Generic Name: glyburide/metformin (GLYE-bure-ide/met-FOR-min)
Brand Name: Glucovance
The metformin in this combination medicine may rarely cause a serious and sometimes fatal condition called lactic acidosis. Most of these cases have occurred in diabetic patients who also have certain kidney problems. The risk of lactic acidosis may be greater if you have liver problems, kidney problems, or heart failure. The risk may also be greater in patients who are elderly or drink alcohol. Lab tests, including kidney function, may be performed while you take Glucovance.
Do not begin to take Glucovance if you are 80 years old or older, unless lab tests show that you do not have decreased kidney function. Do not take it if you have a severe infection, have low blood oxygen levels, or are dehydrated. Tell your doctor you take Glucovance before you have any surgery or lab procedures.
Contact your doctor right away if you notice symptoms such as fast or difficult breathing; muscle pain or tenderness; slow or irregular heartbeat; unusual drowsiness, dizziness, or light-headedness; unusual stomach discomfort; or unusual weakness or tiredness. Contact your doctor right away if you start to feel unusually cold or if you have a general feeling of being unwell.
Glucovance is used for:
Treating type 2 diabetes. It is used along with diet and exercise. It may be used alone or with other antidiabetic medicines.
Glucovance is a sulfonylurea and biguanide antidiabetic combination. The sulfonylurea works by causing the pancreas to release insulin, which helps to lower blood sugar levels. The biguanide works by decreasing the amount of sugar that the liver produces and the intestines absorb. It also helps to make your body more sensitive to the insulin that you naturally produce.
Do NOT use Glucovance if:
- you are allergic to any ingredient in Glucovance
- you have a severe infection, low blood oxygen levels, kidney or liver problems, type 1 diabetes, or high blood ketone or acid levels (eg, diabetic ketoacidosis), or you are dehydrated
- you have had a stroke or a recent heart attack, or you are in shock
- you are 80 years old or older, unless lab tests show that you do not have decreased kidney function
- you are pregnant and are within 2 weeks of the expected delivery date
- you will be having surgery or certain lab procedures
- you are taking bosentan
Contact your doctor or health care provider right away if any of these apply to you.
Before using Glucovance:
Some medical conditions may interact with Glucovance. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have had a severe allergic reactions (eg, a severe rash, hives, itching, breathing difficulties, dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, or zonisamide
- if you have heart failure, especially heart failure that is treated by medicine
- if you have a history of heart problems (eg, a heart attack, heart failure), blood vessel problems, lung or breathing problems, thyroid problems, stomach or bowel problems (eg, a blockage, paralysis), adrenal gland or pituitary problems, or lactic acidosis
- if you have vomiting, diarrhea, poor health or nutrition, low blood calcium or vitamin B12 levels, or anemia
- if you or a family member have a condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency
- if you have an infection, fever, recent injury, or moderate to severe burns
- if you drink alcohol or have a history of alcohol abuse
- if you will be having surgery or certain lab procedures
- if you take a beta-blocker (eg, propranolol)
Some MEDICINES MAY INTERACT with Glucovance. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Bosentan because liver problems may occur; the effectiveness of both medicines also may be decreased
- Beta-blockers (eg, propranolol) because the risk of low blood sugar may be increased. They may also hide certain signs of low blood sugar and make it more difficult to notice
- Anticoagulants (eg, warfarin), azole antifungals (eg, miconazole), chloramphenicol, clarithromycin, clofibrate, fenfluramine, insulin, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolones (eg, ciprofloxacin), salicylates (eg, aspirin), sulfonamides (eg, sulfamethoxazole), or thiazolidinediones (eg, pioglitazone) because the risk of low blood sugar may be increased
- Calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), hydantoins (eg, phenytoin), isoniazid, nicotinic acid, phenothiazines (eg, chlorpromazine), rifamycins (eg, rifampin), sympathomimetics (eg, albuterol, pseudoephedrine), or thyroid hormones (eg, levothyroxine) because they may decrease Glucovance's effectiveness, resulting in high blood sugar
- Gemfibrozil because blood sugar may be increased or decreased
- Amiloride, cimetidine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin, or medicines that may harm the kidney (eg, aminoglycoside antibiotics [eg, gentamicin], amphotericin B, tacrolimus) because they may increase the risk of Glucovance's side effects. Ask your doctor if you are unsure if any of your medicines might harm the kidney
- Cyclosporine because the risk of its side effects may be increased by Glucovance
This may not be a complete list of all interactions that may occur. Ask your health care provider if Glucovance may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Glucovance:
Use Glucovance as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Glucovance. Talk to your pharmacist if you have questions about this information.
