Glibenclamide and Metformin are combined in this medicine.
Glibenclamide + Metformin is used to treat type 2 diabetes (a long-term condition in which the body gradually becomes resistant to the effects of insulin or the pancreas does not produce enough insulin).
This medicine helps treat your diabetes by keeping your blood sugar under control.
This medicine is meant to be taken as part of a complete diabetes care programme that should include exercise, a healthy diet and regular monitoring of blood sugar levels.
Take Glibenclamide + Metformin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take it together with food or immediately after a meal. Try to take it at the same time each day.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition.
Glibenclamide + Metformin must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- metabolic acidosis (too much acid in the body) including diabetic ketoacidosis (a serious complication of diabetes that occurs when there are high levels of certain acids called ketones in the blood)
- condition that can affect kidney functions e.g. severe infection, shock
- disease that may cause low level of oxygen in tissues e.g. unstable heart disease, recent heart attack, severe blood loss
- if you drink too much alcohol or have an alcohol addiction
- porphyria (an inherited disorder that may cause skin or nervous system abnormalities)
- kidney disease
- liver disease
as Glibenclamide + Metformin may not be suitable for you.
If you are going for major surgery or any procedure which involves an injection of contrast medicine that contains iodine such as an x-ray, inform your doctor that you are taking this medicine.
Do not take Glibenclamide + Metformin with medicine used to treat high blood pressure in the blood vessels leading to the lungs, such as bosentan, or medicine used to treat fungal infection, such as miconazole.
Inform your doctor if you have the following conditions:
- G6PD deficiency (an inherited blood disorder that affects the red blood cell)
- problems with thyroid, adrenal or pituitary gland
- stable heart problem
- suffering from malnutrition (lack of proper nutrition)
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Glibenclamide + Metformin to the elderly or debilitated patient (a person who is physically or mentally weak usually due to illness or old age). Elderly people or debilitated patients may be more sensitive to the side effects.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
Routine tests (e.g. kidney and liver functions, blood glucose, HBA
1c, other blood tests, vitamin B
12 and folate levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
You may have been warned about hypoglycaemia (low blood sugar) while being treated with Glibenclamide + Metformin.
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, sweating. These signs are your body's way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 grams of glucose tablet at the first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 grams of glucose tablet.
If you don't have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms did not improve after the second serving.
Glibenclamide + Metformin may cause dizziness or impaired alertness or capacity to react. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: nausea, vomiting, diarrhoea, altered taste, loss of appetite, indigestion, stomach pain, rash, itching, and headache.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- general feeling of discomfort, stomach ache with muscle cramps, difficulty breathing
- hunger, fast heartbeat, sweating, weakness, shaking or feeling jittery
- abnormal paleness of the skin, confusion, cannot handle physical activity
- yellowing of the skin or eyes, dark coloured urine, swelling in the legs and ankles
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Glibenclamide + Metformin if you must undergo a procedure involving iodinated contrast agents (dyes).
Do not take this medicine with the following medicines:
- bosentan (medicine used to treat pulmonary arterial hypertension [high blood pressure in the blood vessels leading to the lungs])
- miconazole (medicine to treat fungal infection)
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- water pills or medicines for water retention e.g. furosemide, hydrochlorothiazide
- certain antibiotics e.g. ciprofloxacin, tetracycline, sulfamethoxazole/trimethoprim combination
- medicines for epilepsy (fits or seizures) e.g. phenytoin
- blood-thinning medicines e.g. aspirin, warfarin
- medicines to treat TB (lung infection known as tuberculosis) e.g. rifampicin, isoniazid
- NSAIDs (medicines for pain and inflammation) e.g. phenylbutazone
- medicines for high blood pressure e.g. captopril
- other medicines for fungal infection e.g. fluconazole, isavuconazole
- medicines for mood disorders e.g. chlorpromazine
- medicines to treat depression e.g. isocarboxazid, phenelzine, tranylcypromine
- probenecid (medicine for gout or high uric acid level in the blood)
- cimetidine (stomach medicine)
This list does not include all medicines that may interact with Glibenclamide + Metformin.
Colesevelam may reduce the effectiveness of this medicine when taken at the same time. If you are taking colesevelam, take Glibenclamide + Metformin at least 4 hours before your colesevelam dose.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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