Glimet 2.5mg+500mg Tablet 10 ‘S

Description

Glimet 2.5mg+500mg Tablet 10 ‘S belongs to a class of drugs called “hypoglycemics” (anti-diabetics, biguanide/sulfonylurea) that are used in the treatment of type 2 diabetes (high blood sugar levels) as an adjunct to diet and exercise as:

• First line therapy 
• Second Line therapy, in patients who were previously being treated with sulfonylureas or metformin alone; combination therapy with thiazolidinedione may be required. 

Type 2 diabetes, also known as non insulin-dependent diabetes, is a condition resulting from a combination of insulin resistance, i.e, body cells failing to respond properly to the insulin produced, inadequate insulin secretion, and excessive production of glucagon. Progression of the disease may lead to insulin deficiency. This causes hyperglycemia. (high blood sugar levels)

Glimet 2.5mg+500mg Tablet 10 ‘S is available in tablet form on prescription. Metformin is an anti diabetic medication (biguanide) that works by decreasing the amount of sugar released into the blood by the liver, delaying sugar absorption from the intestines and increasing the body’s responsiveness to insulin. Whereas, glibenclamide is an anti-diabetic medication (sulfonylurea) that decreases blood sugar levels by increasing insulin (hormone controlling blood sugar levels) production by the pancreas.

Dosage of Glimet 2.5mg+500mg Tablet 10 ‘S depends on age, severity of condition, patient’s response to medicine and their comorbidities.

The most common side effects of Glimet 2.5mg+500mg Tablet 10 ‘S are change in taste, nausea, vomiting, diarrhoea, stomach pain, headache, upper respiratory tract infection and  hypoglycemia (low blood glucose level).

Indications

Glimet 2.5mg+500mg Tablet 10 ‘S is prescribed to adults between the age of 18-65.

It is used in the treatment of type 2 diabetes (high blood sugar levels) as an adjunct to diet and exercise as:

• First line therapy 
• Second Line therapy, in patients who were previously being treated with sulfonylureas or metformin alone; combination therapy with thiazolidinedione may be required. 

 

How does Glimet 2.5mg+500mg Tablet 10 ‘S work?

Metformin is an anti diabetic medication (biguanide) that works by decreasing the amount of sugar released into the blood by the liver, delaying sugar absorption from the intestines and increasing the body’s responsiveness to insulin. Whereas, glibenclamide is an anti-diabetic medication (sulfonylurea) that decreases blood sugar levels by increasing insulin (hormone controlling blood sugar levels) production by the pancreas.

 

How to use Glimet 2.5mg+500mg Tablet 10 ‘S?

It comes in tablet form that needs to be swallowed whole with a glass of water.

It is better to take Glimet 2.5mg+500mg Tablet 10 ‘S with meals to avoid side effects like having an upset stomach or a hypoglycemic episode. 

 

Dosage 

Dosage needs to be personalized keeping in mind the patients current regime, effectiveness and tolerability towards the treatment.

First line therapy as an adjunct to diet and exercise

• Recommended starting dose:
  • For patients with fasting glucose <200mg/dL; 250mg/1.25mg taken once daily with meals usually at breakfast.
  • For patients with fasting glucose >200mg/dL; may start with 250mg/1.25mg taken twice daily – with breakfast and dinner.

• Dosage is usually increased at intervals of 2 weeks in increments of 250mg/1.25mg.
• Maximum daily dose is 2000mg/10mg.

Second line therapy in patients previously treated with metformin or sulfonylurea alone

• Recommended starting dose is 500mg/2.5mg or 500mg/5mg taken twice daily which may then be increased in increments.
• Maximum daily dose is 2000mg/20mg. 

To achieve optimal glycemic control, titrate the doses accordingly.

 

Pregnancy use and lactation

Use of Glimet 2.5mg+500mg Tablet 10 ‘S is not recommended in pregnancy or while breastfeeding. Please inform your doctor if you are pregnant, planning to conceive or breastfeeding so that they can prescribe you a medicine accordingly without causing any complications for you or your baby.

