Perglim M-2

Glimepiride 2 mg, metformin HCl 500 mg

Adjunct to diet & exercise in type 2 DM patients, in case when monotherapy w/ glimepiride or metformin does not result in adequate glycemic control.

1 tab once daily. Individualized dosage. Max: metformin 2,000 mg & glimepiride 8 mg once daily.

Should be taken with food: Swallow whole, do not chew/crush.

Hypersensitivity to metformin HCl, glimepiride, sulfonylureas, or other sulfonamides. Not suitable for treatment of insulin-dependent (type I) DM (eg, for diabetics w/ history of ketoacidosis), or of oral diabetic precoma or coma. Impaired renal function; acute complications (severe infections, major operations & trauma), before x-ray exam w/ iodinated contrast materials; liver damage; alcoholism; deficiencies of vit B₁₂, folic acid & iron; ketosis-prone diabetes; severe CV or resp disease; general ill health (malnutrition, dehydration); diabetes w/ significant late complications (nephropathy, retinopathy).

Hypoglycemia. Contraindicated during pregnancy. Avoid during lactation. Elderly. Glimepiride: Patients w/ autonomic neuropathy, or receiving concurrent treatment w/ β-blockers, clonidine, reserpine, guanethidine or other sympatholytic drugs. Exceptional stress situations (eg, trauma, surgery, infections w/ fever). Regularly check glucose levels in blood & urine, additionally, proportion of HbA1c. May impair alertness & reactions. May affect ability to operate vehicle or machinery. Metformin: Lactic acidosis; regular monitoring of renal function, & use of minimum effective dose in conditions like impaired hepatic function, renal dysfunction, hypoxemia, dehydration, sepsis, excessive alcohol intake. Discontinue immediately in patient w/ lactic acidosis. Concomitant therapies that may affect renal function or interfere w/ the disposition of metformin (eg, cationic drugs). Stop at least 2 days before x-ray exam w/ iodinated contrast material, & reinstitute only after renal function has been reevaluated & found to be normal. Promptly discontinue when hypoxic states occur. Temporarily discontinue in surgical procedures & restart only when patient resumes oral intake & has normal function. Excessive alcohol intake, acute or chronic. Avoid in patients w/ hepatic disease. Annually measure serum vit B₁₂ conc during long-term treatment. Monitor response to therapy periodically through measurement of fasting blood glucose & HbA1c levels.

Hypoglycemia; temporary visual impairment; nausea, vomiting, sensations of pressure or fullness in epigastrium, abdominal pain & diarrhea; allergic or pseudoallergic reactions like itching, urticaria or rashes.

Metformin: Interacts w/ cimetidine. May partly offset the anti-hyperglycemic action w/ drugs w/ hyperglycemic potential (eg, thiazides, corticosteroids). Potentiated action on lactate metabolism as well as anti-hyperglycemic effect w/ alcohol. Increased plasma levels w/ furosemide & nifedipine. Reduced absorption w/ acarbose & guar gum. Glimepiride: Hypoglycemia w/ insulin & other oral antidiabetics, ACE inhibitors, allopurinol, anabolic steroids & male sex hormones, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine, fenyramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAOIs, miconazole, para-aminosalicylic acid, pentoxifylline (high dose parenteral), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, sulfonamides, tetracyclines, tritoqualine, trofosfamide. Hyperglycemia w/ acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine (adrenaline) & other sympathomimetic agents, glucagons, laxatives (after protracted use), nicotinic acid (in high doses), estrogens & progestogens, phenothiazines, phenytoin, rifampicin, thyroid hormones. May lead to either potentiation or weakening of blood sugar-lowering effect w/ H₂-receptor antagonists, clonidine & reserpine. May increase the tendency to hypoglycemia w/ β-blockers. May potentiate or weaken the effect of coumarin derivatives.

Antidiabetic Agents

A10BD02 - metformin and sulfonylureas ; Belongs to the class of combinations of oral blood glucose lowering drugs. Used in the treatment of diabetes.

Rx