Zoliget 15mg+2mg Tablet 7 ‘S

Description

Zoliget 15mg+2mg Tablet 7 ‘S belongs to a class of drugs called “hypoglycemics” (anti-diabetics, thiazolidinedione/sulfonylureas) that are used to treat type 2 diabetes in patients inadequately controlled by diet and exercise; obese and in whom metformin is either contraindicated or are inadequately controlled by metformin or sulfonylurea. 

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)

This medicine is available in tablet form on prescription. Pioglitazone is an anit-diabetic medication (thiazolidinedione) that decreases blood sugar levels by increasing insulin sensitivity (your body’s response to insulin). Whereas, glimepiride 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 Zoliget 15mg+2mg Tablet 7 ‘S depends on age, severity of condition, patient’s response to medicine and their comorbidities.

Common side effects of this medication are nausea, indigestion, diarrhoea, headache, dizziness, muscle pain, sore throat, or tooth problems. 

Indications

Zoliget 15mg+2mg Tablet 7 ‘S is prescribed to adults above 18 years of age. It is not advised to give to children.

It is used in the treatment of type 2 diabetes (high blood sugar levels) in patients inadequately controlled by diet and exercise; obese and in whom metformin is either contraindicated or are inadequately controlled by metformin or sulfonylurea. 

 

How does Zoliget 15mg+2mg Tablet 7 ‘S work?

Pioglitazone is an anit-diabetic medication (thiazolidinedione) that decreases blood sugar levels by increasing insulin sensitivity (your body’s response to insulin). Whereas, glimepiride 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 Zoliget 15mg+2mg Tablet 7 ‘S?

It is better to take the medication with a meal to avoid side effects. Swallow the tablet whole with a glass of water. 

 

Dosage 

Zoliget 15mg+2mg Tablet 7 ‘S is available in tablet form as 15 mg pioglitazone + 2mg glimepiride and 30mg pioglitazone + 2mg/4mg glimepiride. It is taken once a day, usually with the first meal of the day.

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

• Recommended starting dose of Zoliget 15mg+2mg Tablet 7 ‘S (as combination tablet): 30 mg/2 mg or 15 mg/4 mg once daily (dosage of glimepiride needs to be reduced in case of hypoglycemia), titrated gradually considering patients effectiveness and tolerability towards Zoliget 15mg+2mg Tablet 7 ‘S. The dosage can be increased to 30mg/4mg once daily. 
• For patients inadequately controlled with glimepiride monotherapy: 30 mg/2 mg or 30 mg/4 mg once daily, titrated gradually considering patients effectiveness and tolerability towards Zoliget 15mg+2mg Tablet 7 ‘S. 
• For patients inadequately controlled with pioglitazone monotherapy: 30 mg/2 mg once daily, titrated gradually considering patients effectiveness and tolerability towards Zoliget 15mg+2mg Tablet 7 ‘S.
• For patients switching from combination therapy of pioglitazone plus glimepiride as separate tablets: Initial dose should be as close as possible to the dose of pioglitazone and glimepiride already being taken
• For patients currently on a different sulfonylurea monotherapy or switching from combination therapy of pioglitazone plus a different sulfonylurea: 30 mg/2 mg once daily titrated gradually considering patients effectiveness and tolerability towards Zoliget 15mg+2mg Tablet 7 ‘S. 
• For patients with systolic dysfunction, Zoliget 15mg+2mg Tablet 7 ‘S should only be prescribed if pioglitazone titration from 15 mg to 30 mg is safely tolerated.

Dosage is completely dependent on the age, severity of condition, patient’s response to medicine and their comorbidities. Your doctor may vary your dosage to regulate your blood sugar levels.

 

Pregnancy use and lactation

Use of Zoliget 15mg+2mg Tablet 7 ‘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 Zoliget 15mg+2mg Tablet 7 ‘S:

Pioglitazone:

• Allergic reaction (hypersensitivity) 
• Kidney impairment (dialysis) 
• Liver impairment
• Cardiac failure or history of heart diseases 
• Diabetic ketoacidosis (abnormally fast breakdown of fat into blood acids called ketones)
• Bladder cancer (history or present condition)
• Undiagnosed hematuria

Glimepiride:

• Allergic reaction (hypersensitivity) to glimepiride or other sulfonylureas or sulfonamides. 
• Type 1 diabetes mellitus (condition in which your body does not produce insulin)
• Diabetic ketoacidosis (abnormally fast breakdown of fat)
• Diabetic coma (life-threatening condition causing unconsciousness) or pre-coma.
• Renal impairment (dialysis) 
• Liver impairment 

 

Precautions

Please tell your doctor about any of the following conditions while using Zoliget 15mg+2mg Tablet 7 ‘S:

