Ticozid Plus2.5mg+500mg

Glipizide + Metformin Hydrochloride belongs to a category of medicines known as anti-diabetic drugs. It is a combination of two medicines used to treat type 2 diabetes mellitus in adults. It helps control blood sugar levels in people with diabetes. Glipizide + Metformin Hydrochloride should be taken with food. Take it regularly at the same time each day to get the most benefit. Your doctor will decide what dose is best for you and this may change from time to time according to how it is working according to your blood sugar levels. Keep taking this medicine, even if you feel well or your blood sugar levels are controlled. If you stop it without consulting your doctor, your blood sugar levels could rise and put you at risk of kidney damage, blindness, nerve problems and loss of limbs. Remember that it is only part of a treatment program that should also include a healthy diet, regular exercise, and weight reduction as advised by your doctor. Your lifestyle plays a big part in controlling diabetes. The most common side effect of Glipizide + Metformin Hydrochloride is low blood glucose levels (hypoglycemia). Make sure you recognize the signs of having low blood glucose levels, such as sweating, dizziness, headache, and shaking and know how to deal with it. To prevent this, it's important to have regular meals and always carry a fast-acting source of glucose such as sugary food or fruit juice with you. Drinking alcohol can also increase your risk of low blood sugar levels and should be avoided. Other side effects that may be seen on taking this medicine include taste changes, nausea, diarrhea, stomach pain, headache, edema (swelling), blurred vision, bone fracture, and upper respiratory tract infection. Some people may find that they put on weight with this medicine. You should not take it if you have type 1 diabetes mellitus, if you have diabetic ketoacidosis (high levels of acid in your blood), or if you have severe kidney or liver disease. Before taking this medicine, tell your doctor if you have ever had heart disease. It may not be suitable. Pregnant or breastfeeding women should also consult their doctor before taking it. Your blood sugar levels should be checked regularly and your doctor may also advise blood tests to monitor your blood cell counts and liver function. Glipizide + Metformin Hydrochloride is a combination of two antidiabetic medicines: Glipizide and Metformin. Glipizide is a sulfonylurea which works by increasing the amount of insulin released by the pancreas in order to lower the blood glucose. Metformin is a biguanide which works by lowering glucose production in the liver, delaying glucose absorption from intestines and increasing the body's sensitivity to insulin.

• Type 2 diabetes mellitus

Glipizide stimulates insulin release from pancreatic beta-cells and reduces gluconeogenesis in liver cells. It also increases insulin sensitivity at target sites. Metformin decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilisation).

Adult Dose: Type 2 Diabetes Mellitus Initial treatment: start at 2.5 mg/250 mg (glipizide/metformin) PO qDay with food If fasting plasma glucose = 280-320 mg/dL: 2.5/500 mg PO q12hr May adjust daily dose in increments of 1 tab every 2 wk. Max: Glipizide 10 mg and metformin 2,000 mg daily. Type 2 DM Inadequately Controlled on Sulfonylurea &/or Metformin 2nd-line treatment: Start at 2.5/500 mg or 5/500 mg PO q12hr with food May adjust daily dose in increments of not more than 5 mg/500 mg. Max: Glipizide 20 mg and metformin 2,000 mg daily. Hepatic impairment: Contraindicated. Renal Dose: Renal impairment: Serum creatinine (SCr) >1.5 mg/dL (males) or >1.4 mg/dL (females) Obtain eGFR before starting metformin eGFR <30 mL/min/1.73 m²: Contraindicated eGFR 30-45 mL/min/1.73 m²: Not recommended to initiate treatment Monitor eGFR at least annually or more often for those at risk for renal impairment (eg, elderly) If eGFR falls below 45mL/min/1.73 m² while taking metformin, risks and benefits of continuing therapy should be evaluated If eGFR falls below 30 mL/min/1.73 m²: while taking metformin, discontinue the drug

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Glipizide + Metformin Hydrochloride is to be taken with food.

Common: • Hypoglycemia (low blood glucose level) • Taste change • Nausea • Stomach pain • Diarrhea • Headache • Upper respiratory tract infection

[CAUTION] Your ability to drive may be affected if your blood sugar is too low or too high. Do not drive if these symptoms occur. Monitor your blood sugar level regularly while you are taking this medicine. It can cause hypoglycemia (low blood sugar level) when used with other antidiabetic medicines, alcohol or if you delay or miss a meal. Inform your doctor about your diabetes treatment if you are due to have surgery under a general anesthetic. Tell your doctor immediately if you experience any deep or rapid breathing or if you have persistent nausea, vomiting, and stomach pain as Glipizide + Metformin Hydrochloride may cause a rare but serious condition called lactic acidosis, which is an excess of lactic acid in the blood. Your doctor may check your liver function regularly. Inform your doctor if you develop symptoms such as abdominal pain, loss of appetite, or yellowing of the eyes or skin (jaundice).

Hypersensitivity. Type 2 diabetes mellitus; ketoacidosis; severe renal or hepatic insufficiency, diabetic coma, cardiac failure, recent MI, CHF. IDDM; severe infection; acute or chronic metabolic acidosis with or without coma; stress, trauma; severe impairment of thyroid function; dehydration, acute or chronic alcoholism. Pregnancy, lactation.

Glipizide: Decreased effect with beta-blockers, cholestyramine, hydantoins, thiazide diuretics and urinary alkalinizers. Metformin: Additive effect with sulphonylureas. Antagonistic effects with diuretics, corticosteroids, phenothiazines, thyroid products, oestrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, Ca channel blockers and isoniazid. Potentially Fatal: Glipizide: Increased glipizide levels and effects with fluconazole, gemfibrozil, ketoconazole, NSAIDs, pioglitazone and sulfonamides. Increased hypoglycaemic effects with H2 antagonists, anticoagulants, androgens, cimetidine, salicylates, tricyclic antidepressants, probenecid, MAOIs, methyldopa, digitalis glycosides and urinary acidifiers. Metformin: Lactic acidosis with alcohol and potentiation of hypoglycaemic effect. Cimetidine and furosemide may increase plasma-metformin levels. Drugs eliminated via renal tubular secretion may increase metformin levels.

[UNSAFE] It is unsafe to consume alcohol with Glipizide + Metformin Hydrochloride.

[CONSULT YOUR DOCTOR] Glipizide + Metformin Hydrochloride may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Glipizide + Metformin Hydrochloride is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[CAUTION] Glipizide + Metformin Hydrochloride should be used with caution in patients with kidney disease. Dose adjustment of Glipizide + Metformin Hydrochloride may be needed. Please consult your doctor. Use of Glipizide + Metformin Hydrochloride is, however, not recommended in patients with severe kidney disease. Regular monitoring of kidney function test is advisable while you are taking this medicine. [CAUTION] Glipizide + Metformin Hydrochloride should be used with caution in patients with liver disease. Dose adjustment of Glipizide + Metformin Hydrochloride may be needed. Please consult your doctor. Glipizide + Metformin Hydrochloride is generally started with low dose in patients with mild to moderate liver disease and its use is not recommended in patients with severe liver disease.

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