•  MERCK SANTE

• Per 2.5 mg/500 mg tab glibenclamide 2.5 mg, metformin HCl 500 mg.Per 5 mg/500 mg tab glibenclamide 5 mg, metformin HCl 500 mg

  
   

• Initial therapy as adjunct to diet & exercise; 2nd-line therapy when diet, exercise & initial treatment w/ sulfonylureas or metformin is inadequate in type 2 diabetes.

• Renal disease or dysfunction, CHF requiring pharmacologic treatment, acute or chronic metabolic acidosis including diabetic ketoacidosis w/ or w/o coma. Diabetic ketoacidosis should be treated w/ insulin. Major surgery, hepatic insufficiency, acute alcohol intoxication, alcoholism, porphyria, in association w/ miconazole. Lactation.

   

   

• Initial therapy Recommended starting dose: 1.25 mg/250 mg once-bd. 2nd-line therapy Recommended starting dose: 2.5 mg/500 mg or 5 mg/500 mg bd, up to a max daily dose of glibenclamide 20 mg/metformin 2,000 mg.

   

•    30's/box

 Per 5 mg/500 mg tab glibenclamide 5 mg, metformin HCl 500 mg

Initial therapy Recommended starting dose: 1.25 mg/250 mg once-bd. 2nd-line therapy Recommended starting dose: 2.5 mg/500 mg or 5 mg/500 mg bd, up to a max daily dose of glibenclamide 20 mg/metformin 2,000 mg.

Updating

Lactic acidosis is rare & may occur in significant renal insufficiency. Regular renal monitoring is needed especially in the elderly. Increased risk of CV mortality; hypoglycaemia. Monitor renal function regularly (CrCl levels: Males: ≥1.5 mg/dL, female: ≥1.4 mg/dL). Avoid use in patients w/ clinical or laboratory evidence of hepatic disease. Patients should be cautioned against excessive alcohol intake; concomitant medications that may affect renal function or result in significant hemodynamic change or may interfere w/ the disposition of metformin. Suspend therapy during surgery & clinical investigations using IV iodinated contrast media. Monitor hematologic parameters annually; routine serum vit B₁₂ measurements at 2- to 3-yr interval & changes in clinical status of patients w/ previously controlled type 2 diabetes.