Perglim M-2 Drug Interactions

Metformin: Cimetidine: Metformin interacts with cimetidine. Therefore, the dose of metformin should be reduced if cimetidine is co-prescribed.
Hyperglycemic Agents: Drugs with hyperglycemic potential (e.g. thiazides, corticosteroids, and others) may partly offset the anti-hyperglycemic action of metformin, and in such cases, the glycemic control should be closely monitored.
Alcohol: Alcohol potentiates the action of metformin on lactate metabolism as well as the anti-hyperglycemic effect. Hence, the patients treated with metformin should preferably avoid alcohol, and alcoholism is a definite contraindication.
Other Interactions: Studies with furosemide and nifedipine suggest that a possible interaction by increasing plasma metformin levels. However, no such changes were found with propranolol and ibuprofen.
The absorption of metformin may be reduced by acarbose and guar gum.
Glimepiride: Hypoglycemia due to interaction with glimepiride may occur when one of the following medicines is taken, for example: insulin and other oral antidiabetics, ACE inhibitors, allopurinol, anabolic steroids and male sex hormones, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine. Fenyramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, miconazole, para-aminosalicylic acid, pentoxifylline (high dose parenteral), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, sulfonamides, tetracyclines, tritoqualine, trofosfamide.
Hyperglycemia due to interaction with glimepiride may occur when one of the following medicines is taken, for example: acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine (adrenaline) and other sympathomimetic agents, glucagons, laxatives (after protracted use), nicotinic acid (in high doses), estrogens and progestogens, phenothiazines, phenytoin, rifampicin, thyroid hormones.
H2-receptor antagonists, clonidine and reserpine may lead to either potentiation or weakening of the blood-sugar-lowering effect.
Beta-blockers may increase the tendency to hypoglycemia.
The effect of coumarin derivatives may be potentiated or weakened.