DILGEM PLUS
GLIMEPIRIDE AND METFORMIN · by SHAIGAN
Composition
Tab 1/500 mg: Glimepiride 1 mg, metformin HCI 500 mg. Tab 2/500 mg: Glimepiride 2 mg, metformin HCI 500 mg. Tab 1/250 mg: Glimepiride 1 mg, metformin HCI 250 mg.
Indications & Dosage
Type 2 Diabetes mellitus: Adults: 1 mg Glimepiride and metformin HCI 500 mg daily; maintenance dose 1 mg to 4 mg Glimepiride daily. Max: Glimepiride 8 mg, metformin HCI 2000 mg. The dosage is administered according to individual requirement. Children: Not recommended
Contraindications
insulin-dependent diabetes, diabetic ketonaemia, coma/precoma, metabolic acidosis, lactic acidosis, congestive heart failure, severe infections, recent surgery, serious trauma, malnourished, starving or debilitated patients, pituitary/ adrenal in sufficiency, severe lung dysfunction, hypoxaemia, hepatic dysfunction, alcoholism, dehydration, GI disturbances, iodinated contrast IV, hypersensitivity to sulfonylureas, sulphonamides or biguanides,
Precautions
Hypoglycaemia,elderly, patients with autonomic neuropathy or taking beta blockers, clonidine, reserpine, guanethidine or other sympatholytic drugs, temporary change over to insulin in excep-tional stress situations (e.g. trauma, surgery, infections with fever), hepatic or renal impairment, monitor haematologic parameters
Interactions
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, increases 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, MAOls, miconazole, fluconazole, salicylates, pentoxyfylline (high dose parenteral), phenylbutazone, probenecid, quinolones, sulfinpyrazone, sulphon-amides, tetracyclines, tritoqualine, trofosfamide, azapropazone, oxyphenbutazone. phenothiazines, phenytoin, rifampicin, thyroid hormones.
Pregnancy
Contraindicated
Lactation
Contraindicated or not recommended
Side Effects
Hypoglycaemia, temporary visual impairment, metallic taste, rash, subnormal vit B12 levels, GI disturbances, liver impairment