Losucon M 2/500 SR Tablet

✔️ Uses of Losucon M 2/500 SR Table

Type 2 Diabetes Mellitus

✔️ How does Losucon M 2/500 SR Table work?

Losucon M 2/500 SR Tablet regulates blood glucose levels by combining the actions of its two components. Glimepiride stimulates insulin release from the pancreas, reducing blood glucose. Metformin decreases liver glucose production, delays absorption from the intestines, and enhances insulin sensitivity.

✔️ Side Effects of Losucon M 2/500 SR Tablet

Common:

• Taste disturbance
• Nausea
• Diarrhea
• Vomiting
• Stomach pain
• Loss of appetite

Rare:

• Low blood sugar levels (hypoglycemia)
• Signs of reduced red blood cells (pale skin, weakness, breathlessness), platelets (easy bleeding or bruising), or white blood cells (frequent infections)
• Decreased vitamin B12 levels
• Skin rashes, redness, itching, and hives

Stop taking Losucon M 2/500 SR Tablet and contact your doctor immediately if you experience the following side effects: 

• Lactic acidosis
• Liver inflammation leading to jaundice (yellowing of skin or eyes)
• Severe allergic reactions (such as skin rash, hives, increased sun sensitivity, blood vessel inflammation that could progress to breathing difficulties, blood pressure drop, and potentially shock)
• Severe low blood sugar levels, including loss of consciousness, seizures, or coma

✔️ Quick Suggestions:

• You have been prescribed this combination medicine as it can control blood sugar better than metformin alone.
• You should continue to exercise regularly, eat a healthy diet, and take your other diabetes medicines along with Glimepiride + Metformin.
• Take it with food to lower your chance of having an upset stomach.
• 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 Glimepiride + Metformin 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).

✔️ Indication of Losucon M 2/500 SR Tablet

Losucon M 2/500 SR Tablet is used to treat type 2 diabetes mellitus; when diet, exercise, and glimepiride or metformin alone are not able to control the blood sugar levels.

✔️ Pharmacology

Glimepiride's mode of action primarily involves increasing insulin release from pancreatic beta cells and enhancing insulin sensitivity in peripheral tissues, while Metformin Hydrochloride mainly works by reducing hepatic glucose production, lowering intestinal glucose absorption, and improving insulin sensitivity without causing hypoglycemia. This combination of actions helps to effectively lower blood glucose levels in individuals with type 2 diabetes. Well done!

✔️ Dosage & Administration of Losucon M 2/500 SR Tablet

For the treatment of type 2 diabetes mellitus, here are the dosage guidelines for Losucon M 2/500 SR Tablet:

Adult Dose:

• Oral Type 2 diabetes mellitus Adult: Each tablet contains glimepiride 1 mg or 2 mg and metformin sustained release 500 mg.
• The initial recommended dose is one tablet once daily.

Maximum Recommended Dose:

• The maximum recommended dose for glimepiride is 8 mg daily.
• The maximum recommended daily dose for metformin sustained release is 2000 mg in adults.

Dosage Individualization:

• Dosage should be individualized based on both effectiveness and tolerance.

Administration:

• Take Losucon M 2/500 SR Tablet as advised by your physician.
• Swallow Losucon M 2/500 SR Tablet with a glass of water.
• Do not crush or chew the medicine.

Medical Guidance:

• Your doctor will determine the correct dose and duration for you based on your age, body weight, and disease condition.
• Do not stop taking Losucon M 2/500 SR Tablet without informing your doctor.

Please note that following your healthcare provider's instructions and regular monitoring are crucial for managing your diabetes effectively. Always consult your doctor before making any changes to your medication regimen.

✔️ Interaction

In the case of Glimepiride:

• Glimepiride is metabolized by cytochrome P450 2C9 (CYP2C9). Be cautious when taking glimepiride with drugs that are inducers (e.g., rifampicin) or inhibitors (e.g., fluconazole) of CYP2C9.
• Potentiation of blood glucose-lowering effects and the risk of hypoglycemia may occur with certain medications like insulin, ACE inhibitors, anabolic steroids, chloramphenicol, coumarin derivatives, and more.
• Weakening of blood glucose-lowering effects and raised blood glucose levels may occur with medications such as acetazolamide, barbiturates, corticosteroids, diuretics, epinephrine, glucagon, and others.
• H2 receptor antagonists, beta-blockers, clonidine, and reserpine may either potentiate or weaken the blood glucose-lowering effect.
• Both acute and chronic alcohol intake may affect the blood glucose-lowering action of glimepiride unpredictably.
• The effects of coumarin derivatives may be potentiated or weakened.
• Colesevelam, a bile acid sequestrant, can reduce glimepiride absorption. Administer glimepiride at least 4 hours prior to colesevelam.

