Metglip DS (500mg+5mg) Tablet

Uses of Metglip DS

Type 2 Diabetes Mellitus

How does Metglip DS work?

Metglip DS works by the combined action of Glipizide and Metformin. Metformin works by decreasing the amount of glucose absorbed from the intestine, lowering the amount of sugar created by the liver, and facilitating the entry of sugar into the cells. Glipizide works by stimulating the release of insulin from your pancreas, thus reducing blood sugar.

Side Effects of Metglip DS

Common side effects of Glipizide and Metformin may include hypoglycemia, diarrhea, nausea/vomiting, abdominal pain, headache, and musculoskeletal pain.

Quick Suggestions:

• Monitor Blood Sugar: Regularly monitor your blood sugar levels while taking this medication to ensure it is effectively controlling your diabetes.
• Risk of Hypoglycemia: Be aware that Glipizide + Metformin can lower your blood sugar levels. This risk is increased when it is used in combination with other antidiabetic medications, alcohol consumption, or if you delay or miss a meal. Be cautious to avoid hypoglycemia.
• Surgery Under General Anesthetic: If you are scheduled to have surgery under general anesthesia, inform your doctor about your diabetes treatment. They may need to adjust your medication regimen.
• Lactic Acidosis: This medication may rarely cause a serious condition called lactic acidosis, characterized by symptoms such as deep or rapid breathing, persistent nausea, vomiting, and stomach pain. If you experience these symptoms, contact your doctor immediately.
• Liver Function Monitoring: Your doctor may periodically check your liver function while you are taking Glipizide + Metformin. Inform your doctor if you develop symptoms like abdominal pain, loss of appetite, or yellowing of the eyes or skin (jaundice).

Indications:

Glipizide & Metformin are prescribed to improve glycemic control in patients with type 2 diabetes who cannot effectively manage their hyperglycemia through diet and exercise alone. It is also used as a second-line therapy in individuals with type 2 diabetes when initial treatment with either a Sulfonylurea or Metformin, along with lifestyle modifications, does not achieve adequate glycemic control.

Pharmacology:

Metformin: This biguanide antihyperglycemic drug enhances glucose tolerance in type 2 diabetic patients by reducing both fasting and post-meal blood glucose levels. It improves insulin sensitivity by increasing peripheral glucose uptake and utilization, decreases glucose production in the liver, and reduces intestinal glucose absorption. Unlike sulfonylureas, Metformin does not cause hypoglycemia or excessive insulin secretion.

Glipizide: This sulfonylurea medication stimulates insulin production from the pancreas, primarily by enhancing the function of beta cells in the pancreatic islets. The mechanism of action of oral sulfonylureas may include extrapancreatic effects.

Dosage & Administration of Metglip DS

Glipizide & Metformin should be taken once or twice daily with meals and should be initiated at a low dose, followed by gradual dose escalation.

Initial Therapy: The recommended starting dose is 250 mg/2.5 mg once a day with a meal.

Second-Line Therapy: The recommended starting dose is 500 mg/2.5 mg or 500 mg/5 mg twice daily with morning and evening meals. The maximum daily dose recommended is 2000 mg Metformin/20 mg Glipizide.

Interaction

• Cimetidine can reduce Metformin clearance in the kidneys.
• Alcohol can amplify Metformin's antihyperglycemic and hyperlactatemic effects.
• Certain medications, including nonsteroidal anti-inflammatory drugs, certain azoles, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, and beta-adrenergic blocking agents, may potentiate the hypoglycemic action of sulfonylureas.

Contraindications

• Hypersensitivity to the medication.
• Renal impairment.
• Diabetic coma and ketoacidosis.
• Chronic renal disorders.
• Congestive heart failure.
• Trauma.
• Dehydration.
• Alcoholism.
• Pregnancy and breastfeeding, among other contraindications.

Pregnancy & Lactation

The use of angiotensin-II receptor antagonists during pregnancy should be avoided unless absolutely necessary. These medications have been associated with issues related to blood pressure management, renal function in newborns, skull abnormalities, and oligohydramnios. There is limited information on the use of angiotensin-II receptor antagonists during breastfeeding, and they are not recommended while nursing.

Precautions & Warnings

Metformin is primarily eliminated through the kidneys, and the risk of Metformin accumulation and lactic acidosis increases as renal function declines. Patients with serum creatinine levels above the upper limit of normal should not receive Metformin. Metformin dosing should be carefully adjusted in elderly individuals with advanced age-related renal function decline. Metformin therapy should be temporarily discontinued before surgery and should not be resumed until the patient's oral intake is restored, and normal renal function is confirmed.

Storage Conditions

Store at temperatures not exceeding 30°C (86°F) and keep out of reach of children.