Glucovance

Generic name: Glyburide and metformin hydrochloride

What is Glucovance?

Glucovance, as an adjunct with diet and exercise, is used to treat type 2 diabetes. This drug combines two glucose-lowering drugs, glyburide and metformin. Glyburide lowers blood sugar primarily by causing more of the body's own insulin to be released, and metformin lowers blood sugar, in part, by helping your body use your own insulin more effectively.

What is the most important information I should know about Glucovance?

Glucovance can cause a rare, but serious condition called lactic acidosis (a build up of an acid in the blood) that can be potentially fatal. Lactic acidosis is a medical emergency and must be treated in the hospital. Stop taking Glucovance and call your doctor right away if you: feel very weak or tired, have muscle pain, have trouble breathing, have stomach pain with nausea, vomiting, and diarrhea, feel cold, especially in your arms and legs, feel dizzy or lightheaded, have a slow or irregular heartbeat, or if a medical condition suddenly changes.

You have a higher chance for getting lactic acidosis with if you have kidney or liver problems, have congestive heart failure that requires treatments with medicines, drink a lot of alcohol, get dehydrated (lose a large amount of body fluids). Dehydration can happen if you are sick with a fever, have diarrhea, or from vomiting. Dehydration can also happen when you sweat a lot with activity or exercise and don't drink enough fluids. You also have a higher chance of getting lactic acidosis if you have certain x-ray tests with injectable dyes used, have surgery, have a heart attack, severe infection, or stroke, or are 80 years of age or older and not had your kidney function tested.

Glucovance may cause hypoglycemia (very low levels of blood sugar). This can happen if you do not follow your diet, exercise too much, drink alcohol, under stress, or get sick. It can also happen if you take other glucose-lowering drugs. Elderly, debilitated, and malnourished patients and those with adrenal or pituitary insufficiency are more susceptible to hypoglycemia. It may be difficult to recognize signs and symptoms of hypoglycemia in the elderly and patients taking "beta-blockers" (type of drug used to treat high blood pressure).

If you experience signs and symptoms of hypoglycemia, eat or drink something with sugar in it right away, such as regular (not diet) soft drink, orange juice, honey, sugar candy, or glucose tablets. If you do not feel better or your blood glucose does not go up, call your doctor immediately. If your doctor is unavailable for an emergency, call 911 or have someone drive you to the nearest emergency room.

Glucovance is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan can lead to serious complications, such as dangerously high or low blood sugar levels.

Who should not take Glucovance?

Do not begin treatment with Glucovance if you have kidney disease, congestive heart failure treated with medications, drink alcohol excessively, are dehydrated, or have high blood ketone or acid levels (including diabetic ketoacidosis).

Do not use Glucovance if you are scheduled to undergo surgery or an x-ray procedure involving special dye or contrast agents.

Do not use Glucovance if you have a serious infection, a history or heart attack or stroke, are 80 years of age or older and have not had your kidney function tested, or are allergic to any of its ingredients.

What should I tell my doctor before I take the first dose of Glucovance?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Glucovance. Also, talk to your doctor about your complete medical history, especially if you have an illness that causes severe diarrhea, vomiting, or fever; or you have heart, kidney or liver problems, or if you have low levels of vitamin B₁₂, are pregnant or planning to become pregnant, or are breastfeeding. Your doctor should also know if you are going to have surgery or an x-ray procedure that requires special dye or contrast agents.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Patients with Inadequate Glycemic Control on Diet and Exercise

Adults: 1.25 milligrams (mg)/250 mg once or twice daily is the recommended starting dose; dosage increases should be made in increments of 1.25 mg/250 mg per day every 2 weeks

Patients with Inadequate Glycemic Control on a Sulfonylurea and/or Metformin: 2.5 mg/500 mg or 5 mg/500 mg twice daily is the recommended starting dose; daily dose should be titrated in increments of no more than 5 mg/500 mg

Do not exceed the maximum daily dose of 20 mg/2000 mg.

How should I take Glucovance?

Glucovance should be taken with meals.

What should I avoid while taking Glucovance?

Do not change your diet, medication, and exercise routines. Changing any of these could affect blood sugar levels.

Avoid alcohol. It can interfere with your blood sugar levels and your diabetes treatment.

What are possible food and drug interactions associated with Glucovance?

If Glucovance is taken with certain other drugs, the effects of either could be increased, decreased, or altered. it is especially important to check you're your doctor before combining Glucovance with the following: amiloride, beta-adrenergic blocking agents, calcium channel blockers, chloramphenicol, coumarins, ciprofloxacin, corticosteroids, digoxin, estrogens, furosemide, isoniazid, miconazole, morphine, monoamine oxidase inhibitors, nicotinic acid, nifedipine, nonsteroidal anti-inflammatory drugs (eg, ibuprofen), oral contraceptives, phenothiazines, phenytoin, procainamide, probenacid, quinidine, quinine, ranitidine, salicylates, sulfonamides, sympathomimetics, thiazide diuretics, thyroid products, trimethoprim, vancomycin.

What are the possible side effects of Glucovance?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: diarrhea, nausea, upset stomach, upper respiratory infection, headache, vomiting, dizziness, abdominal pain

Symptoms of hypoglycemia (low blood sugar): dizziness, hunger, lightheadedness, shakiness

If you experience signs and symptoms of hypoglycemia, eat or drink something with sugar in it right away, such as regular (not diet) soft drink, orange juice, honey, sugar candy, or glucose tablets. If you do not feel better or your blood glucose does not go up, call your doctor immediately. If your doctor is unavailable for an emergency, call 911 or have someone drive you to the nearest emergency room.

Symptoms of lactic acidosis: dizziness, feeling cold, irregular/slow heartbeat, lightheadedness, muscle pain, stomach problems, tired or uncomfortable, trouble breathing

Lactic acidosis is a medical emergency and must be treated in the hospital.

Can I receive Glucovance if I am pregnant or breastfeeding?

The effects of Glucovance during pregnancy are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Glucovance?

If you miss a dose of Glucovance, take it as soon as possible. Of it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

How should I store Glucovance?

Store at room temperature.