- Take Glucovance by mouth with meals.
- High amounts of dietary fiber may decrease Glucovance's effectiveness, resulting in high blood sugar. If you have questions about including fiber in your diet while you are taking Glucovance, talk with your doctor.
- If you also take colesevelam, take Glucovance at least 4 hours before your dose of colesevelam. Check with your doctor if you have questions.
- Take Glucovance on a regular schedule to get the most benefit from it. Taking Glucovance at the same time each day will help you remember to take it.
- Continue to take Glucovance even if you feel well. Do not miss any doses.
- If you miss a dose of Glucovance, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Glucovance.
Important safety information:
- Glucovance may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Glucovance with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Follow the diet and exercise program given to you by your health care provider.
- Do NOT take more than the recommended dose without checking with your doctor.
- Do not drink large amounts of alcohol while you take Glucovance. Alcohol may increase the risk of Glucovance's side effects. Also, alcohol may rarely interact with Glucovance and cause a serious reaction with symptoms such as flushing, nausea, vomiting, dizziness, or stomach pain. Talk with your doctor or health care provider before you drink alcohol while you take Glucovance.
- Tell your doctor or dentist that you take Glucovance before you receive any medical or dental care, emergency care, or surgery.
- Be careful not to become dehydrated, especially during hot weather, while you are being active, or if you have vomiting or diarrhea. Dehydration may increase your risk of side effects from Glucovance.
- Glucovance contains a sulfonylurea. It may increase the risk of death from heart disease. Talk with your doctor about the benefits and risks of this or other therapies to treat your condition.
- Carry an ID card at all times that says you have diabetes. Check your blood sugar levels as directed by your doctor. If they are often higher than they should be and you take Glucovance exactly as prescribed, tell your doctor.
- Glucovance may cause low blood sugar levels. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
- The risk of low blood sugar may be increased by heavy or prolonged exercise, drinking alcohol, or skipping meals.
- Fever, infection, injury, or surgery may increase your risk of high or low blood sugar levels. If any of these occur, check your blood sugar levels closely and tell your doctor right away.
- Glucovance may commonly cause stomach upset, indigestion, nausea, vomiting, or diarrhea at the beginning of treatment. If you develop unusual or unexpected stomach problems, or if you develop stomach problems later during treatment, contact your doctor at once. This may be a sign of lactic acidosis.
- Lab tests, including kidney and liver function, fasting blood glucose, hemoglobin A1c, and complete blood cell counts, may be performed while you take Glucovance. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use Glucovance with caution in the ELDERLY; they may be more sensitive to its effects. Low blood sugar levels may also be more difficult to recognize in the elderly.
- Glucovance should be used with extreme caution in CHILDREN younger than 9 years; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Glucovance while you are pregnant. If you take Glucovance during pregnancy, do not take it within 2 weeks of the expected delivery date without first checking with your doctor. It is not known if Glucovance is found in breast milk. Do not breast-feed while taking Glucovance.
Possible side effects of Glucovance:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Diarrhea; headache; indigestion; mild stomach pain; nausea; stomach upset; vomiting.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); back pain; chest pain or discomfort; confusion; dizziness or light-headedness; fainting; fast or difficult breathing; feeling of being unusually cold; fever, chills, or persistent sore throat; general feeling of being unwell; low blood sugar symptoms (eg, anxiety, dizziness, fast heartbeat, headache, tremors, unusual sweating); muscle pain or weakness; severe or persistent blurred vision or other vision problems; slow or irregular heartbeat; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, stomach pain, yellowing of the eyes or skin); unusual bruising or bleeding; unusual drowsiness; unusual or persistent nausea, or stomach or back pain or discomfort; unusual tiredness or weakness.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include coma; confusion; dizziness or light-headedness; fainting; fast or difficult breathing; fast, slow, or irregular heartbeat; feeling of being unusually cold; general feeling of being unwell; muscle pain or tenderness; seizures; tremor; unusual drowsiness; unusual stomach discomfort; unusual weakness or tiredness.Proper storage of Glucovance:
Store Glucovance at 77 degrees F (25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Glucovance out of the reach of children and away from pets.
- If you have any questions about Glucovance, please talk with your doctor, pharmacist, or other health care provider.
- Glucovance is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take Glucovance or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Glucovance. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Glucovance. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Glucovance.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.