Type:Tablet
Generic Name:Glimepiride + Metformin
Manufacturer:Pacific Pharmaceuticals Ltd.
Price:৳12.00
Type 2 diabetes mellitus
Should be taken with breakfast or first main meal of the day.
Oral Type 2 diabetes mellitus Adult: Each tablet contains glimepiride 1 mg or 2 mg and metformin sustained release 500 mg The initial recommended dose is one tablet once daily Maximum Recommended Dose The maximum recommended dose for glimepiride is 8 mg daily. The maximum recommended daily dose for metformin sustained-release is 2000 mg in adults. Dosage should be individualized on the basis of both effectiveness and tolerance.
Renal disease or renal dysfunction, as suggested by serum creatinine levels ≥1.5 mg/dL [males], ≥1.4 mg/dL [females] or abnormal creatinine clearance, which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicaemia. Hepatic impairment. Known hypersensitivity to this product or any of its components. Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Diabetic ketoacidosis should be treated with insulin. Patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials, because the use of such products may result in acute alteration of renal function Pregnancy, lactation.
Glimepiride stimulates the insulin release from functioning pancreatic β-cells and inhibits gluconeogenesis at hepatic cells. It also increases insulin sensitivity at peripheral target sites. Metformin decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilisation).
Renal and hepatic impairment. Avoid alcohol consumption. Hypoglycaemic episodes.
Diarrhoea, vomiting, metallic taste, rash, isolated transaminase elevations, cholestatic jaundice, allergic skin reactions, photosensitivity reactions, leukopaenia, agranulocytosis, thrombocytopaenia, haemolytic anaemia, aplastic anaemia, pancytopaenia, blurred vision. Potentially Fatal: Lactic acidosis.
Cationic drugs: Certain medications used concomitantly with metformin may increase the risk of lactic acidosis. Cationic drugs that are eliminated by renal tubular secretions (e.g: amiloride, digoxin, morphine, procainamide, quinidine, ranitidine, or vancomycin) may decrease metformin elimination by competing for common renal tubular transport systems. Hence, careful patient monitoring and dose adjustment of metformin/cationic drug is recommended. Miconazole (systemic route, oromucosal gel) and Phenylbutazone (systemic route): Increases hypoglycemic effect of glimepiride. Thiazide: Interactions between thiazide diuretics and oral antidiabetic agents decreases insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Hence diabetic patients should be monitored closely. Other: Concomitant administration of angiotensin enzyme inhibitors (captopril, enalapril), other antidiabetic drugs (insulin, acarbose) beta-blockers, fluconozole, monoamine oxidase inhibitors (MAOIs), sulphonamides and NSAIDs, increasessensitivity to insulin and potentiates blood glucose lowering effect and may in some 6 instances, cause hypoglycemia. Patients receiving estrogens or oral contraceptives, phenytoin, quinolones should be closely monitored for loss of diabetic control. Potentially Fatal: NSAIDS, salicylates, sulfonamides, chloramphenicol, coumarins, probenecid, MAOs, and beta blockers potentiate the hypoglycemic action of glimepiride.