 

Contraindications

Please inform your doctor if you have a history of any before using Glimet 2.5mg+500mg Tablet 10 ‘S:

• Children or adults above the age of 65
• Hypersensitivity to any of the constituents of Glimet 2.5mg+500mg Tablet 10 ‘S
• Type I diabetes mellitus also known as insulin dependent diabetes
• Type II diabetes that is already well controlled by diet alone
• Metabolic acidosis (electrolyte disorder characterized by acid-base imbalance in the body) including diabetic ketoacidosis (abnormally fast breakdown of fat into blood acids called ketones)with or without coma.
• Severe liver disease
• Kidney failure or severe kidney disease
• Dehydration (for instance due to persistent or severe diarrhoea or recurrent vomiting), severe blood loss or shock
• Severe infection or gangrene
• Heart or blood vessel problems, including a recent heart attack or heart failure (when the heart fails to pump blood effectively)
• Severe breathing difficulties
• Blood clots in the lung (symptoms include coughing, shortness of breath, chest pain and a fast heart rate)
• Pancreatitis (inflammation of the pancreas) – symptoms include severe upper stomach pain, nausea and vomiting 
• Alcohol intoxication 
• Porphyria (inherited disorder)
• Glucose and galactose malabsorption syndrome or lactase deficiency.
• About to have surgery 
• Administration of iodinated contrast mediums

 

Precautions

Please tell your doctor about any of the following conditions while using Glimet 2.5mg+500mg Tablet 10 ‘S:

• Renal function to prevent lactic acidosis (excessive lactic acid accumulation in the blood) 
• Renal insufficiency – regular renal monitoring, especially in the elderly, is needed (CrCl levels: Males: >1.5 mg/dL, females: >1.4 mg/dL)
• State of hypoxia (eg caused by heart failure or myocardial infarction)
• Hypoglycemia (low blood sugar levels)
• History of hepatic (liver) impairment/disease 
• Concomitant medications that may affect renal function or result in significant haemodynamic change or may interfere with the disposition of metformin.
• Monitor haematological parameters annually – treatment of patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency with sulfonylurea agents can lead to hemolytic anemia.
• Vitamin B12 levels need to be measured routinely at 2-3 year interval
• Changes in clinical status of patients with previously controlled type II diabetes. 
• Surgical procedures (product should be temporarily discontinued 48 hours pre and post surgery)
• Administration of iodinated contrast mediums
• Alcohol intake
• Elderly 

 

Interaction with other medications

Certain medications could interact with Glimet 2.5mg+500mg Tablet 10 ‘S, hence, in that case your doctor might alter your dosage and make sure to monitor blood sugar levels more closely.

Please inform your doctor about the use of the following before taking Glimet 2.5mg+500mg Tablet 10 ‘S:

• other medicines containing metformin or glibenclamide
• other medicines used to treat diabetes
• iodinated contrast agents (dyes)
• medicines that contain alcohol, such as cough and cold syrups
• Diuretics such as furosemide and thiazide diuretics
• Sulfonamides
• salicylates
• Certain antifungal medicines, such as miconazole and fluconazole (Diflucan)
• Certain antibiotics (chloramphenicol) including medicines used to treat tuberculosis
• medicines used to treat high blood pressure and heart conditions (clonidine, reserpine, guanethidine, sympathomimetics, beta-blockers, calcium channel blockers and ACE inhibitors)
• disopyramide (Rythmodan), a medicine used to treat an irregular heart beat
• non-steroidal anti-inflammatory drugs (NSAIDS), medicines used to relieve pain, swelling and other symptoms of inflammation including arthritis, such as aspirin and phenylbutazone
• desmopressin (Minirin) – used to treat diabetes insipidus (a condition causing large amounts of urine to be produced)
• danazol (Danocrine, Azol) – for endometriosis
• Bosentan – for pulmonary hypertension
• phenytoin (Dilantin) – used to treat epilepsy (fits or seizures)
• Antidepressant – fluoxetine and monoamine oxidase inhibitors (MAOIs)
• medicines used to treat schizophrenia and mental illnesses, such as chlorpromazine (Largactil) and phenothiazines
• corticosteroids, such as prednisone and cortisone 
• Adrenocortical stimulatory hormones, such as tetracosactide 
• anabolic steroids
• oestrogens and progestagens in hormone replacement therapy and oral contraceptives
• thyroid hormones, such as thyroxine
• some medicines used for asthma
• medicines used to treat for ulcers and reflux, such as cimetidine and ranitidine 
• medicines used to prevent or to treat blood clots such as warfarin, heparin or sulfinpyrazone
• medicines used to lower lipids, such as bezafibrate, clofibrate, gemfibrozil and nicotinic acid
• pentoxifylline (oxpentifylline) injection, a medicine used to treat blood vessel problems
• certain medicines used to treat cancer
• certain medicines used to treat gout such as probenecid 
• acetazolamide, a medicine used to treat glaucoma
• certain weight reducing medicines
• large doses of laxatives
• medicines that are substrates/ inhibitors of organic cation transporters – OCT 1 such as verapamil; OCT 2 such as dolutegravir, crizotinib, olaparib, daclatasvir or vandetanib
• medicines that are inducers of OCT 1 such as rifampicin
• medicines that may increase the risk of lactic acidosis when concomitantly used with metformin hydrochloride such as topiramate and other carbonic anhydrase inhibitors, such as zonisamide, acetazolamide or dichlorphenamide.

