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Glyburide (Glibenclamide) + Metformin

 

Glyburide (Glibenclamide) + Metformin (generic Glucovance) Review

brand name: Glucophage
generic names: Metformin, Metformin hydrochloride

How does it work?

Glucophage tablets and Glucophage SR tablets both contain the active ingredient metformin hydrochloride. (NB. Metformin is also available without a brand name, ie as the generic medicine.) Metformin is used to help control blood sugar levels in people with type 2 or non-insulin dependent diabetes (NIDDM).

People with diabetes have a deficiency or absence of a hormone produced by the pancreas called insulin. Insulin is the main hormone responsible for the control of sugar in the blood. In type 2 diabetes the pancreas does not produce sufficient insulin and the cells of the body are resistant to the low levels of insulin circulating in the blood. Insulin would normally make the cells remove sugar from the blood, hence in type 2 diabetes blood sugar levels can rise too high.

Metformin hydrochloride is a type of antidiabetic medicine known as a biguanide. It works in a number of ways to decrease the amount of sugar in the blood of people with type 2 diabetes.

Firstly, it reduces the amount of sugar produced by cells in the liver. Secondly, it increases the sensitivity of muscle cells to insulin. This enables the cells to remove sugar from the blood more effectively. Finally, it also delays absorption of sugar from the intestines into the bloodstream after eating. Overall, metformin reduces blood sugar levels both between and directly after meals.

Metformin is used as a first line treatment of type 2 diabetes in people who are overweight. It is used when diet and exercise have failed to control blood sugar levels. It can also be used in combination with other antidiabetic medicines to provide better control of blood sugar.

Glucophage tablets are standard release tablets that are taken two or three times a day either during or just after meals.

Glucophage SR tablets are prolonged release tablets that are designed to release metformin slowly and continuously over several hours. This produces a steady blood level of the medicine throughout the day. The tablets are designed to be taken once or twice a day with meals, depending on your blood sugar control. They must be swallowed with water and not broken, chewed or crushed, as this would damage the prolonged release action.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from moisture and light. Throw away any unused medicine after the expiration date.

What other drugs will affect Metformin (Glyburide)?

You may be more likely to have hyperglycemia (high blood sugar) if you are taking Metformin (Glyburide) with other drugs that raise blood sugar. Drugs that can raise blood sugar include:

• diet pills, or medicines to treat asthma, colds or allergies.
• seizure medicines (Dilantin and others); and
• birth control pills and other hormones;
• thyroid medicine (Synthroid and others);
• phenothiazines (Compazine and others);
• steroids (prednisone and others);
• diuretics (water pills);
• isoniazid;

You may be more likely to have hypoglycemia (low blood sugar) if you are taking Metformin (Glyburide) with other drugs that lower blood sugar. Drugs that can lower blood sugar include:

• probenecid (Benemid).
• beta-blockers (Tenormin and others); or
• a monoamine oxidase inhibitor (MAOI);
• sulfa drugs (Bactrim and others);
• aspirin or other salicylates (including Pepto-Bismol);
• some nonsteroidal anti-inflammatory drugs (NSAIDs);

Some medications may interact with Metformin (Glyburide). Tell your doctor if you are using any of the following drugs:

• vancomycin (Vancocin, Lyphocin).
• trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra); or
• quinidine (Cardioquin, Quinidex, Quinaglute);
• procainamide (Procan, Pronestyl, Procanbid);
• morphine (MS Contin, Kadian, Oramorph);
• digoxin (Lanoxin);
• amiloride (Midamor) or triamterene (Dyrenium);
• cimetidine (Tagamet) or ranitidine (Zantac);
• nifedipine (Adalat, Procardia);
• furosemide (Lasix);

If you are using any of these drugs, you may not be able to take Metformin (Glyburide), or you may require a dosage adjustment or special monitoring.

There may be other drugs not listed that can affect Metformin (Glyburide). Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, herbal products, minerals, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Why should Glucophage not be prescribed?

Glucophage is processed primarily by the kidneys, and can build up to excessive levels in the body if the kidneys aren't working properly. It should be avoided if you have kidney disease or your kidney function has been impaired by a condition such as blood poisoning, shock, or a heart attack.

Do not take Glucophage if you have metabolic or diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, pain below the breastbone, fatigue, nausea, and fruity breath). Diabetic ketoacidosis should be treated with insulin.

Do not take Glucophage if you have ever had an allergic reaction to Metformin (Glyburide).

You should not use Glucophage if you need to take medicine for congestive heart failure.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine passes into breast milk. As it could have side effects on a nursing infant, mothers who need to take this medicine should not breastfeed. It is important to seek medical advice from your doctor.
  
  
• This medicine should not be used during pregnancy. Control of diabetes mellitus in pregnancy is usually achieved using insulin, because this provides a more stable control of blood sugar. If you get pregnant while taking this medicine, or are planning a pregnancy, you should seek medical advice from your doctor.
  
  

What drug(s) may interact with Metformin?

•alcohol
•cephalexin
•cimetidine
•digoxin
•dofetilide
•entecavir
•morphine
•nifedipine
•procainamide
•propantheline
•quinidine
•quinine
•ranitidine
•trimethoprim
•trospium
•vancomycin
•water pills (diuretics like amiloride, nutritional supplements, including non-prescription medicines, or cough
•niacin
•pentamidine
•phenytoin
•some herbal dietary supplements
•steroid medicines such as or contraceptive pills
•isoniazid
•male hormones or anabolic steroids
•medications for weight loss
•medicines for allergies, asthma, cold, prednisone or cortisone
•thyroid hormones
•water pills (diuretics)

Tell your prescriber or health care professional about all other medicines you are taking, progestins,. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.