Pioglitazone:

• Monitor for fluid retention 
• Observe for signs of  cardiac failure (discontinue if deteriorates).
• Monitor for signs of hepatic dysfunction and check liver enzymes prior to therapy and every 2 months thereafter for at least 12 months.
• Monitor body weight

Glimepiride:

• Pregnancy and lactation
• Hypoglycemia (low blood sugar levels) – can be prevented by monitoring sugar levels in blood and urine, regularly. Signs indicating hypoglycemia are: blurred vision, confusion, anxiety, cool, pale skin, drowsiness, excessive hunger, fast heart beat, headache, nausea, anxiety and overall tiredness and weakness. Usually experienced by patients with autonomic neuropathy (damage of nerves controlling involuntary body functions) taking beta blockers, clonidine, reserpine, guanethidine or other sympatholytic drugs
• Liver disease (like hepatitis)
• Kidney impairment 
• Stress in situations like trauma, surgery – doctor might switch over to insulin in this case
• Weight gain
• Adrenocortical insufficiency (condition characterised by inability of adrenal glands to produce adequate steroid hormones)
• Elderly
• Alcohol intake
• Heart problem (indicated by signs like, chest pain, breathing difficulty, pain in arms, neck and back, sweating and vomiting)
• Allergic reactions (indicated by skin rash, swelling around face area, wheezing, chest tightness and breathing difficulty)

 

Interaction with other medications

Certain medications could interact with Zoliget 15mg+2mg Tablet 7 ‘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 Zoliget 15mg+2mg Tablet 7 ‘S:

• Insulin or other anti – diabetics
• Steroid tablets – e.g prednisolone
• Anti – tuberculosis drug – e.g rifampicin
• Angiotensin-converting enzyme (ACE) inhibitors used to treat high blood pressure and other heart problems
• Allopurinol
• Probenecid
• Quinolones
• Salicylates
• Sulfonamides
• Tetracyclines
• Trofosfamide
• Acetazolamide
• Barbiturates
• Corticosteroids
• Diazoxide
• Diuretics
• Epinephrine and other sympathomimetic agents
• Glucagon
• Laxatives
• Nicotinic acid (in high doses)
• Oestrogens
• Phenothiazines
• Phenytoin
• Thyroid hormones
• H2-receptor antagonists
• Clonidine
• Reserpine
• NSAIDs – e.g phenylbutazone
• Anticoagulants 
• MAOIs
• Beta blockers
• Anti bacterials – e.g chloramphenicol, clarithromycin
• Disopyramide
• Fibrates
• Azole antifungals
• Cyclophosphamide
• Pentoxifylline 
• Colesevelam
• Alcohol intake
• Male sex hormones

 

Adverse effects

Like most medicines, Zoliget 15mg+2mg Tablet 7 ‘S has some side effects which include:

Common:

• Nausea
• Indigestion
• Diarrhoea
• Headache
• Dizziness
• Hypoglycemia 

 

Serious:

Pioglitazone:

• Monotherapy – visual disturbance, upper respiratory tract infection, weight gain, hypoesthesia. 
• With metformin – anaemia, weight gain, headache, visual disturbance, arthralgia, haematuria, erectile dysfunction, oedema. 
• With sulfonylureas – weight gain, dizziness, flatulence, oedema, arthralgia. 
• Triple therapy – raised creatinine kinase, hypoglycaemia, arthralgia. 
• With insulin – hypoglycemia, back pain, arthralgia, dyspnoea, cardiac failure.

Glimepiride: 

• Hypoglycemia (low blood sugar) indicated by feeling hungry, trembling or shaking, sweating, confusion and difficulty concentrating
• Anaphylaxis (allergic) reactions – difficulty breathing, swelling of your throat or tongue, hives, or difficulty swallowing
• Liver damage (hepatitis)
• Blood dyscrasias (blood disorder)
• Haemolytic anemia (low red blood cells because of rapid destruction)
• Thrombocytopenia (abnormally low levels of platelets)
• Transient visual disturbances
• Skin rash or itching – skin disease

How to cope with some of the adverse effects

• Nausea (feeling sick) – Take Zoliget 15mg+2mg Tablet 7 ‘S with meals and avoid having spicy food

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

• Stomach ache (indigestion) – 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.

• Headache – Take a painkiller, rest and keep yourself hydrated at all times.