Make sure to inform your doctor that you are taking Glimet 2.5mg+500mg Tablet 10 ‘S before you start or stop any other medicine.

 

Adverse effects

Like most medicines, Glimet 2.5mg+500mg Tablet 10 ‘S has some side effects which include:

COMMON:

• Nausea
• Vomiting 
• Diarrhea
• Stomach pain
• Loss of appetite
• Dizziness 
• Headache 
• Upper respiratory tract infection
• Hypoglycemia (low blood glucose level)
• Change in taste

SERIOUS:

• Hypoglycemia (low blood sugar) manifested as dizziness, weakness, drowsiness, headache and sweating
• Temporary visual impairment
• Liver impairment
• Hepatic (liver) porphyria
• Lactic acidosis (excess lactic acid in the blood)
• Elevated levels of serum urea and creatinine 
• Skin rash or itching (skin disease) 
• Reduced B12 absorptions
• Hypersensitivity (allergic) reactions including anaphylaxis indicated by itching, difficulty breathing, swelling of your throat or tongue, hives, or difficulty swallowing.
• Some rare side effects include: Leukopenia, thrombocytopenia, pruritus, urticaria, maculopapular rash, agranulocytosis, haemolytic anaemia, bone marrow aplasia and pancytopenia, erythema multiforme, exfoliative dermatitis, photo-sensitization

How to cope with some of the adverse effects

• Nausea (feeling sick) – Take Glimet 2.5mg+500mg Tablet 10 ‘S with meals and avoid having spicy food

• Headaches – Take a painkiller, rest and keep yourself hydrated at all times. Avoid drinking alcohol

• Vomiting and Diarrhoea – Keep yourself hydrated by having lots of fluids and still if the problem persists, consult your doctor before taking any medication for vomiting and diarrhoea.

• Stomach ache – Try to rest as much as possible and have smaller and more frequent meals. Using a heat pack or hot water bottle over the area in pain might help in giving some relief. If the pain still persists and is severe, speak to your doctor.

• Loss of appetite – Have smaller meals than usual at times that you would normally eat.

• Dizziness – Try and rest until you feel better and refrain from driving or using any tools or machinery

• Metallic taste in the mouth – Have something that would change the taste of your mouth for example, sugar-free gum

• Hypoglycemia – Carry fast acting carbohydrates (like sweets and juice) to prevent your body from going into a state of hypoglycemia (low blood sugar)

Inform your doctor immediately if you experience any of the serious side effects.

 

Key facts about Glimet 2.5mg+500mg Tablet 10 ‘S

• Glimet 2.5mg+500mg Tablet 10 ‘S is used for the treatment of type 2 diabetes mellitus (a condition resulting in elevated levels of sugar in the blood) as an adjunct to diet and exercise, as first line therapy and second Line therapy, in patients who were previously being treated with sulfonylureas or metformin alone; combination therapy with thiazolidinedione may be required.
• It is prescribed to adults between 18-65 years of age.
• When using Glimet 2.5mg+500mg Tablet 10 ‘S with other medicines it can cause hypoglycemia, (low blood sugar) hence, carry something sweet in case that happens.
• Inform your doctor about your treatment if you are to undergo surgery.
• Matter of concern arises when you experience deep or rapid breathing, persistent nausea, vomiting, and stomach pain, as Glimet 2.5mg+500mg Tablet 10 ‘S may cause a rare but serious condition called lactic acidosis.
• Long term use can cause vitamin B12 deficiency. 
• It is important for your doctor to monitor your blood sugar levels regularly, along with repeated kidney and liver function tests to prevent you from any complications
• Keep this medicine tightly closed in the container or the pack it came in. Store it according to the instructions mentioned and dispose of the unused medicine. 

FAQs

1. WHAT EXACTLY DOES Glimet 2.5mg+500mg Tablet 10 ‘S DO?

Metformin is an anti diabetic medication (biguanide) that works by decreasing the amount of sugar released into the blood by the liver, delaying sugar absorption from the intestines and increasing the body’s responsiveness to insulin. Whereas, glibenclamide is an anti-diabetic medication (sulfonylurea) that decreases blood sugar levels by increasing insulin (hormone controlling blood sugar levels) production by the pancreas.

