Sugana 2/4

• Type 2 diabetes mellitus

Glimepiride: Initial effect to increase insulin secretion from beta cells; may also decrease rate of hepatic glucose production and increase insulin receptor sensitivity. Rosiglitazone: Lowers glucose by improving target cell response to insulin without increasing pancreatic cell secretion; activates nuclear peroxisome proliferator-activated receptor gamma, which influences the production of gene products involved in glucose and lipid metabolism.

Adult Dose:

• Starting Dose: 1 tab (4mg/1mg) once daily with first meal of day
• Glimepiride component increased not to exceed 2 mg every 1-2 weeks
• Not to exceed 8 mg rosiglitazone/4 mg glimepiride

Elderly: 1 tab (4mg/1mg) once daily, titrate carefully

Hepatic Impairment: ALT >2.5x ULN: Do not administer

Renal Impairment: 1 tab (4mg/1mg) once daily, titrate carefully

* Use as directed by the registered physician

Common Side Effects:

• Hypoglycemia (low blood sugar)
• Nausea
• Taste change
• Diarrhea
• Stomach pain
• Headache
• Edema (swelling)
• Weight gain
• Blurred vision
• Bone fracture
• Respiratory tract infection

Use in Pregnancy: May be unsafe during pregnancy. Animal studies have shown harmful effects.

Precautions:

• Patients with established Class III or IV heart failure is contraindicated.
• Hypoglycemia may occur - always carry sugary food or fruit juice.
• Avoid alcohol (increases hypoglycemia risk).
• Risk of edema and heart failure - caution required.
• Regular liver function tests (ALT monitoring) required.

Overdose: Severe hypoglycemia with coma, seizure. Administer glucagon or IV glucose. Hypoglycemia may recur - continue monitoring.

Storage: Store in a cool and dry place. Protect from light and moisture. Keep out of reach of children.