Glimepiride and Metformin

Hypoglycaemic excluding Insulin · Biguanide/Sulphonylurea

Indications

Adjunct to diet & exercise in NIDDM when glimepiride or metformin monotherapy results in inadequate glycaemic control.

Dosage

Adults: The dosage administered according to individual glucose blood level. Usual initial dosage 1 mg Glimepiride and metformin HCl 500 mg daily; usual maintenance dose 1 mg to 4 mg Glimepiride daily. Max: Glimepiride 8 mg, metformin HCl 2000 mg. Children: Not recommended.

Adverse Effects

Hypoglycaemia, temporary visual impairment, GI disturbances, liver impairment. Metallic taste, rash, subnormal vit B12 levels.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Hypersensitivity to sulfonylureas, sulphonamides or biguanides. IDDM (type 1 DM), diabetic ketonaemia & coma/precoma, metabolic acidosis. Lactic acidosis, iodinated contrast IV, severe infections, pre- & post-op, serious trauma, malnourished, starving or debilitated patients, pituitary/ adrenal insufficiency. Severe lung dysfunction, hypoxaemia, hepatic dysfunction, alcoholism, dehydration, GI disturbances, CHF. Precautions: Regularly monitor glucose & glycosylated Hb. Milder or absent symptoms of hypoglycaemia e.g. in the elderly, patients with autonomic neuropathy or taking beta-blockers, clonidine, reserpine, guanethidine or other sympatholytic drugs. Temporary change over to insulin in exceptional stress situations (e.g. trauma, surgery, infections with fever). Hepatic or renal…

Interactions

Potentiation of the blood glucose-lowering effect by insulin & other oral antidiabetics, ACE inhibitors, allopurinol, anabolic steroids, male sex hormones, chloramphenicol, coumarin anticoagulants, cyclophosphamide, disopyramide, fenfluramine, phenyramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAOIs, miconazole, fluconazole, salicylates, pentoxyfylline (high dose parenteral), phenylbutazone, probenecid, quinolones, sulfinpyrazone, sulphonamides, tetracyclines, tritoqualine, trofosfamide, azapropazone, oxyphenbutazone. Weakening of the blood glucose-lowering effect by acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine & other sympathomimetics, glucagon, laxatives (long-term use), nicotinic acid (high dose), oestrogens, progestogen, phenothiazines, phenytoin, rifampicin, thyroid hormones.

Advice to Patient

Take just before meals or with first meal of the day. Do not skip the meal after taking medication.

Pharmacokinetics

GLIMEPIRIDE: Onset of action: Peak effect: Blood glucose reductions: 2-3 hrs. Duration: 24 hrs. Absorption: 100%. Metabolism: Hepatic. Half-life elimination: 5-9 hrs. Time to peak, plasma: 2-3 hrs. Excretion: Urine, faeces. METFORMIN: Onset of action: Within days, max effects up to 2 wks. Metabolism: Not metabolized by the liver. Bioavailability: Absolute: Fasting: 50%-60%. Half-life elimination: Plasma: 4-9 hrs. Blood: Approx. 17.6 hrs. Time to peak, serum: Immediate release: 2-3 hrs. Extended release: 7 hrs. (Range: 4-8 hrs). Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.