Glimepiride + Metformin
Generic Details
Generic Name
Glimepiride-Metformin
Other Names
- Amaryl-M
- Glimcip-M
- Gluconorm-G
- Glimisave-M
Drug Class
- Antidiabetic Combination
Chemical Formula
Molecular Weight
Mechanism of Action
- Glimepiride stimulates the release of insulin from pancreatic beta cells by closing ATP-sensitive potassium channels. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Indications
- Type 2 diabetes mellitus
Common Dosage Forms
- Tablet
Typical Dosage
- The usual starting dose is one tablet of glimepiride 1 mg-metformin 500 mg taken once daily with meals. Dosage may be titrated based on patient response.
Pediatric Dosage
Geriatric Dosage
Side Effects
- Hypoglycemia
- Nausea
- Vomiting
- Diarrhea
- Metallic taste
- Hypoglycemia when used in combination with insulin or other antidiabetic agents
Contraindications
- Hypersensitivity to either glimepiride or metformin
- Severe renal impairment, metabolic acidosis, diabetic ketoacidosis
Pregnancy Category
- Category C for glimepiride
- Category B for metformin (extended-release version is Category B)
Lactation Safety
- Metformin is excreted into human milk; it is recommended to discontinue breastfeeding or discontinue the drug.
Drug Interactions
- Alcohol can potentiate the effect of both drugs on lowering blood sugar levels.
- Glimepiride can interact with certain medications like NSAIDs, salicylates, sulfonamides, etc.
- Metformin can interact with cimetidine, carbonic anhydrase inhibitors, and others.
Overdose Symptoms
- Hypoglycemia, lactic acidosis
Antidote for Overdose
- Glucose for hypoglycemia, supportive measures for lactic acidosis
Storage Conditions
- Store at room temperature away from moisture and heat.
Pharmacokinetics
- Absorption:
- Distribution:
- Metabolism:
- Excretion:
Precautions
- Monitor renal function regularly as metformin can cause lactic acidosis in patients with renal impairment.
- Regular blood sugar monitoring is essential to prevent hypoglycemia.
Warnings
- May cause hypoglycemia; caution in the elderly and in patients with renal or hepatic impairment.
- Potential risk of lactic acidosis with metformin use, especially in patients with risk factors like renal impairment.