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This medication is used for managing non-insulin dependent diabetes

Some patients might experience hypoglycemia and liver failure. Please consult your doctor if you experience any of these symptoms.

Please consult your doctor before taking this medication if you have any of these conditions; insulin-dependent diabetes mellitus (type of diabetes), or diabetic Ketoacidosis (diabetic complication).

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.
  • Inform your physician about any other medication you are taking. Especially NSAIDs, thyroid medicines or blood pressure medications (such as Beta Blockers, or ACE inhibitors.)

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.
  • Alcohol consumption should be avoided.
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
This drug belongs to a class of drugs known as sulfonylureas. These drugs are used in the treatment and management of diabetes.
It is safe to take these medications together, if your physician has recommended it. However, it is important to be even more careful about your meals and dosing schedule, to lower the risk of low blood sugar.
If your physician has recommended adding insulin to your treatment, then it should be taken along with this drug. Please make sure that you do not change the prescribed doses in any way, since this may cause changes in blood sugar levels.
Metformin belongs to a different class of drugs, and it can be used along with this drug to improve blood sugar levels. It is safe to take metformin along with this drug, only if your doctor recommends it, and keeping the necessary precautions in mind.
This is a possible side effect, but can be avoided if meals are taken regularly.
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.
This medicine is not recommended for use in kidney problems because it can further worsen the condition. Please consult your doctor for further assistance.
Glimepiride is advised to use cautiously in patients with liver disease. Your doctor may carefully alter the doses if you suffer from it.
This medicine should not be skipped as it can worsen your diabetes. If however, this medication is missed, take the missed pill as soon as you remember but do not double the dose. Complete the full course as recommended by your doctor.
Avoid using this drug if you are allergic to sulfonylureas or sulfonamides.
Certain blood pressure medicines may increase the effect of glimepiride and cause the blood sugar levels to fall even more causing hypoglycemia. For this reason, you must consult your doctor before starting therapy with this drug along with any hypertension medicines.
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.
Research suggests that this medication should be avoided by pregnant women.
Research suggests this medication 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 regularly monitor blood glucose levels.
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. 

Glimepiride + Metformin

Indication

It is primarily indicated for treating Diabetes Mellitus type 2 uncontrolled by metformin or glimepiride alone.

Mechanism of Action

It increases B cell insulin secretion, receptors and sensitivity. It also decreases the liver production of glucose. A combination of both the ingredients offers a controlled glucose level in blood in diabetes type 2 and prevents vascular complications in patients where metformin alone is insufficient.

Dosage

Form: tablet

Dosing interval: 24 Hr

Maximum Dose: 8/2000mg per day

Dialyzable:Metofrmin: yes

Maintainance dose

1/500mg once daily then adjust the dose according to the dose response.

Renal Adjustment

Adjust the dose if Creatinine clearence of the patient is greater then 1.5mg/dl and 1.4mg/dl in females.

  • pregnant

    Pregnancy

    Doctors consultation is important before use, as human and animal research is insufficient or animals showed defects and human research hasn?t been conducted.

  • mother

    Lactation

    The use of combination product in nursing mothers is not recommended.

ContraIndication
Cautions

Use with great care if the patient had suffered from cardiovascular events inclusiding hypoxic conditions. It is generally not recommended to be used in patients with metabolid acidosis (diabetic ketoacidosis). Alocholic or hypoglycemic patients should be instructed properly when taking sulfonylureas. Patients with a 6GDP (6-phosphate dehydrogenase) leads to severe anemia, so care should be taken with prescribing a sulfonylurea (Glimepride) when taken along with non-sulfonylureas.

Pharmacokinetics

Time of onset: 1 hr (delayed to about 12% if taken with meals, known to be insignificant)

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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