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- What is glyburide/metformin tablets-oral, and how does it work (mechanism of action)?
- What brand names are available for glyburide/metformin tablets-oral?
- Is glyburide/metformin tablets-oral available as a generic drug?
- Do I need a prescription for glyburide/metformin tablets-oral?
- What are the uses for glyburide/metformin tablets-oral?
- What are the side effects of glyburide/metformin tablets-oral?
- What is the dosage for glyburide/metformin tablets-oral?
- Which drugs or supplements interact with glyburide/metformin tablets-oral?
- Is glyburide/metformin tablets-oral safe to take if I'm pregnant or breastfeeding?
- What else should I know about glyburide/metformin tablets-oral?
What is the dosage for glyburide/metformin tablets-oral?
For patients inadequately controlled on diet and exercise
- Generally, the recommended starting dose of Glucovance is 1.25/250 mg administered once daily with a meal.
- A starting dose of 1.25/ 250 mg twice daily may be considered for patients with HbA1c >9% or fasting plasma glucose (FPG) >200 mg/dL.
- If necessary, dosage may be increased in increments of 1.25/250 mg at two week intervals.
- The maximum daily dose of Glucovance is 20/2000 mg.
- For patients inadequately controlled on a sulfonylurea and/or metformin
- Generally, the recommended starting dose of Glucovance is 2.5 mg/500 mg or 5 mg/500 mg orally twice a day with meals.
- Metformin-containing drugs may be safely used in patients with mild to moderate renal impairment. Renal function should be assessed before starting treatment and at least yearly.
- Metformin should not be used by patients with an estimated glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m2 and starting metformin in patients with an eGFR between 30-45 mL/minute/1.73 m2 is not recommended.
- Metformin should be stopped at the time of or before administering iodinated contrast in patients with an eGFR between 30 and 60 mL/minute/1.73 m2; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast.
- Kidney function should be evaluated 48 hours after receiving contrast and metformin may be restarted if kidney function is stable.
- The safety and efficacy of Glucovance has not been established in pediatric patients. Therefore, use of Glucovance in this patient population is not recommended.
Which drugs or supplements interact with glyburide/metformin tablets-oral?
- Drugs that cause blood glucose levels to increase may diminish the effectiveness of Glucovance therapy. When these drugs are stopped, patients should be closely observed for signs of low blood glucose. These drugs include
- Cimetidine (Tagamet), by decreasing the elimination of metformin from the body, can increase the amount of metformin in the blood by 40%. This may increase the frequency of side effects from metformin.
- Contrast media used for radiological procedures may reduce kidney function which reduces elimination of metformin, leading to increased concentrations of metformin in the blood. Metformin should be stopped 48 hours before and after use of contrast media.
- Alcohol consumption increases the effect of metformin on lactate production, increasing the risk of lactic acidosis.
- Certain drugs may increase the blood glucose lowering actions of glyburide. It is possible that hypoglycemia (low blood glucose) and symptoms from hypoglycemia may result. Such drugs include
- Coadministration of glyburide with bosentan (Tracleer) may cause an abnormal increase in liver enzymes. Therefore, concomitant use of these agents is not recommended.
- Colesevelam (Welchol) may reduce blood levels of glyburide. Patients are advised to take glyburide 1 hour before or 4 hours after colesevelam administration to minimize the risk of their interaction.
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