Metglip DS 5/500

• Type 2 diabetes mellitus - as an adjunct to diet and exercise
• Initial therapy when hyperglycemia cannot be managed with diet and exercise alone
• Second-line therapy when sulfonylurea or metformin does not result in adequate control

Metformin is a biguanide antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Its pharmacological mechanisms of action are different from other classes of oral antihyperglycemic agents. Glipizide is a sulfonylurea which appears to lower blood glucose by stimulating the release of insulin from the pancreas, an effect dependent upon functioning beta cells in the pancreatic islets.

Initial Therapy:

• Start: 2.5 mg/250 mg (glipizide/metformin) once daily with food
• If FPG 280-320 mg/dL: 2.5/500 mg twice daily
• Maximum: Glipizide 10 mg and metformin 2,000 mg daily

Second-Line Therapy:

• Start: 2.5/500 mg or 5/500 mg twice daily with food
• Maximum: Glipizide 20 mg and metformin 2,000 mg daily

* Use as directed by the registered physician

Common Side Effects:

• Hypoglycemia (low blood sugar)
• Taste change
• Nausea
• Stomach pain
• Diarrhea
• Headache
• Upper respiratory tract infection

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

Precautions:

• Hypoglycemia may occur when used with other antidiabetic medicines, alcohol or if you delay or miss a meal.
• Avoid alcohol (increases hypoglycemia risk).
• Inform doctor if you experience deep or rapid breathing, persistent nausea, vomiting, or stomach pain (signs of lactic acidosis).
• Regular kidney and liver function tests recommended.

Overdose: Hypoglycemia from glipizide. Lactic acidosis from metformin. Gastric lavage, activated charcoal and supportive care. Hemodialysis is effective.

Storage: Keep below 30°C, away from light and moisture. Keep out of reach of children.