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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 glyburide/metformin tablets-oral, and how does it work (mechanism of action)?
- Glucovance (glyburide/metformin) is a combination antidiabetic medication containing glyburide and metformin. Glucovance is used to improve blood glucose (sugar) control in adults with type 2 diabetes mellitus.
- Glyburide is a second generation oral sulfonylurea. It helps to lower blood glucose by stimulating the release of insulin, the hormone responsible for regulating blood glucose.
- Metformin is an oral biguanide antidiabetic agent. It decreases the production of glucose in the liver, decreases the absorption of glucose by the intestines, and increases the uptake and use of blood glucose by cells throughout the body.
- In clinical studies, glyburide/metformin therapy was observed to be superior in improving fasting plasma glucose, post-meal blood glucose, and HbA1c levels versus treatment with glyburide or metformin alone.
- Glucovance was approved by the FDA in July, 2000.
What are the uses for glyburide/metformin tablets-oral?
What are the side effects of glyburide/metformin tablets-oral?
The most common side effects include
Other commonly reported side effects with Glucovance therapy include
Other side effects include
- hypoglycemia (low blood glucose),
- blood disorders,
- decrease blood sodium levels,
- sensitivity to the sunlight,
- liver disease,
- hives, and
- hypersensitivity type reactions.
Metformin can cause a rare but serious condition known as lactic acidosis, a build-up of acid in the blood. Lactic acidosis can cause death and requires immediate treatment. Symptoms of lactic acidosis include
- muscle pain,
- pain in the stomach,
- difficulty breathing,
- dizziness, and
- slow or irregular heartbeat.
Patients suspected of having signs or symptoms of lactic acidosis must seek emergency medical help.
Quick GuideDiabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
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.
Is glyburide/metformin tablets-oral safe to take if I'm pregnant or breastfeeding?
- Glucovance has not been adequately evaluated in pregnant women. Due to the lack of conclusive safety data, Glucovance should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Glucovance is classified as FDA pregnancy risk category B.
- It is not known if Glucovance is excreted in breast milk. Due to the lack of safety data and the potential risk for hypoglycemia (low blood glucose) in nursing infants, use of Glucovance in nursing mothers is not recommended.
What else should I know about glyburide/metformin tablets-oral?
What preparations of glyburide/metformin tablets-oral are available?
Oral tablets: 1.25/250, 2.5/500, and 5/500 mg
How should I keep glyburide/metformin tablets-oral stored?
- Tablets should be stored at room temperature, between 15 C and 30 C (59 F to 86 F).
- Tablets should be dispensed and stored in an air- tight, light resistance container.
REFERENCE: FDA Prescribing Information.
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Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
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- and a diabetic diet.
- weight reduction,
- a diabetic diet,
- and exercise.
Diabetic Diet for Type 2 DiabetesA type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as:
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- Paleo diet,
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Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2 diabetes are at risk for this condition. There are other diseases that can cause a person's blood sugar levels to go too low, for example, pancreatitis, Cushing's syndrome, and pancreatic cancer. Symptoms and signs that your blood sugar levels are too low include:
- Intense hunger
If your blood sugars become too have the following nearby as a quick treatment.
- Table sugar
- Glucose tablets
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- double vision or vision loss,
- vertigo, and
- difficulty speaking or understanding speech.
A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Type 1 vs Type 2 Diabetes Similarities Differences
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by:
Eating a lot of foods and drinking beverages with simple carbohydrates (pizza, white breads, pastas, cereals, pastries, etc.) and simple sugars (donuts, candy, etc.)
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- Lack of activity
While the signs and symptoms of both types of diabetes are the same, which include:
- Increased urination
- Increased hunger
- Increased thirst
- Unexplained weight loss.
However, the treatments are different. Type 1 diabetes is insulin dependent, which means a person with this type of diabetes requires treatment with insulin. People with type 2 diabetes require medication, lifestyle changes like eating a healthy diet, and getting regular exercise.
Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body. Causes of type 2 diabetes are a sedentary lifestyle, eating excess sugar and carbohydrates, lack of exercise, being overweight, and genetics. Symptoms of type 2 diabetes are often subtle, but may include:
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- Unintentional weight gain or loss
- Frequent urination
- Dark skin under the chin, armpits, or groin
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