2. HOW LONG DOES IT TAKE FOR Glimet 2.5mg+500mg Tablet 10 ‘S TO START WORKING?

Glimet 2.5mg+500mg Tablet 10 ‘S starts working in around 48 hours and reaches its maximum efficacy in 4-5 days. Initially, you might not feel that it is effective, but that does not mean you stop taking the medicine thinking it is not working. Make sure to continue taking Glimet 2.5mg+500mg Tablet 10 ‘S as directed by your doctor.

3. HOW LONG WILL I HAVE TO TAKE Glimet 2.5mg+500mg Tablet 10 ‘S FOR?

Glimet 2.5mg+500mg Tablet 10 ‘S is usually prescribed for long term use, possibly life long. Your dosage and time period is decided by your doctor after knowing the severity of your condition.

4. CAN I STOP TAKING Glimet 2.5mg+500mg Tablet 10 ‘S?

This medicine largely controls your blood sugar levels, but does not cure your condition. Hence, do not just stop taking the medicine without consulting your doctor, otherwise your condition could possibly get worse.

5. WHAT IF Glimet 2.5mg+500mg Tablet 10 ‘S STOPS WORKING?

If it stops working, then your doctor will either give it to you with a combination of other medicines or recommend a different treatment to you by switching it with other anti-diabetics.

6. WILL Glimet 2.5mg+500mg Tablet 10 ‘S AFFECT MY KIDNEYS?

It does not affect those with normal kidney function and hence, is safe to use for them. However, if you have a history of kidney disease, inform your doctor as you might need to alter your daily dose.

7. DOES Glimet 2.5mg+500mg Tablet 10 ‘S CAUSE WEIGHT GAIN?

Some patients have experienced weight gain when taking Glimet 2.5mg+500mg Tablet 10 ‘S

8. CAN Glimet 2.5mg+500mg Tablet 10 ‘S CAUSE VITAMIN B12 DEFICIENCY?

Long term use of Glimet 2.5mg+500mg Tablet 10 ‘S is known to cause vitamin B12 deficiency as it interferes with its absorption. If left untreated, it may cause anemia and nerve problems indicated by tingling sensation and numbness in hands and feet, weakness, urinary problems, change in mental status and difficulty in maintaining balance (ataxia). To prevent this condition, it is advised to have vitamin b12 supplements when taking Glimet 2.5mg+500mg Tablet 10 ‘S.

9. WHAT IF I TAKE TOO MUCH OF Glimet 2.5mg+500mg Tablet 10 ‘S?

An overdose of Glimet 2.5mg+500mg Tablet 10 ‘S alone usually does not cause hypoglycemia (low blood sugar) indicated by feeling hungry, trembling or shaking, sweating, feeling confused and having problems concentrating. However, it could occur if a good diet is not maintained. Contact your doctor immediately if you experience any of these signs or experience stomach pain, nausea/vomiting and dizziness.

10. WHAT IF I FORGET TO TAKE Glimet 2.5mg+500mg Tablet 10 ‘S?

Incase you miss a dose, take your next dose on time and do not try making up for the missed dose by doubling it up. If it helps to remind you, set an alarm so you do not miss any dose.

11. CAN I DRINK ALCOHOL WHILE TAKING Glimet 2.5mg+500mg Tablet 10 ‘S?

Avoid drinking alcohol while you are on Glimet 2.5mg+500mg Tablet 10 ‘S as it can interfere with your treatment causing low blood sugar levels especially in aged patients and on occasions where you have skipped a meal.

12. CAN I TAKE Glimet 2.5mg+500mg Tablet 10 ‘S BEFORE SURGERY ?

Inform your doctor that you are using Glimet 2.5mg+500mg Tablet 10 ‘S before surgery as he/she might ask you to stop taking the medicine before your operation.

13. CAN I DRIVE OR RIDE A BIKE AFTER TAKING Glimet 2.5mg+500mg Tablet 10 ‘S?

Glimet 2.5mg+500mg Tablet 10 ‘S alone might not affect your ability to drive or ride a bike, but when given in combination with other medicines, it could result in low blood sugar levels resulting in loss of concentration vision impairment (your eyesight is affected). To be on the safe side, always carry fast acting carbohydrates (like sweets and juice) to prevent your body from going into a state of hypoglycemia (low blood sugar)

14. HOW SHOULD Glimet 2.5mg+500mg Tablet 10 ‘S BE STORED?

Keep the medicine at room temperature in a cold, dry place, away from direct sunlight. Make sure to keep it away from pets, children and other people.