Special Precautions:
Monitor regularly glucose levels in blood & urine & proportion of glycated/glycosylated Hb. Lactation. Frequent monitoring of serum creatinine & dose reduction in elderly. Glimepiride: Risk factors for hypoglycemia. May impair ability to drive or operate machinery. Metformin: Discontinue use in patients w/ lactic acidosis or at least 2 days prior to x-ray exam w/ iodinated contrast material. Increased risk of lactic acidosis: Impaired renal & hepatic function, hypoxemia, dehydration, sepsis, excessive alcohol intake. Monitor renal function regularly. Surgical procedures (temporarily discontinue); hypoxic states (promptly discontinue); hepatic disease. Annually measure vit B12, folic acid & Fe deficiencies in long-term use.
Side Effects / Adverse Reactions:
Hypoglycemia. Temporary visual impairment at the start of treatment. Occasionally, nausea, vomiting, epigastric sensations of pressure or fullness, abdominal pain & diarrhea. Mild allergic or pseudo-allergic reactions eg, itching, urticaria or rashes (may become serious if accompanied by dyspnea & fall in BP, sometimes leading to shock).
Dosage / Direction for Use:
Adult & adolescent ≥18 yr 1 tab once daily. Max daily dose: Metformin 2,000 mg & glimepiride 8 mg once daily.