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Glimepiride with Metformin Hydrocloride Sustained Release Tablets

Indication & Dosage
Oral Type 2 diabetes mellitus Adult: Per tablet contains glimepiride 1 mg and metformin 500mg or glimepiride 2 mg and metformin 500 mg: Take as directed. Titrate according to response. 
Hypersensitivity diabetic ketoacidosis (DKA); renal dysfunction; CHF (CHF), patients undergoing radiological studies; acute or chronic metabolic acidosis. Pregnancy, lactation.
Special Precautions
Renal and hepatic impairment. Avoid alcohol consumption. Hypoglycaemic episodes.
Adverse Drug Reactions
Diarrhoea, vomiting, metallic taste, rash, isolated transaminase elevations, cholestatic jaundice, allergic skin reactions, photosensitivity reactions, leukopaenia, agranulocytosis, thrombocytopaenia, haemolytic anaemia, aplastic anaemia, pancytopaenia, blurred vision. Potentially Fatal: Lactic acidosis.
Drug Interactions
Concomitant admin with propranolol increases Cmax, AUC, and T1/2 of glimepiride. Aspirin increases the mean AUC of glimepiride. Furosemide increases the Cmax of metformin. Potentially Fatal: NSAIDS, salicylates, sulfonamides, chloramphenicol, coumarins, probenecid, MAOs, and beta blockers potentiate the hypoglycemic action of glimepiride.
Mechanism of Action
Glimepiride stimulates the insulin release from functioning pancreatic β-cells and inhibits gluconeogenesis at hepatic cells. It also increases insulin sensitivity at peripheral target sites. Metformin decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilisation).