What is/are Glucovance Tablets?

GLYBURIDE; METFORMIN helps to treat type 2 diabetes. Treatment is combined with a diet and exercise. This medicine helps your body to use insulin better. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

• diabetic ketoacidosis
• become easily dehydrated
• heart disease
• if you frequently drink alcohol containing drinks
• kidney disease
• liver disease
• polycystic ovaries
• serious infection or injury
• stroke
• thyroid disease
• undergoing surgery or certain x-ray procedures with injectable contrast agents
• an unusual or allergic reaction to glyburide, metformin, sulfa drugs, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with meals. Swallow with a drink of water. Follow the directions on the prescription label. Take your medicine at the same time each day. Do not take more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Patients over 65 years old may need a smaller dose than younger adults.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

• bosentan
• cimetidine
• cisapride
• cyclosporine
• digoxin
• dofetilide
• entecavir
• fluconazole
• medicines for fungal or yeast infections
• metoclopramide
• morphine
• nifedipine
• other medicines for diabetes
• procainamide
• quinine
• quinidine
• ranitidine
• trimethoprim
• vancomycin
• warfarin

Many medications may cause an increase or decrease in blood sugar, these include:

• alcohol containing beverages
• aspirin and aspirin-like drugs
• chloramphenicol
• chromium
• female hormones, like estrogens or progestins and birth control pills
• heart medicines
• isoniazid
• male hormones or anabolic steroids
• medicines for weight loss
• medicines for allergies, asthma, cold, or cough
• medicines for mental problems
• medicines called MAO Inhibitors like Nardil, Parnate, Marplan, Eldepryl
• niacin
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• pentamidine
• phenytoin
• probenecid
• quinolone antibiotics like ciprofloxacin, levofloxacin, ofloxacin
• some herbal dietary supplements
• steroid medicines like prednisone or cortisone
• thyroid medicine
• water pills or diuretics

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• breathing difficulties
• dark yellow or brown urine, or yellowing of the eyes or skin
• fever, chills, sore throat
• low blood sugar (ask your doctor or healthcare professional for a list of these symptoms)
• severe skin rash, redness, swelling, or itching
• unusual bleeding or bruising

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• diarrhea
• dizziness
• headache
• heartburn
• infection
• nausea, vomiting
• stomach discomfort

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Learn how to check your blood sugar. Tell your doctor or health care professional if your blood sugar is high, you might need to change the dose of your medicine. If you are sick or exercising more than usual, you might need to change the dose of your medicine. Do not skip meals. Ask your doctor or health care professional if you should avoid alcohol. If you have symptoms of low blood sugar, eat or drink something containing sugar at once and contact your doctor or health care professional. Make sure family members know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, like seizures or unconsciousness. They must get medical help at once.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Wear a medical identification bracelet or chain to say you have diabetes, and carry a card that lists all your medications.

Where should I keep this medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 25 degrees C (59 and 77 degrees F). Keep container tightly closed and protect from light. Throw away any unused medicine after the expiration date. ,

Glimepiride is used for:

Treating patients with type 2 diabetes who cannot control blood sugar levels by diet and exercise alone. Glimepiride may be used in combination with insulin.

Glimepiride is a sulfonylurea. Glimepiride lowers blood glucose (sugar) by stimulating the release of insulin from the pancreas gland. It also may help lower blood glucose by other actions on fat and muscle cells. Glimepiride does not work in type 1 (insulin-dependent) diabetes mellitus because in this condition, the pancreas gland is not capable of making or releasing insulin.

Do NOT use Glimepiride if:

• you are allergic to any ingredient in Glimepiride
• you have type 1 diabetes, severe second or third degree burns, increased ketone levels, severely increased acid levels in your bodily fluids (acidosis), or a history of a diabetic coma
• you are pregnant and near delivery
• you are using bosentan or drink alcohol

Contact your doctor or health care provider right away if any of these apply to you.

Before using Glimepiride :

Some medical conditions may interact with Glimepiride. 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 increased levels of acid in your bodily fluids (acidosis), a weak stomach, liver problems, intestinal problems, a high fever, kidney problems, severe diarrhea, an infection, or thyroid problems
• if you have recently suffered from major surgery or trauma, or you are debilitated or malnourished

Some MEDICINES MAY INTERACT with Glimepiride. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Bosentanbecause liver problems may occur and the effectiveness may be decreased
• Angiotensin converting enzyme (ACE) inhibitors (eg, enalapril), beta-blockers (eg, propranolol), certain medicines that act on the liver (eg, cimetidine, fluoxetine, miconazole, and others), chloramphenicol, clofibrate, fenfluramine, gemfibrozil, monoamine oxidase (MAO) inhibitors (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, celecoxib), oral anticoagulants (eg, warfarin), probenecid, salicylates (eg, aspirin), or sulfonamides (eg, sulfamethoxazole) because the risk of abnormally low blood sugar levels (eg, hunger, shakiness or weakness, dizziness, headache, sweating) may be increased
• Birth control pills, certain medicines that act on the liver (eg, phenytoin, rifampin, and others), diazoxide, diuretics (eg, hydrochlorothiazide), corticosteroids (eg, prednisone), estrogens (eg, estradiol), gemfibrozil, isoniazid, nicotinic acid, phenothiazines (eg, chlorpromazine), or certain stimulants (eg, albuterol, amphetamine, pseudoephedrine) because the effectiveness of Glimepiride may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Glimepiride 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 Glimepiride :

Use Glimepiride as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• The usual dose is given once daily with breakfast or the first main meal of the day.
• If you miss a dose of Glimepiride , 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 Glimepiride.

