Limaryl M 1 mg+500 mg (Tablet (Extended Release))

Unit Price: ৳ 9.00 (3 x 10: ৳ 270.00)
Strip Price: ৳ 90.00

Medicine Details

Category Details
Generic Glimepiride metformin
Company Popular pharmaceuticals ltd
Also available as
Limaryl m 2 mg tablet

Indications

  • Adjunct to diet and exercise in type 2 diabetes mellitus patients
  • For inadequate glycemic control with glimepiride or metformin monotherapy
  • Replacement of combination therapy of glimepiride and metformin

Pharmacology

  • Decreases blood glucose concentration
  • Stimulates insulin release from pancreatic beta cells
  • Improves sensitivity of beta cells to glucose stimulus
  • Reduces basal hepatic glucose production
  • Increases peripheral tissue sensitivity to insulin
  • Improves glucose uptake
  • Hypoglycemic action persists for 24 hours in non-fasting diabetic patients

Dosage

  • Governed by desired blood glucose level
  • Must be lowest sufficient to achieve metabolic control
  • Regular measurement of blood and urine glucose levels
  • Avoid correcting mistakes by taking a larger dose
  • Glimepiride requirements may fall as treatment proceeds
  • Maximum recommended daily dose: 8mg glimepiride, 2000mg metformin

Administration

  • Tablet must be swallowed whole, not crushed or chewed

Interaction

  • Metabolized by CYP2C9
  • Potential potentiation and hypoglycemia with coadministered drugs
  • Potential weakening and raised blood glucose levels with coadministered drugs
  • Alcohol intake may potentiate or weaken blood-glucose-lowering action
  • Bile acid sequestrant (e.g., colesevelam) reduces glimepiride absorption

Contraindications

  • Hypersensitivity to glimepiride, metformin, other sulfonylureas, sulfonamides, or excipients
  • Pregnancy
  • Breastfeeding
  • Severe impairment of liver function
  • Severe renal failure or renal dysfunction
  • Acute metabolic acidosis, diabetic ketoacidosis

Side Effects

  • Hypoglycemia
  • Temporary visual impairment
  • Gastrointestinal symptoms
  • Liver enzyme elevation, cholestasis, jaundice
  • Changes in blood picture
  • Alopecia
  • Allergic reactions
  • Weight gain
  • Nausea, vomiting, diarrhea, abdominal pain, loss of appetite
  • Metallic taste
  • Decrease of vitamin B12 absorption
  • Lactic acidosis
  • Hemolytic anemia
  • Reduction of thyrotropin level
  • Hypomagnesemia
  • Encephalopathy
  • Photosensitivity

Pregnancy & Lactation

  • Glimepiride must not be taken during pregnancy
  • Metformin not recommended during pregnancy, insulin should be used
  • Glimepiride not for breastfeeding women, switch to insulin if necessary
  • Metformin excreted into milk, consider the importance of the compound to the mother

Precautions & Warnings

  • Increased risk of hypoglycemia in initial weeks of treatment
  • Careful monitoring in risk factors for hypoglycemia
  • Caution in patients with G6PD-deficiency
  • Regular monitoring of TSH levels in patients with hypothyroidism
  • Decrease in vitamin B12 serum levels with long-term metformin treatment
  • GFR assessment before initiating metformin therapy

Use in Special Populations

  • Insufficient data for pediatric use
  • Renal function assessment before initiation of metformin therapy
  • Maximum daily doses based on GFR levels

Overdose Effects

  • Severe life-threatening hypoglycemia with glimepiride
  • Immediate treatment and hospital admission for severe reactions
  • Lactic acidosis, pancreatitis in metformin overdose
  • Medical emergency and treatment in hospital for lactic acidosis

Therapeutic Class

  • Combination Oral hypoglycemic preparations

Storage Conditions

  • Store in a cool and dry place, protected from light

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