Regarding Metformin:

• Avoid alcohol consumption as it increases the risk of lactic acidosis, especially during fasting or hepatic insufficiency.
• Discontinue metformin before imaging procedures with iodinated contrast agents and restart only after 48 hours if renal function is stable.
• Be cautious when using medications that may affect renal function in combination with metformin, as they could increase the risk of lactic acidosis.
• Some medications like glucocorticoids, beta-2-agonists, and diuretics have intrinsic hyperglycemic activity and require more frequent blood glucose monitoring.
• ACE inhibitors may decrease blood glucose levels, and metformin may decrease the anticoagulant effect of phenprocoumon, so INR monitoring is recommended.
• Levothyroxine can reduce the hypoglycemic effect of metformin; monitor blood glucose levels and adjust metformin dosage as needed.
• Metformin is a substrate for organic cation transporters (OCT). Interaction with inhibitors or inducers of these transporters can affect metformin efficacy and plasma levels.

Note that careful consideration and medical supervision are crucial when combining medications to manage potential interactions and their effects. Always consult your healthcare provider before making any changes to your medication regimen.

✔️ Contraindications

For Glimepiride:

• Hypersensitivity to glimepiride, metformin, other sulfonylureas, other sulfonamides, or any excipients of Amaryl M.
• Pregnancy and breastfeeding.
• No experience with severe liver function impairment or dialysis patients; insulin is recommended for those with significant hepatic function impairment.

For Metformin:

• Hypersensitivity to metformin or its excipients.
• Any form of acute metabolic acidosis, including lactic acidosis, diabetic ketoacidosis, and diabetic pre-coma.
• Severe renal failure or dysfunction (e.g., specific creatinine levels and GFR criteria).
• Conditions that may alter renal function, such as dehydration, severe infection, or administration of iodinated contrast agents.
• Conditions causing tissue hypoxia, like cardiac or respiratory failure, recent myocardial infarction, and shock.
• Hepatic insufficiency.
• Acute alcohol intoxication and alcoholism.

✔️ Pregnancy & Lactation

Pregnancy:

For Glimepiride:

• Glimepiride is not recommended during pregnancy due to the potential risk of harm to the fetus.
• Pregnant patients are advised to switch to insulin for glycemic control.
• Patients planning to become pregnant should inform their doctor, and it is suggested they switch to insulin.

For Metformin:

• Metformin is not recommended for treating diabetes during pregnancy.
• Insulin is recommended to maintain normal blood glucose levels and reduce the risk of fetal malformations associated with abnormal blood glucose levels.

Lactation:

Glimepiride should not be used by breastfeeding mothers to avoid the potential transmission to the infant via breast milk.

If needed, patients should consider switching to insulin or discontinuing nursing.

Metformin's presence in human breast milk is uncertain, and a decision should be made considering the benefits of the medication for the mother against potential risks to the nursing infant.

✔️ Precautions & Warnings

For Glimepiride:

• During the initial weeks of treatment with Glimepiride, there is an increased risk of hypoglycemia (low blood sugar), which requires careful monitoring.
• Adjustments to the dosage of Glimepiride or the entire therapy might be necessary if risk factors for hypoglycemia are present, or if there are changes in the patient's lifestyle or during illness.
• Despite initial successful countermeasures, hypoglycemia can recur with Glimepiride and other sulfonylureas.
• Patients on Glimepiride should be closely observed and monitored, and severe hypoglycemia should be treated promptly and followed up by a physician, and in some cases, in-patient hospital care might be required.
• Patients with G6PD deficiency (a genetic condition) should exercise caution when using sulfonylurea agents like Glimepiride, as they can lead to hemolytic anemia. Non-sulfonylurea alternatives should be considered.

For Metformin:

• Patients on long-term metformin therapy should have their thyroid-stimulating hormone (TSH) levels checked regularly, especially if they have hypothyroidism.
• Long-term use of metformin has been associated with decreased levels of vitamin B12 in the blood, which can lead to peripheral neuropathy (nerve damage).
• Regular monitoring of vitamin B12 levels is advised for patients on metformin therapy to prevent or manage potential deficiency-related complications.

✔️ Storage Conditions

Store in a cool (nothing above 25°C) and dry location away from light.