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Glimepiride and  pioglitazone

Generic name: glimepiride and pioglitazone [glye-MEP-ir-ide-and-PYE-oh-GLI-ta-zone]
Brand name: Duetact
Oral Tablet: (2 mg-30 mg; 4 mg-30 mg).Combinations of anti-diabetic drugs

What are Glimepiride and  pioglitazone?

Glimepiride and pioglitazone are two oral diabetes medications that help control blood sugar levels.The glimepiride-pioglitazone combination is used in conjunction with diet and physical activity to control blood sugar levels in adults with type 2 diabetes mellitus. The combination of glimepiride and pioglitazone does not treat type 1 diabetes.This medication guide does not list all possible uses for glimepiride or pioglitazone.

Side effects of Glimepiride and pioglitazone

If you experience symptoms of an allergic reaction, such as hives, difficulty breathing, swelling on your face or in your throat, or a severe reaction to the skin (fever or sore throat with burning eyes, skin rash, blistering or peeling skin, or red or purple rash), seek emergency medical attention.

Glimepiride or pioglitazone can cause serious side effects. If you experience:

  • Pink or red urine; painful or difficult urination; a new or worsening urge or need to urinate
  • Changes in your vision
  • You may experience sudden, unusual pain in the hand, foot, or arm.
  • Liver problems: upper stomach pain, nausea (vomiting), tiredness, dark urine, jaundice (yellowing on the skin or in the eyes),
  • Symptoms of heart failure include shortness of breath (even when lying down) and swelling in the legs or feet. Rapid weight gain.

Side effects of glimepiride or pioglitazone include:

  • Headache;
  • Muscle pain;
  • Nausea, diarrhoea,
  • Cold symptoms include stuffy noses, sinus pains, sneezing, and sore throats.

There may be other side effects. Call your physician if experiencing side effects; alternatively, the FDA can be reached at 1-800-FDA-1088 if any serious reactions arise.

Warnings

If you have a severe or uncontrolled heart condition, such as bladder carcinoma or diabetes ketoacidosis, then it is not recommended that you use glimepiride or pioglitazone.This medicine may cause or worsen congestive cardiac failure. If you experience shortness of breath (even when doing mild exercise), swelling, or rapid weight gain, call your doctor immediately.

Before you take this drug

This medicine should not be used if:

  • Heart failure that is severe or advanced
  • Active bladder cancer
  • Diabetic ketoacidosis: Call your doctor to get treated.

Pioglitazone can increase your risk of serious heart problems. Not treating diabetes can cause damage to your heart and organs. Speak to your doctor regarding the risks and benefits associated with taking glimepiride or pioglitazone.

Notify your doctor of any of the following issues:

  • Congestive heart disease
  • Fluid retention;
  • Bladder cancer
  • Liver disease
  • Kidney disease
  • A genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency;
  • Diabetes can cause eye problems.
  • A stroke or heart attack

This medication can increase your risk of bladder cancer. Speak to your doctor about the specific risks you face.If you're pregnant or plan to become pregnant, follow your doctor’s instructions for using this medication. It is important to control diabetes during pregnancy. High blood sugar can cause complications for both the mother and the baby. You may have to temporarily stop taking pioglitazone and glimepiride just before your due date.While taking pioglitazone and glimepiride, women may be at a higher risk of breaking a bone. Speak to your doctor about how you can keep your bones strong.Pioglitazone can cause you to get pregnant even if your periods are irregular or you're premenopausal. Discuss with your doctor whether birth control is necessary.Breastfeeding may not be possible while taking this medication. You should consult your doctor if you are concerned about any risks.

How to take Glimepiride or pioglitazone?

Follow all instructions or guides included with your medication and adhere to its directions.Sometimes, your doctor will change the dose. Take your medication exactly as instructed.Glimepiride and pioglitazone can be taken with the first meal of the day.Low blood sugar (hypoglycemia) can affect anyone with diabetes. The symptoms of low blood sugar include headaches, nausea, dizziness, and irritability. Keep a quick-acting sugar source such as hard candy, crackers, or raisins with you to treat low blood sugar.If you are suffering from severe hypoglycemia, your doctor may prescribe an emergency injection kit. Make sure that your family members and friends are familiar with how to administer this emergency injection.Watch for other signs of hyperglycemia, such as increased thirst, blurred vision, or fatigue.Stress, illness, surgery, or alcohol consumption can affect blood sugar levels. Consult your doctor before changing the dose or schedule of your medication.Glimepiride or pioglitazone may be part of a comprehensive treatment plan that includes diet, exercise, and weight management, as well as blood sugar tests, eye exams, and other medical attention. You should follow your doctor's advice.Store away from heat, moisture, and light. When not in use, keep the bottle tightly shut.

Details on dosage

Adult dosage for diabetes type 2:

Individualise dosage based on safety, efficacy, and prior therapy.
Initial Dose of Pioglitazone-Glimepiride (4 mg). Orally taken once daily.For patients with inadequate control on glimepiride alone: Pioglitazone (30 mg)-glimepiride (2 mg) or pioglitazone (30 mg)-glimepiride (4 mg), orally, once daily
For patients with inadequate control on pioglitazone alone: Pioglitazone (30 mg) and glimepiride (2 mg) orally, once daily
For patients who are receiving pioglitazone or glimepiride individually, start with a combination product that contains doses as close to each component as possible.
For patients who are currently taking a sulfonylurea as monotherapy or have switched from a combination therapy consisting of pioglitazone and a sulfonylurea that is different: Pioglitazone (30 mg)-Glimepiride (2 mg), orally once daily
For patients with systolic dysfunction, start with pioglitazone alone and begin combination therapy only after the patient has tolerated pioglitazone from 15 mg to 30mg.
Maintenance Dose: Titrate the dose according to the therapeutic responses and tolerance for each component.
Comments:
Take the first meal of each day.
For patients who are switching from another sulfonylurea to this one, monitor hypoglycemia carefully for a period of 1 to 2 weeks. This is due to the potential for overlapping effects.
If hypoglycemia is observed in a patient who has been coadministered insulin, the dose should be decreased.
If hypoglycemia is observed in the co-administered patient's insulin, the insulin dosage should be reduced by 10% to 25%. Further adjustments will depend on the glycemic responses.
Use: To improve glycemic management in patients with type II diabetes who are treated with a combination of thiazolidinediones and sulfonylureas or have inadequate control with either a single thiazolidinedione or sulfonylurea.

What happens if I miss the dose?

Do not take the missed dose. Use your next dose as usual. Do not take two doses in one go.

What happens if you overdose?

Call the Poison Help Line at 1-800-222-1222 or seek emergency medical care. An overdose of glimepiride or pioglitazone can lead to life-threatening hypoglycemia.

What should be avoided?

Avoid alcohol. Alcohol lowers your blood sugar levels and can interfere with diabetes treatment.You may get sunburned easier if you take glimepiride or pioglitazone. Avoid tanning beds or sunlight. When you're outdoors, wear protective clothing and use sunblock (SPF 30 or higher).

Interaction with other drug

Tell your doctor if you use insulin. If you use insulin, taking glimepiride or pioglitazone may increase the risk of heart problems.This includes prescription and over-the-counter medicines, vitamins (https://www.drugs.com/drugclass/vitamins.html), and herbal products. These include prescription and over-the-counter medicines, vitamins, and herbal products.This list does not encompass every possible interaction. Inform your doctor of all medications you begin or stop taking.