Limpet M 2 mg+500 mg (Tablet (Extended Release))
Unit Price: ৳ 12.00 (3 x 7: ৳ 252.00)
Strip Price: ৳ 84.00
Medicine Details
| Category | Details |
|---|---|
| Generic | Glimepiride metformin |
| Company | Drug international ltd |
| Also available as |
Indications
- Adjunct to diet and exercise in type 2 diabetes mellitus patients
- For patients who do not achieve adequate glycemic control with glimepiride or metformin monotherapy
- As a replacement for 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 and glucose uptake
Dosage
- Governed by desired blood glucose levels
- Must be the lowest sufficient to achieve desired metabolic control
- Glucose levels in blood and urine must be measured regularly
- Highest recommended dose per day: 8 mg of glimepiride and 2000 mg of metformin
- Starting dose should not exceed daily doses of glimepiride or metformin already being taken
- Dose reduction or cessation must be considered to avoid hypoglycemia
Administration
- Must be swallowed whole, not crushed or chewed
Interaction
- Metabolized by cytochrome P450 2C9 (CYP2C9)
- Potentiation of blood-glucose-lowering effect may occur with drugs like insulin, ACE inhibitors, anabolic steroids, etc.
- Weakening of blood-glucose-lowering effect may occur with drugs like barbiturates, corticosteroids, diazoxide, etc.
- Both acute and chronic alcohol intake may potentiate or weaken the blood-glucose-lowering action
- Bile acid sequestrant (e.g., Colesevelam) binds to glimepiride, reducing its absorption
Contraindications
- Hypersensitivity to glimepiride, metformin, or sulfonylureas
- Pregnancy, breastfeeding
- Severe impairment of liver function and in dialysis patients for glimepiride
- Hypersensitivity to metformin or any of its excipients
- Acute metabolic acidosis, severe renal failure, hepatic insufficiency for metformin
Side Effects
- Hypoglycemia, prolonged hypoglycemia, temporary visual impairment for glimepiride
- Gastrointestinal symptoms, liver enzyme elevation, dysgeusia, changes in blood picture for glimepiride
- Nausea, vomiting, diarrhea, abdominal pain, metallic taste, decrease in vitamin B12 absorption, lactic acidosis, hepatobiliary disorders for metformin
Pregnancy & Lactation
- Glimepiride must not be taken during pregnancy
- Diabetes should be treated with insulin during pregnancy
- Glimepiride must not be taken by breastfeeding women
- Metformin excreted into milk, decision should be made to discontinue nursing or discontinue metformin
Precautions & Warnings
- Initial weeks of treatment may increase the risk of hypoglycemia
- Regular monitoring of thyroid-stimulating hormone levels for patients with hypothyroidism
Use in Special Populations
- Insufficient data for pediatric use
- Assessment of GFR before initiation of treatment with metformin
Overdose Effects
- Acute overdosage may lead to severe life-threatening hypoglycemia for glimepiride
- Lactic acidosis is a medical emergency and must be treated in hospital for metformin
Therapeutic Class
- Combination oral hypoglycemic preparations
Storage Conditions
- Cool (not exceeding 25°C) and dry place
- Protected from light