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

• 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 Zoliget 15mg+2mg Tablet 7 ‘S

• Zoliget 15mg+2mg Tablet 7 ‘S is used for the treatment of type 2 diabetes mellitus (condition resulting in elevated levels of sugar in the blood) in patients inadequately controlled by diet and exercise; obese and in whom metformin is either contraindicated or are inadequately controlled by metformin or sulfonylurea. 
• It is prescribed to adults above 18 years of age.
• It should be avoided in elderly, debilitated and malnourished patients.
• Zoliget 15mg+2mg Tablet 7 ‘S is best known to be taken with meals to avoid common side effects  like nausea, indigestion, diarrhoea, headache, dizziness, muscle pain, sore throat, or tooth problems
• Some people have shown to gain weight when taking Zoliget 15mg+2mg Tablet 7 ‘S.
• Matter of concern arises when you experience signs like chest pain, breathing difficulties, skin rashes or an allergic reaction and a fall in red blood cell and platelet count. In that case contact your doctor immediately.
• It is important for your doctor to monitor your blood sugar levels regularly, along with repeated tests to prevent you from any complications. 
• Patients need to avoid alcohol intake and other anti diabetic medications like insulin, along with maintaining a good diet to prevent hypoglycemic events. 
• Use of Zoliget 15mg+2mg Tablet 7 ‘S is not recommended in pregnancy or while breastfeeding.

FAQs

1. WHAT EXACTLY DOES Zoliget 15mg+2mg Tablet 7 ‘S DO?

People with type 2 diabetes fail to respond properly to the insulin produced, secrete inadequate insulin, or produce excessive glucagon. Pioglitazone is an anit-diabetic medication (thiazolidinedione) that decreases blood sugar levels by increasing insulin sensitivity (your body’s response to insulin). Whereas, glimepiride 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 Zoliget 15mg+2mg Tablet 7 ‘S TO START WORKING?

It takes around 2-3 weeks for Zoliget 15mg+2mg Tablet 7 ‘S to start working by decreasing the blood glucose levels and optimal affect is usually achieved in 2-3 months. 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 Zoliget 15mg+2mg Tablet 7 ‘S as directed by your doctor.

3. DOES Zoliget 15mg+2mg Tablet 7 ‘S AFFECT KIDNEYS?

Since Zoliget 15mg+2mg Tablet 7 ‘S is mainly eliminated by the kidneys, people with severe kidney disease should avoid using this medicine. It does not affect those with normal kidney function and hence, is safe to use for them.

4. HOW LONG WILL I HAVE TO TAKE Zoliget 15mg+2mg Tablet 7 ‘S FOR?

Zoliget 15mg+2mg Tablet 7 ‘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.

5. CAN I STOP TAKING Zoliget 15mg+2mg Tablet 7 ‘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.

6. IS IT NECESSARY TO TAKE Zoliget 15mg+2mg Tablet 7 ‘S WITH FOOD?

It is advised to take Zoliget 15mg+2mg Tablet 7 ‘S with or after meals to reduce side effects like an upset stomach.

7. CAN I DRINK ALCOHOL WHILE TAKING Zoliget 15mg+2mg Tablet 7 ‘S?

Avoid drinking alcohol while you are on Zoliget 15mg+2mg Tablet 7 ‘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.

8. WHAT IF I TAKE TOO MUCH OF Zoliget 15mg+2mg Tablet 7 ‘S?

An overdose of Zoliget 15mg+2mg Tablet 7 ‘S can cause hypoglycemia (low blood sugar) indicated by feeling hungry, trembling or shaking, sweating, feeling confused and having problems concentrating. It can also severely affect your kidneys, heart and can possibly cause an allergic reaction. Contact your doctor immediately if you experience any of these signs.

9. WHAT IF I FORGET TO TAKE Zoliget 15mg+2mg Tablet 7 ‘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.

10. CAN I TAKE Zoliget 15mg+2mg Tablet 7 ‘S DURING PREGNANCY OR BREASTFEEDING?

Use of Zoliget 15mg+2mg Tablet 7 ‘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.

11. WHAT IF Zoliget 15mg+2mg Tablet 7 ‘S IS NO LONGER WORKING?

Type 2 diabetes is a progressive disease which means, in the long run, your body might start producing even less insulin than before and its ability to utilise the insulin produced could deteriorate as well. Hence, the dose of Zoliget 15mg+2mg Tablet 7 ‘S is usually increased over time to manage your blood glucose levels. At times, Zoliget 15mg+2mg Tablet 7 ‘S alone might not be effective and in that case your doctor will prescribe a combination of medicines so that your body is more reactive to it.

12. CAN I DRIVE OR RIDE A BIKE AFTER TAKING Zoliget 15mg+2mg Tablet 7 ‘S?

Zoliget 15mg+2mg Tablet 7 ‘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)

13. HOW SHOULD Zoliget 15mg+2mg Tablet 7 ‘S BE STORED?

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. Make sure it is not consumed by pets, children and other people.