Drug Name

Glucovance (Metformin & Glyburide)

Common use

Glucovance is a combination of two orally taken drugs possessing a hyproglycemic effect which belong to two different groups: metformin and glibenclamide. Metformin belongs to biguanide class of substances and decreases blood levels of glucose by increasity susceptibility of peripheral tissues to action of insulin. Metmorfin decreases absorption of carbohydrates in gastrointestinal tract and inhibits synthesis of glucose in the liver. Glibenclamide is a derivate of sulfonylurea and acts stimulating secretion of insulin by β-cells of the pancreas. It is used along with a diet and exercise program to to treat type 2 diabetes (non-insulin-dependent diabetes).

Dosage and direction

Take Glucovance twice daily with meals and full glass of water. Take it regularly and each time every day to get the best benefit from it.

Drug interaction

Cimetidine (Tagamet) increases blood levels of Glucophage affecting its metabolism. Glucophage is not compatible with alcohol. Concomitant administration with indirect anticoagulants and Cimetidine should be done with cautiousness. Glucophage enhances metabolism of Furosemide. Derivatives of sulfonylurea, insulin, acarbose, inhibitors of MAO, ACE inhibitors (such as captopril), oxytetracycline, cyclophosphamide and salicylates increase the effects of Glucophage. Decrease of hypoglycemic effect of Glucophage is caused by co-administration with thyroid medicines, birth control pills and other hormones, Epinephrine, Glucagon, thiazide diuretics, nicotinic acid derivates. Azole antifungals (fluconazole) also interact with Glucovance.

Missed dose

If you forgot to take your dose in time, please do it as soon as you remember. But do not take if it is too late or almost time for your next dose. Do not take double or extra doses. Take your usually dose next day in the same regularly time.

Overdose

Symptoms of Glucovance overdose are ones of low blood sugar: hunger, tremors, confusion, irritability, drowsiness, headache, weakness, sweating, fast heartbeat, seizure and have a source of sugar at hand always. If you experience one of them or any unusual symptoms call your doctor immediately.

Storage

Store at room temperature between 20-25 C (68-77 F). Store away from moisture, heat, and sunlight. It is not recommended to store in a bathroom and places available for children.

Precautions

Avoid drinking alcoholic beverages during treatment with this medication. Notify your doctor first than to take Glucovance if you have any kind of fever, thyroid gland diseases with functional disorders, hypofunction of the anterior pituitary or the adrenal cortex. Inform your physician if you are pregnant or breastfeeding before to take this drug and also if you have severe breathing problems (e.g., obstructive lung disease, severe asthma), thyroid disease, blood problems (e.g., anemia, vitamin B-12 deficiency).

Contraindications

Hypersensitivity to metformin, glyburide, or other derivatives of sulfonylurea, type 1 diabetes, diabetic ketoacidosis, diabetic precoma, diabetic coma, kidney failure or kidney dysfunction, severe conditions which may lead to kidney dysfunction (dehydration, severe infection, shock), acute or chronic diseases that are accompanied by hypoxia of tissues: cardiac or respiratory failure, recent myocardial infarction, hepatic impairment, porphyria, pregnancy, breast-feeding, co-administration with miconazole (anti-fungal), infectious diseases, extensive surgery, trauma, extensive burns and other conditions requiring a therapy with insulin, abnormal liver function, chronic alcoholism, acute alcohol intoxication, lactic acidosis, usage 48 hours before and 48 hours after the radioisotope or radiological examinations with help of iodinated contrast agents, in patients over 60 y.o., or doing hard physical work (risk of lactic acidosis increases), low glucose diet.

Side effects

The following side effects are most common and be rather severe to stop taking of the medication: swelling or rapid weight gain, nausea, vomiting, gas, bloating, diarrhea and loss of appetite. In case of lactic acidosis also get emergency medical help: shortness of breath, stomach pain, weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, feeling light-headed, and fainting. Allergic reaction is also possible: hives, swelling, rash.