glyburide and metformin

Pronunciation

Generic Name: glyburide and metformin (GLYE bure ide and met FOR min)
Brand Name: Glucovance

What is glyburide and metformin?

Glyburide and metformin is a combination of two oral diabetes medicines that help control blood sugar levels.

Glyburide and metformin is used to treat type 2 diabetes. This medicine is not for treating type 1 diabetes.

Glyburide and metformin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about glyburide and metformin?

You should not use this medicine if you have kidney disease or are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking glyburide and metformin.

Slideshow: Prediabetes - Am I at Risk?

Some people develop lactic acidosis while taking metformin. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired.

What should I discuss with my healthcare provider before taking glyburide and metformin?

You should not use this medicine if you are allergic to glyburide or metformin, or:

  • if you have kidney disease;

  • if you are also using bosentan (to treat pulmonary arterial hypertension); or

  • if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking glyburide and metformin.

Some people taking metformin develop a serious condition called lactic acidosis. This may be more likely if you have liver or kidney disease, congestive heart failure, a severe infection, if you are dehydrated, or if you drink large amounts of alcohol. Talk with your doctor about your risk.

To make sure glyburide and metformin is safe for you, tell your doctor if you have:

  • an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD);

  • liver disease; or

  • heart disease or a history of heart attack or stroke.

FDA pregnancy category B. This medicine is not expected to harm an unborn baby. Similar diabetes medications have caused severe hypoglycemia in newborn babies whose mothers had used the medication near the time of delivery. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether this medicine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while taking glyburide and metformin.

Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of taking glyburide and metformin.

How should I take glyburide and metformin?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take glyburide and metformin with meals. Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, confusion, irritability, dizziness, or feeling shaky. Always keep a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, hard candy, crackers, raisins, and non-diet soda. Be sure your family and close friends know how to help you in an emergency.

If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. Your doctor can prescribe a glucagon emergency injection kit and tell you how to use it.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.

Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your medication dose or schedule without your doctor's advice.

If you need surgery, tell the surgeon ahead of time that you are using glyburide and metformin. You may need to stop using the medicine for a short time.

Glyburide and metformin is only part of a treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Your doctor may have you take extra vitamin B12 while you are taking glyburide and metformin. Take only the amount of vitamin B12 that your doctor has prescribed.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember (be sure to take the medicine with food). Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, confusion, tremors, sweating, fast heart rate, trouble speaking, nausea, vomiting, rapid breathing, fainting, and seizure (convulsions).

Overdose may also cause lactic acidosis symptoms such as muscle pain, numbness, trouble breathing, vomiting, slow heart rate, and extreme weakness.

What should I avoid while taking glyburide and metformin?

Avoid drinking alcohol. It can lower your blood sugar and may increase the risk of lactic acidosis while you are taking this medicine.

Glyburide and metformin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Stop taking this medicine and get emergency medical help if you have even mild symptoms such as:

  • muscle pain or weakness;

  • numb or cold feeling in your arms and legs;

  • trouble breathing;

  • feeling dizzy, light-headed, tired, or very weak;

  • stomach pain, nausea with vomiting; or

  • slow or uneven heart rate.

Call your doctor at once if you have:

  • pale or yellowed skin, dark colored urine, fever, confusion or weakness.

Common side effects may include:

  • stomach pain, nausea, vomiting, diarrhea;

  • cold symptoms such as stuffy nose, sneezing, sore throat;

  • headache; or

  • dizziness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Glyburide and metformin dosing information

Usual Adult Dose for Diabetes Type 2:

Initial therapy:

1 tablet (1.25 mg-250 mg) orally once or twice daily with meals.

Previously treated patients:

1 tablet (2.5 mg-500 mg) orally twice daily with meals.

-or-

1 tablet (5 mg- 500 mg) orally twice daily with meals.

Comments: Glyburide-metformin should be administered at least 4 hours prior to colesevelam to ensure that colesevelam does not reduce the absorption of glyburide-metformin.

What other drugs will affect glyburide and metformin?

There are many other medicines that can increase or decrease the effects of glyburide and metformin on lowering your blood sugar. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about glyburide and metformin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 9.01. Revision Date: 2014-05-12, 7:14:16 AM.

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