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Glyburide and Metformin

IMPORTANT WARNING:

Metformin may cause a serious condition called lactic acidosis. Tell your doctor if you are over 80 years old and if you have ever had kidney or liver disease. Do not drink large amounts of alcohol while taking glyburide and metformin. If you are having a radiologic test with injectable contrast agents (for example, a CT scan, angiogram, urogram, or MRI), talk to your doctor about stopping glyburide and metformin a few days before the test. If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking glyburide and metformin. If you experience any of the following symptoms, stop taking glyburide and metformin and call your doctor immediately: severe shortness of breath, excessive tiredness, muscle aches, stomach pain after the first few weeks of treatment, feeling cold, dizziness, or a slow or irregular heartbeat.

Why is this medication prescribed?

The combination of glyburide and metformin is used to treat type 2 (noninsulin-dependent) diabetes (formerly called 'adult-onset') in people whose diabetes cannot be controlled by diet and exercise alone. Glyburide belongs to a class of drugs called sulfonylureas, and metformin is in a class of drugs called biguanides. Glyburide lowers blood sugar by stimulating the pancreas, the organ that makes insulin. Insulin helps control blood sugar levels. The pancreas must produce insulin for this medication to work. Metformin helps your body regulate the amount of glucose (sugar) in your blood. It decreases the amount of glucose you get from your diet and the amount made by your liver. It also helps your body use its own insulin more effectively. Glyburide and metformin are not used to treat type 1 (insulin-dependent) diabetes (formerly called 'juvenile-onset').

How should this medicine be used?

Glyburide and metformin combination comes as a tablet to take by mouth. It is usually taken one to two times daily with meals. Your doctor may gradually increase your dose, depending on your response to glyburide and metformin. Monitor your blood glucose closely. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take glyburide and metformin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Glyburide and metformin combination controls diabetes but does not cure it. Continue to take glyburide and metformin even if you feel well. Do not stop taking glyburide and metformin without talking to your doctor.

Other uses for this medicine

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking glyburide and metformin,

  • tell your doctor and pharmacist if you are allergic to glyburide, metformin, or any other drugs.
  • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially albuterol (Proventil, Ventolin); allergy or cold medications; anticoagulants ('blood thinners') such as warfarin (Coumadin); antipsychotics such as mesoridazine (Serentil) or thioridazine (Mellaril); aspirin or other nonsteroidal antiflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn); beta-blockers such as propranolol (Inderal); calcium channel blockers such as diltiazem (Cardizem, Tiazac), nifedipine (Adalat, Procardia), or verapamil (Calan, Verelan); chloramphenicol (Chloromycetin); chlorpromazine (Thorazine); cimetidine (Tagamet); ciprofloxacin (Cipro); corticosteroids such as dexamethasone (Decadron), methylprednisolone (Medrol), or prednisone (Deltasone, Orasone); digoxin (Lanoxin); diuretics ('water pills'); epinephrine; estrogens; isoniazid (INH); medications that contain alcohol or sugar; miconazole (Lotrimin, others); morphine (MS Contin, others); niacin; oral contraceptives (birth control pills); phenelzine (Nardil); phenytoin (Dilantin); probenecid (Benemid); procainamide (Procanbid, Pronestyl); prochlorperazine (Compazine); promethazine (Phenergan); quinidine (Quinalan, Quinidex); quinine (Quinamm); ranitidine (Zantac); salicylates such as diflunisal (Dolobid) or salsalate (Disalcid); terbutaline (Brethine, Bricanyl); thyroid medications; tranylcypromine (Parnate); trimethoprim (Proloprim, Trimpex); vancomycin (Vancocin, others); and vitamins or herbal products.
  • in addition to the conditions listed in the IMPORTANT WARNING section, tell your doctor if you have or have ever had heart, pituitary, or thyroid disease; adrenal insufficiency; acute or chronic metabolic acidosis; diabetic ketoacidosis; hormone problems; or gastrointestinal absorption problems.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking glyburide and metformin, call your doctor immediately.
  • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
  • remember that alcohol can add to the drowsiness caused by this drug.
  • tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of glyburide and metformin.
  • plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Glyburide and metformin may make your skin sensitive to sunlight.
  • tell your doctor if you have fever, infection, injury, or illness with vomiting or diarrhea. These may affect your blood sugar level.

What special dietary instructions should I follow?

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. Calorie reduction, weight loss, and exercise will help control your diabetes and will also make glyburide and metformin work better. It is important to eat a healthy diet. Alcohol increases blood sugar and can affect the amount of lactic acid made. Ask your doctor for information on how much is safe to drink.

What should I do if I forget a dose?

Before you start taking glyburide and metformin, ask your doctor what to do if you forget to take a dose or accidently take an extra dose. Write these directions down so you can refer to them later.

As a general rule, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Glyburide and metformin are used to control the amount of sugar (glucose) in your blood. You should know the symptoms of low and high blood sugar and what to do if you have them.

If you have any of the symptoms of low blood sugar, eat or drink a food or beverage with sugar in it, such as hard candy or fruit juice, and call your doctor immediately. The symptoms of low blood sugar include:

  • shakiness
  • dizziness
  • fast pulse or heartbeat
  • sweating
  • confusion
  • blurred vision
  • headache
  • numbness or tingling of the mouth
  • weakness
  • fatigue
  • pale color
  • sudden hunger

If you have any of the symptoms of high blood sugar (hyperglycemia), call your doctor immediately. The symptoms of high blood sugar include:

  • thirst
  • dry mouth
  • tiredness
  • flushing
  • dry skin
  • frequent urination
  • increased appetite or feelings of hunger
  • trouble breathing

Although side effects from glyburide and metformin are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

  • headache
  • nasal congestion
  • runny nose
  • dizziness
  • stomach pain
  • upset stomach
  • vomiting
  • cough
  • diarrhea

If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

  • seizures
  • loss of consciousness
  • skin rash or hives
  • itching or redness
  • exaggerated sunburn
  • yellowing of the skin or eyes
  • light-colored stools
  • dark or clay-colored urine
  • unusual bleeding or bruising
  • fever
  • sore throat

Keep this medication in the container it came in (which is light resistant), tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your blood sugar and glycosylated hemoglobin (HbA1c) should be checked regularly to determine your response to glyburide and metformin. Your doctor may order other lab tests to check your response to glyburide and metformin.

To monitor the effectiveness of glyburide and metformin, measure the amount of sugar (glucose) in your blood or urine (when blood sugar is above a certain high level, you will have sugar in your urine). For measuring the amount of glucose in your blood, you can use a blood glucose meter. For the urine measurements, you will need special paper tapes, tablets, or plastic strips that change color depending on how much sugar is present. Your doctor also may ask you to test your urine for ketones (substances present when diabetes is not under control). Follow your doctor's directions for testing your urine and blood and for recording the results. If your blood sugar is high or if sugar or ketones are present in your urine, call your doctor.

Keep yourself and your clothes clean. Wash cuts, scrapes, and other wounds quickly, and do not let them get infected.

Wear medical alert identification (a bracelet or tag) that says you have type 2 diabetes.

Tell your doctor if you become seriously dehydrated (have lost a large amount of body fluids) or have severe vomiting, diarrhea, or fever. Tell your doctor if you have a heart attack or stroke.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT
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