Glyburide and Metformin
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WARNING
Lactic acidosis is a dangerous, potentially fatal disease that metformin may occasionally cause. In case you have kidney illness, let your doctor know. Most likely, your doctor will advise against using metformin plus glyburide. Additionally, let your doctor know if you are over 65 years old, have ever experienced a heart attack, stroke, diabetic ketoacidosis (a condition when blood sugar levels are so high that they require immediate medical attention), a coma, or liver or heart problems. Mention topiramate (Topamax, in Qsymia), acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, and zonisamide (Zonegran) to your doctor if you are on any of these medications.
If you have recently experienced any of the following issues, or if you develop them while receiving medication, let your doctor know: a major infection; extreme diarrhoea, vomiting, or fever; or if you are drinking much less fluid than normal for any reason. Metformin and glyburide may need to be discontinued until you feel better.
Tell the surgeon that you are taking glyburide and metformin before having any type of surgery, including dental surgery or any other serious medical operation. Tell your doctor if you intend to have any x-ray procedures that include injecting dye, especially if you currently or previously consume substantial amounts of alcohol, have liver illness, or have experienced heart failure. Before the procedure, you might need to stop taking metformin and glyburide. Then, you might need to wait 48 hours before starting them again. The exact time that you should stop taking glyburide and metformin and the new time that you should begin will be specified by your doctor.
Call your doctor right away and stop taking glyburide with metformin if you suffer any of the following symptoms: Extreme fatigue, weakness, or discomfort; dizziness; lightheadedness; fast or slow heartbeat; flushing of the skin; muscle pain; or feeling cold in your hands or feet; nausea; vomiting; stomach pain; decreased appetite; deep and quick breathing; or shortness of breath.
If you frequently consume high amounts of alcohol in a short period of time (binge drinking) or occasionally do so, let your doctor know. Alcohol consumption raises your risk of lactic acidosis and may lower blood sugar levels. Rarely, drinking alcohol while taking glyburide and metformin may result in symptoms like flushing (reddening of the face), headache, nausea, vomiting, chest discomfort, weakness, blurred vision, mental confusion, sweating, choking, difficulty breathing, and anxiety. How much alcohol is safe to consume while taking glyburide and metformin should be discussed with your doctor.
Keep all of your appointments with your physician and the lab. Before and during therapy, your doctor will request specific tests to see how well your kidneys are functioning and how your body is responding to glyburide and metformin. Discuss the dangers of taking metformin and glyburide with your doctor.
Why is this medication prescribed?
Glyburide and metformin are used to treat type 2 diabetes in persons whose blood sugar levels cannot be controlled by diet and exercise alone. Type 2 diabetes is a condition in which the body does not use insulin normally and cannot control the quantity of sugar in the blood. Glyburide is a member of the sulfonylurea drug class, while metformin is a member of the biguanide drug class. Glyburide lowers blood sugar by encouraging the pancreas to create insulin, a hormone that the body naturally needs to break down sugar. It also facilitates the body’s effective utilization of insulin. This drug only lowers blood sugar in those whose bodies naturally manufacture insulin. Your body uses metformin to manage the level of glucose (sugar) in your blood. Both the quantity of glucose your liver produces and the amount you absorb from food are reduced. Additionally, it improves the way your body uses its own insulin. Glyburide and metformin are not used to treat diabetic ketoacidosis, a serious condition that can happen if high blood sugar is not treated, or type 1 diabetes, a condition in which the body does not make insulin and can therefore not control the quantity of sugar in the blood.
How should this medicine be used?
The drug combination of glibenclamide and metformin is available as an oral tablet. It is often taken with meals once or twice a day. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Take metformin and glyburide exactly as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.
Your doctor will likely start you on a modest dose of metformin and glyburide and then gradually raise it, no more than once every two weeks. based on how you respond. Keep a watchful eye on your blood glucose.
The combination of glyburide and metformin manages diabetes but does not cure it. Even if you feel good, keep taking metformin and glyburide. Without consulting your doctor, do not discontinue taking metformin and glyburide.
For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.
Other uses for this medicine
Ask your doctor or pharmacist for more details if you’re interested in using this drug for any other conditions.
What special precautions should I follow?
Before taking glyburide and metformin,
- If you have any allergies to glyburide, metformin, any of the substances in glyburide and metformin tablets, other medicines, or food, inform your doctor right away. Request a list of the components from your pharmacist.
- If you are taking bosentan (Tracleer), let your doctor know. If you are currently on this medicine, your doctor might advise against using glyburide.
