glimepiride and pioglitazone
Generic Name: glimepiride and pioglitazone (glye MEP ir ide and PYE oh GLI ta zone)
Brand Name: Duetact
What is glimepiride and pioglitazone?
Glimepiride and pioglitazone is a combination of two oral diabetes medicines that help control blood sugar levels.
Glimepiride and pioglitazone is for people with type 2 diabetes. Glimepiride and pioglitazone is sometimes given with other diabetes medications when greater blood sugar control is needed.
This medication is not for treating type 1 diabetes.
Glimepiride and pioglitazone may also be used for purposes not listed in this medication guide.
What is the most important information I should know about glimepiride and pioglitazone?
You should not use this medicine if you have severe or uncontrolled heart failure, or if you have bladder cancer. Do not use this medicine if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). Glimepiride and pioglitazone is not for treating type 1 diabetes.
Glimepiride and pioglitazone can cause or worsen congestive heart failure. Stop using this medicine and call your doctor at once if you have shortness of breath (even with mild exertion), swelling, or rapid weight gain.
What should I discuss with my health care provider before taking glimepiride and pioglitazone?
You should not use this medicine if you are allergic to glimepiride or pioglitazone, or if you have:
severe or advanced heart failure;
an allergy to sulfa drugs; or
if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
To make sure glimepiride and pioglitazone is safe for you, tell your doctor if you have:
congestive heart failure or heart disease;
a history of bladder cancer;
a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency;
eye problems caused by diabetes; or
a history of heart attack or stroke.
Taking glimepiride and pioglitazone 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 treating your diabetes with this medicine.
This medication may increase your risk of developing bladder cancer. Talk with your doctor about your specific risk.
Women may be more likely than men to have bone fractures in the upper arm, hand, or foot while taking medicine that contains pioglitazone. Talk with your doctor if you are concerned about this possibility.
Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. Similar diabetes medications have caused severe hypoglycemia in newborn babies whose mothers had used the medication near the time of delivery.
Some women using glimepiride and pioglitazone have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control.
It is not known whether glimepiride and pioglitazone passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
How should I take glimepiride and pioglitazone?
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 glimepiride and pioglitazone with your first meal of the day.
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, pale skin, irritability, dizziness, feeling shaky, or trouble concentrating. 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.
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.
Use glimepiride and pioglitazone regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Glimepiride and pioglitazone is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, vision exams, and special medical care. Follow your doctor's instructions very closely.
Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.
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. A glimepiride and pioglitazone overdose can cause life-threatening hypoglycemia. Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).
What should I avoid while taking glimepiride and pioglitazone?
Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.
Avoid exposure to sunlight or tanning beds. Glimepiride and pioglitazone can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
Glimepiride and pioglitazone side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using this medicine and call your doctor at once if you have:
shortness of breath (even with mild exertion), swelling, rapid weight gain;
pink or red urine, painful or difficult urination, urinating more than usual;
pale skin, easy bruising or bleeding;
changes in your vision;
sudden unusual pain in your hand, arm, or foot;
liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common side effects may include:
nausea, diarrhea; or
cold symptoms such as stuffy nose, sinus pain, sneezing, sore throat.
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)
Glimepiride and pioglitazone dosing information
Usual Adult Dose for Diabetes Type 2:
Individualize dose based on safety, efficacy, and prior therapy
Initial dose: pioglitazone 30 mg-glimepiride 2 mg or pioglitazone 30 mg-glimepiride 4 mg orally once a day
-For patients inadequately controlled on glimepiride monotherapy: pioglitazone 30 mg-glimepiride 2 mg or pioglitazone 30 mg-glimepiride 4 mg orally once a day
-For patients inadequately controlled on pioglitazone monotherapy: pioglitazone 30 mg-glimepiride 2 mg orally once a day
-For patients receiving pioglitazone and glimepiride as individual components: Initiate with the combination product containing doses that are as close as possible to the dose of each component
-For patients currently on a different sulfonylurea monotherapy or switching from combination therapy of pioglitazone plus a different sulfonylurea: pioglitazone 30 mg-glimepiride 2 mg orally once a day
-For patients with systolic dysfunction, initiate with pioglitazone monotherapy and only initiate combination therapy after titration from pioglitazone 15 mg to 30 mg has been safely tolerated.
Maintenance Dose: Gradually titrate dose based on adequacy of therapeutic response and tolerability for each component
-Take with first meal of the day.
-For patients switching from a different sulfonylurea, carefully monitor for hypoglycemia for 1 to 2 weeks due to a potential overlapping drug effect.
-If hypoglycemia occurs in a patient coadministered an insulin secretagogue, the dose of the insulin secretagogue should be reduced.
-If hypoglycemia occurs in a patient's coadministered insulin, the insulin dose should be decreased by 10% to 25% with further adjustments based on glycemic response.
Use: As an adjunct to diet and exercise, to improve glycemic control in adult patients with type 2 diabetes mellitus who are already treated with a thiazolidinedione and sulfonylurea or who have inadequate glycemic control in a thiazolidinedione alone or a sulfonylurea alone.
What other drugs will affect glimepiride and pioglitazone?
Tell your doctor if you use insulin. Taking glimepiride and pioglitazone while you are using insulin may increase your risk of serious heart problems.
Many other medicines can increase or decrease the effects of glimepiride and pioglitazone on lowering your blood sugar. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
More about glimepiride/pioglitazone
- Pioglitazone and glimepiride
- Pioglitazone and glimepiride (Advanced Reading)
- Other brands: Duetact
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about glimepiride and pioglitazone.
- 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.
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