Important safety information:

• Do not drink alcohol while you are using Glimepiride. It can increase the risk of developing abnormally low blood sugar. Alcohol can sometimes interact with Glimepiride and cause a serious reaction with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain.
• Sulfonylurea antidiabetic medicines have been associated with increased risk of death from heart disease. Talk to your doctor about the possible risks and benefits of using Glimepiride and alternative treatments for your condition.
• Carry an identification card at all times that says you are diabetic. Monitor your blood sugar levels regularly according to your doctor’s directions. If your blood sugar level is often higher than it should be and you are taking Glimepiride according to directions, check with your doctor.
• Glimepiride may cause low blood sugar (eg, increased heartbeat, headache, chills, sweating, tremor, increased hunger, changes in vision, nervousness, weakness, dizziness, drowsiness, or fainting). It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you do not have a reliable source of glucose available, eat a quick source of sugar, such as table sugar, honey, or candy, or drink a glass of orange juice or nondiet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction. To prevent low blood sugar levels, eat meals on a regular schedule and do not skip meals.
• Use Glimepiride with caution in the ELDERLY because they may be more sensitive to its effects, especially abnormally low blood sugar levels.
• Glimepiride is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Glimepiride during pregnancy. It is unknown if Glimepiride is excreted in breast milk. Do not breast-feed while taking Glimepiride.

Possible side effects of Glimepiride :

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:

Dizziness; headache; nausea; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Pioglitazone is used for:

Treating type 2 diabetes in certain patients. It is used along with diet and exercise. It may be used alone or with other antidiabetic medicines.

Pioglitazone is a thiazolidinedione antidiabetic. It lowers blood sugar by making the cells of the body more sensitive to the action of insulin.

Do NOT use Pioglitazone if:

• you are allergic to any ingredient in Pioglitazone
• you have moderate to severe heart failure
• you have type 1 diabetes
• you have a history of liver problems, including jaundice (yellowing of the skin or eyes), during therapy with a similar medicine called troglitazone

Contact your doctor or health care provider right away if any of these apply to you.

Before using Pioglitazone :

Some medical conditions may interact with Pioglitazone. 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 diabetic ketoacidosis (a severe problem associated with diabetes)
• if you have a history of liver problems, abnormal liver function tests, heart problems (eg, congestive heart failure), or eye or vision problems
• if you have swelling problems (edema)

Some MEDICINES MAY INTERACT with Pioglitazone. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Gemfibrozil, insulin, or oral antidiabetic medicines (eg, glipizide) because the risk of low blood sugar may be increased
• Rifampin because it may decrease Pioglitazone ’s effectiveness, resulting in high blood sugar
• Anticoagulants (eg, warfarin) because their effectiveness may be decreased or the risk of their side effects may be increased by Pioglitazone

This may not be a complete list of all interactions that may occur. Ask your health care provider if Pioglitazone 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 Pioglitazone :

Use Pioglitazone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Pioglitazone by mouth with or without food.
• Continue to take Pioglitazone even if you feel well. Do not miss any doses. Taking Pioglitazone at the same time each day will help you remember to take it.
• If you miss a dose of Pioglitazone , take it as soon as possible. If it 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 Pioglitazone.

Important safety information:

• Carry an ID card at all times that says you have diabetes.
• Proper diet, regular exercise, and regular blood sugar testing are important for best results with Pioglitazone. Follow the diet and exercise program given to you by your health care provider.
• Check your blood sugar levels as directed by your doctor. If they are often higher than they should be and you take Pioglitazone exactly as prescribed, tell your doctor.
• It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.
• Do NOT take more than the recommended dose without checking with your doctor.
• Pioglitazone may lower your blood sugar levels when it is used along with insulin or other oral diabetic medicines. 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.
• Pioglitazone may cause ovulation in women who have not reached menopause but do not ovulate. Be sure to use effective birth control while using Pioglitazone.
• Tell your doctor or dentist that you take Pioglitazone before you receive any medical or dental care, emergency care, or surgery.
• Pioglitazone may be associated with an increased risk of bladder cancer. Discuss any questions or concerns with your doctor.
• Lab tests, including fasting blood sugar, hemoglobin A_1c, eye examinations, and liver function, may be performed while you use Pioglitazone. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Pioglitazone should not be used in CHILDREN younger than 18 years old; 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 using Pioglitazone while you are pregnant. It is not known if Pioglitazone is found in breast milk. Do not breast-feed while taking Pioglitazone.

Possible side effects of Pioglitazone :

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:

Headache; muscle aches; sore throat; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; symptoms of heart failure (eg, shortness of breath; sudden unexplained weight gain; swelling of the hands, ankles, or feet); symptoms of liver problems (eg, dark urine; yellowing of the skin or eyes; unexplained nausea, vomiting, or loss of appetite; stomach pain); symptoms of low blood sugar (eg, anxiety, increased sweating, dizziness or drowsiness, headache, chills, tremors, increased hunger); unusual tiredness or weakness.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.