- Inform your doctor and pharmacist about any vitamins, nutritional supplements, herbal items, and prescription and over-the-counter medicines you are now taking or intend to take. Any of the following should be mentioned: Amiloride (Midamor), angiotensin-converting enzyme (ACE) inhibitors such captopril, enalapril (Vasotec, Vaseretic), and benazepril (Lotensin, in Lotrel), anticoagulants (‘blood thinners’), such as warfarin (Coumadin, Jantoven), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), aspirin, or other nonsteroidal anti-inflammatory medications (NSAIDs); beta-blockers like atenolol (Tenormin), nadolol (Corgard, in Corzide), propranolol (Hemangeol, Inderal, InnoPran), metoprolol (Lopressor, Toprol XL), and labetalol (Trandate); calcium channel blockers such amlodipine (Norvasc), felodipine, isradipine, nicardipine (Cardene), nifedipine (Adalat, Afeditab CR, Procardia), verapamil (Calan, Covera, Verelan, in Tarka), or diltiazem (Cardizem, Cartia, Diltzac, among others); cyclosporine (Gengraf, Neoral, Sandimmune); digoxin (Lanoxin); disopyramide (Norpace); diuretics (‘water pills’); chloramphenicol; cimetidine (Tagamet); clarithromycin (Biaxin, in Prevpac); digoxin (Lanoxin); cimetidine; isoniazid (Laniazid, in Rifamate, in Rifater), fluconazole (Diflucan), fluoxetine (Prozac, Sarafem, Selfemra), furosemide (Lasix), hormone replacement therapy, insulin or other diabetes drugs; medications for allergies, asthma, and colds; MAO inhibitors like isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); oral contraceptives (birth control pills); oral steroids like dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); phenytoin (Dilantin, Phenytek); probenecid (Benemid, in Colbenemid); procainamide; quinidine (in Nuedexta); quinine; medications for nausea and mental illness; miconazole (Lotrimin, Monistat, others); quinolone and fluoroquinolone antibiotics, such as gatifloxacin, levofloxacin (Levaquin), ciprofloxacin (Cipro), enoxacin (no longer available in the U.S., Penetrex), and cinoxacin (no longer available in the U.S., Cinobac), nalidixic acid, norfloxacin, and lomefloxacin are no longer sold in the United States under the brand names Maxaquin, Avelox, NegGram, and Maxaquin, ranitidine (Zantac); ofloxacin (no longer available in the United States; Floxin); sparfloxacin (no longer available in the United States; Zagam); trovafloxacin and alatrofloxacin combo (no longer available in the United States; Trovan); rifampin; salicylate analgesics such salsalate (Argesic, Disalcid, Salgesic), choline magnesium trisalicylate, choline salicylate (Arthropan), diflunisal, and others; thyroid medicines, triamterene (Dyrenium, in Maxzide, among others), trimethoprim (Primsol, in Bactrim, in Septra), or vancomycin (Vancocin, among others) are examples of sulfa antibiotics.
- In addition to the conditions mentioned in the IMPORTANT WARNING section, let your doctor know if you or any members of your family have ever experienced G6PD deficiency, an inherited disorder that results in hemolytic anemia or premature red blood cell destruction. You should also let your doctor know if you have ever experienced thyroid, pituitary, or adrenal hormone disorders, as well as acute or chronic metabolic acidosis.
- Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. Call your doctor if you conceive while taking metformin and glyburide.
- Make a plan to limit your time spent in the sun and to use sunscreen, sunglasses, and protective clothes. Metformin and glyburide both increase photosensitivity in skin.
- If you eat less or exercise more than usual, let your doctor know. Your blood sugar may be impacted by this. If this occurs, your doctor will give you instructions.
What special dietary instructions should I follow?
Make sure to abide by all dietary and exercise advice given to you by your physician or nutritionist. It’s crucial to maintain a healthy diet.
What should I do if I forget a dose?
Ask your doctor what to do if you miss a dose or unintentionally take more than you should before beginning to use glyburide with metformin. So you can remember them later, write these instructions down.
Take the missed dose right away, as a general rule. To continue with your regular dosing plan, skip the missed dose if it is almost time for the next one. If you miss a dose, don’t take a second one to make up for it.
What side effects can this medication cause?
Your blood sugar levels may alter as a result of this drug. You should be aware of the signs of low and high blood sugar as well as what to do if you experience these signs.
Metformin with glyburide may have negative side effects. If any of these symptoms are severe or do not go away, let your doctor know right once:
- Abdominal pain
- Dizziness or vomiting
- Diarrhea
- Dizziness
Call your doctor right away if you suffer any of the following symptoms or those detailed in the IMPORTANT WARNING section:
- Chest ache
- Rash
- Eyes or skin that have a yellow tint
- Stools with a light color
- Dark feces
- Stomach ache in the right upper portion
- Uncommon bruising or bleeding
- Fever
- Unwell throat
- Enlargement of the throat, lips, tongue, eyes, or face
In one trial, patients with diabetes who took a drug identical to glyburide had a higher risk of dying from cardiac problems than those who received insulin and dietary adjustments as treatment.
Metformin with glyburide may result in additional adverse effects. If you experience any strange issues while taking this medicine, contact your doctor right away.
You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088 if you have a serious side event.
What should I know about storage and disposal of this medication?
Keep this medication tightly closed in the original container and out of the reach of children. It should not be kept in the bathroom. Store it at room temperature and away from light, excessive heat, and moisture.
Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilizing a medicine take-back program is the easiest approach to get rid of your medication. To find out about take-back programs in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back program, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.
As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.http://www.upandaway.org
In case of emergency/overdose
Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.
In addition to hypoglycemic symptoms, overdose symptoms may also include the following:
- Seizures
- Consciousness is lost
- Extreme fatigue
- Weakness
- Discomfort
- Vomiting
- Nausea
- Abdominal pain
- Reduction in appetite
- Fast, deep breathing
- Breathing difficulty
- Dizziness
- Lightheadedness
- Unusually slow or quick heartbeat
- Redness of the skin
- Muscular ache
- Being chilly
What other information should I know?
Your doctor will instruct you on how to take home blood sugar readings to monitor your response to glyburide and metformin. Pay close attention to these directions.
Wearing a diabetes identity bracelet will ensure that you receive the right care in an emergency.
No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.
You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.