Glucovance (glyburide/metformin)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

DOSAGE:

  • 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.
Medically Reviewed by a Doctor on 8/31/2016

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