Generic Glucovance ® : Glyburide/ Glibenclamide 5mg + Metformin HCL 500mg

Tablets
Chemical Name: GLYBURIDE (GLYE-byoo-ride) and METFORMIN (met-FOR-min)

Common uses : This anti-diabetic medicine is a combination of two medicines (a sulfonylurea and a biguanide). It is used along with a diet and exercise program to control high blood sugar in patients with type 2 diabetes (non-insulin-dependent diabetes). This medicine works by stimulating the release of your body's natural insulin and by restoring your body's proper response to insulin. Controlling high blood sugar helps prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (impotence).

Before using : WARNING: The metformin in this combination medicine can rarely cause a condition called lactic acidosis, which can be fatal. Seek immediate medical attention if you develop any of the following symptoms of lactic acidosis: unusual tiredness (fatigue) or severe drowsiness, cold skin, muscle pain, trouble breathing or rapid breathing, or unusually slow or irregular heartbeat. Lactic acidosis is more likely to occur in patients who have certain conditions, including heart failure, kidney or livery problems, excessive alcohol use, a lack of body fluids (dehydration), x-ray or scanning procedures that require an injectable iodinated contrast drug, surgery, a serious infection, heart attack, or stroke. Also at a higher risk are those who are elderly, especially if you are over 80 years of age and have not had kidney or liver tests. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. USE OF THIS MEDICINE IS NOT RECOMMENDED if you are also taking bosentan. If you are currently using bosetan, contact your doctor before starting this medicine. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking other diabetes medicines (e.g., insulin, rosiglitazone), aspirin or aspirin-like medicines (e.g., salicylates, NSAIDs such as ibuprofen, phenylbutazone), azole antifungals (e.g., fluconazole), cimetidine, birth control pills, "blood thinners" (e.g., warfarin), chloramphenical, clofibrate, clomiphene, corticosteroids (e.g., prednisone), decongestants (e.g., pseudoephedrine), diazoxide, diet pills, epinephrine, estrogens, high blood pressure medicines (beta-blockers such as propranolol, calcium channel blockers such as nifedipine, ACE inhibitors such as captopril), isoniazid, monoamine oxidase inhibitors (MAOIs)(e.g., furazolindone, linezolid, moclobemide, phenelzine, procarbazine, selegiline, isocarboxazid, tranylcypromine), niacin, phenothiazines (e.g., chlorpromazine), phenytoin, probenecid, quinolone antibiotics (e.g., ciprofloxacin), rifampin, sulfonamides (e.g., sulfa antibiotics), thyroid medicine, "water pills" (diuretics such as hydrochlorothiazide, furosemide), fenugreek, or ginseng. DO NOT START OR STOP ANY MEDICINE without doctor or pharmacist approval. Inform your doctor of any other medical conditions including thyroid problems, blood problems (e.g., anemia, vitamin B-12 deficiency), scheduled upcoming surgery, scheduled upcoming x-ray or scanning procedures, alcohol use, certain hormonal conditions (adrenal/pituitary insufficiency, SIADH-syndrome of inappropriate secretion of antidiuretic hormone), electrolyte imbalance (hyponatremia), high blood pressure, allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have certain medical conditions including kidney disease, liver disease, congestive heart failure, metabolic conditions (e.g., diabetic ketoacidosis), recent heart attack or stroke, serious infection, or dehydration.

Directions : Follow the directions for using this medicine provided by your doctor. This medicine may come with a patient leaflet. Ask your doctor, nurse or pharmacist any questions you may have about this medicine. TAKE THIS MEDICINE WITH A MEAL. DRINKING EXTRA FLUIDS while you are taking this medicine is recommended. Check with your doctor or nurse for instructions. Your dosage is based on your medical condition and your response to therapy. Use this medicine regularly in order to receive the most benefit from it. Taking this medicine at the same time each day will help you remember. STORE THIS MEDICINE in a tightly-closed container at room temperature 77 degrees F (25 degrees C), away from heat, moisture, and light. CONTINUE TO TAKE THIS MEDICINE even if you feel well. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If 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.

