may occur if you are taking other anti-diabetic medication.
Weight gain is unlikely with this medicine, however, it does cause weight loss. This is because it improves the actions of insulin, and decreases hunger. Please take note that this drug is not a medicine which treats weight loss, and should only be used if prescribed by your physician. This medicine may, however, cause bloating. It is best taken after meals to avoid this side effect.
This medication can result in a vitamin B12 deficiency after being used for a long time, and this can cause anemia. Please discuss with your doctor if you are already anemic, or if you start experiencing symptoms such as paleness, weakness, lethargy, etc.
In patients who have fatty liver, and hepatitis C related liver disease, it is safe and is recommended. However, it is discouraged in patients who have liver cirrhosis, due to its association with lactic acidosis.
Please consult your doctor before taking this medicne.
Research suggests that this medicine should be avoided by women who are breastfeeding.
Please avoid driving when taking this medicine as it may affect your ability to drive.
Please avoid consuming alcohol when taking this medicine.
Please consult your doctor as a precaution before taking this medicine if you have cross-sensivity to sulfonamides and sulfonamide derivative (type of antibiotic).
This medicine is safe to use in pregnant females. No evidence of risk found. 
This medicine is contraindicated in lactating females.
Please avoid consuming alcohol when taking this medicine.
Assess risk factors for lactic acidosis (buildup of lactate causing acidic pH of blood stream). Discontinue immediately if metabolic acidosis (overproduction of acid in the body) is suspected. Monitor renal (kidney) function at least annually. Discontinue the medicine for 48 hours before and after the elective surgery. 

Glibenclamide + Metformin

Indication

It is primarily indicated for treating Diabetes Mellitus type 2.

Mechanism of Action

It is known to Increase the B cell insulin secretion of the pancreas. It enhances insulin sensitivity and basal insulin secretions. Its short acting and more potent

Dosage

Strength: 5mg/500mg

Form: tablet

Dosing interval: 24 hr or 12 Hr

Maximum Dose: It is advised to not exceed 20/2000mg per day

Dialyzable:Metformin is dialyzable only

Maintainance dose

The recommended dose as per suggested studies is 1.25/250mg once daily or every 12 hourly, observe the effects then modify after a gap of 14 days.

Hepatic Adjustment

Data suggests reports of lactic acidosis. Not recommended as per experts

Renal Adjustment

It is suggested to determine eGFR (estimated glomerular filteration rate ), if found to be less than 30ml/min/1.73m2, contraindication reported. If between 30-45ml/min/1.73m2, not recommended to start a treatment..

  • pregnant

    Pregnancy

    Research on animals showed no effect and no human research was conducted. Or Research on animals have shown some degree of effect but human research did not show any effects.

  • mother

    Lactation

    Insufficient data to prove if the drug enters breast milk, hence not recommended.

ContraIndication
Cautions

Estimate eGFR (estimated glomerular filteration rate) prior to initate treatment. In patients with eGFR less than 30ml/min/1.73m2 the combination is contraindicated. Skin allergies or severe hypoglycemia condition do not favour the therapy unless treated.

Pharmacokinetics

Disclaimer

Dawaai's intention is to make sure that it's consumers get information that is accurate, reviewed by an expert and error-free. However, the information mentioned here should not be used as a replacement for the advice of a qualified physician. The information given here is for informational purposes only, which may not cover all possible precautions, side effects, contraindications or drug interactions. Consult your doctor and discuss your queries related to any medicine or disease.

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