Glibenclamide with Metformin & Pioglitazone

Glibenclamide, metformin, and pioglitazone is a combination medication used to manage blood sugar levels in people with type 2 diabetes. Glibenclamide is a sulfonylurea that stimulates insulin secretion from the pancreas, metformin is a biguanide that decreases glucose production in the liver and improves insulin sensitivity, and pioglitazone is a thiazolidinedione that enhances insulin sensitivity in muscle and fat cells. This combination medication helps to control blood sugar levels when diet and exercise alone have not been effective.

Indications

Type 2 diabetes mellitus in adults, particularly when monotherapy with metformin, glibenclamide, or pioglitazone is inadequate to achieve optimal blood glucose control.

Dosage

-Dosage should be individualized based on current treatment, effectiveness, and tolerance. -The medication is typically taken orally once or twice daily with meals. -Monitor blood glucose levels regularly and adjust dosage as necessary under the supervision of a healthcare provider.

Contra-Indications

-Known hypersensitivity to any of the components in the medication. -Severe renal impairment (e.g., creatinine clearance <30 mL/min). -Acute or chronic metabolic acidosis (e.g., diabetic ketoacidosis). -Heart failure or active liver disease. -Pregnant or breastfeeding women.

Special Precautions

-Hypoglycemia: Increased risk when combined with other glucose-lowering agents or when caloric intake is low. -Lactic Acidosis: Metformin can rarely cause lactic acidosis; monitor patients for signs and symptoms. -Heart Failure: Use with caution in patients with heart failure, particularly with pioglitazone. -Liver Impairment: Monitor liver function regularly. -Weight Gain: Pioglitazone may cause weight gain in some patients. -Fluid Retention: Pioglitazone can cause fluid retention and should be used cautiously in patients with heart failure.

Side Effects

-Common side effects include hypoglycemia, weight gain, nausea, diarrhea, and dizziness. -Metformin may cause gastrointestinal side effects such as upset stomach and diarrhea. -Pioglitazone may lead to fluid retention and an increased risk of heart failure. -Rarely, metformin may cause lactic acidosis, a serious condition.

Drug Interactions

-Alcohol: Can increase the risk of hypoglycemia and lactic acidosis. -Beta-Blockers: May mask the symptoms of hypoglycemia. -Diuretics and Corticosteroids: May reduce the efficacy of the medication. -Other Antidiabetic Drugs: Can enhance the hypoglycemic effect and increase the risk of hypoglycemia.