Cautions : DO NOT TAKE THIS MEDICINE if you have had an allergic reaction to it or are allergic to any ingredient in this product. Laboratory and/or medical tests may be performed to monitor your progress or to check for side effects. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS while you are taking this medicine. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, OR SURGERY, OR IF YOU ARE SCHEDULED TO HAVE ANY X-RAY OR SCANNING PROCEDURE that requires the use of iodinated contrast dye, tell the doctor or dentist that you are taking this medicine. During times of stress, such as fever, infection, injury, or surgery, it may be more difficult to control your blood sugar. Consult your doctor as a change in your medicine may be needed. LIMIT ALCOHOLIC BEVERAGES while using this medicine because they can increase the risk of developing hypoglycemia. Rarely, alcohol can interact with this medicine and cause a serious reaction with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about the safe use of alcohol. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Taking this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. THIS MEDICINE MAY CAUSE increased sensitivity to the sun. Avoid exposure to the sun or sunlamps until you know how you react to this medicine. Use a sunscreen or protective clothing if you must be outside for a prolonged period. THIS MEDICINE MAY CAUSE HYPOGLYCEMIA (low blood sugar). Signs of hypoglycemia include increased heartbeat, headache, chills, sweating, tremor, increased hunger, changes in vision, nervousness, weakness, dizziness, drowsiness, or fainting. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you do not have a reliable source of glucose available, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or non-diet soda to quickly raise your blood sugar level. TELL YOUR DOCTOR IMMEDIATELY about the reaction. To prevent hypoglycemia, eat meals on a regular schedule and do not skip meals. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. CAUTION IS ADVISED WHEN USING THIS MEDICINE IN THE ELDERLY since they may be more sensitive to the effects of this medicine, especially hypoglycemia. FOR WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of taking this medicine during pregnancy. If this medicine is taken during pregnancy, it should be stopped at least 2 weeks before the expected delivery date to minimize the risk of severe low blood sugar in the newborn infant. IT IS UNKNOWN IF THIS MEDICINE IS EXCRETED in breast milk. DO NOT BREAST-FEED while taking this medicine. MONITOR BLOOD GLUCOSE AND URINE KETONES on a regular basis, as directed by your doctor.

Possible side effects : Also see the BEFORE USING THIS MEDICINE section. SIDE EFFECTS, that may occur initially during treatment, include nausea, stomach upset, diarrhea, or weight gain. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if your stomach symptoms recur later (after you are taking the same dose for several days or weeks). A later recurrence of stomach symptoms may be due to lactic acidosis. CONTACT YOUR DOCTOR IMMEDIATELY if you experience persistent sore throat or fever, easy bleeding or bruising, severe stomach pain, yellowing eyes or skin, dark urine, unusual tiredness or weakness, unusual or sudden weight gain, mental/mood changes, swelling of the hands or feet, or seizures. THIS MEDICINE CAN CAUSE LOW BLOOD SUGAR (hypoglycemia). This effect may occur if you do not consume enough calories (from food, juices, fruit, etc). The symptoms include chills, cold sweat, blurred vision, dizziness, drowsiness, shaking, rapid heartbeat, weakness, headache, fainting, tingling of the hands or feet, or hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you are in a situation where you don't have these reliable forms of glucose, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or non-diet soda to quickly raise your blood sugar level. TELL YOUR DOCTOR IMMEDIATELY about the reaction. To help prevent hypoglycemia, eat meals on a regular schedule and do not skip meals. Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor. If these symptoms occur, TELL YOUR DOCTOR IMMEDIATELY. Your medicine dosage may need to be increased. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Drug interactions : Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions

If you take too much : If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include rapid breathing or trouble breathing, severe drowsiness, fast/slow/irregular heartbeat, shakiness, sweating, and loss of consciousness.

Additional information : Carry an identification card at all times that says you are taking this medicine. Proper diet, regular exercise, and regular testing of blood sugar are important for best results when using this medicine. This medicine is not a substitute for them. Be sure to follow the diet plan provided by your doctor. It is recommended that you attend a diabetes education program to better understand diabetes, prevention of complications, and all the important aspects of its treatment. These include meals/diet, exercise, weight loss, personal hygiene, medicines and blood glucose monitoring, and the need for regular eye, foot, and medical exams. Follow your doctor's instructions carefully. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children and pets. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.