Glyburide (GLYE-bure-ide), Metformin Hydrochloride (met-FOR-min hye-droe-KLOR-ide)
Used with diet and exercise to help control blood sugar in patients with type 2 diabetes.
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to glyburide or metformin, or if you have kidney disease or metabolic acidosis, including diabetic ketoacidosis (high ketones and acid in the blood). Do not use this medicine if you are also taking bosentan (Tracleer®).
How to Use This Medicine
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- It is best to take this medicine with food or milk.
- This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Many medicines can raise or lower your blood sugar. Tell your doctor about ALL other medicines you are using while taking glyburide/metformin. It is especially important to let your doctor know whenever you start or stop any other medicine.
- Make sure your doctor knows if you are also using a pain or arthritis medicine called an "NSAID" (such as aspirin, Aleve®, Feldene®, Indocin®, Orudis®, Relafen®, or Voltaren®), medicine to treat an infection (such as chloramphenicol, ciprofloxacin, clarithromycin, gatifloxacin, isoniazid, rifampin, sulfamethoxazole/trimethoprim, Bactrim®, Biaxin®, Chloromycetin®, Cipro®, Cotrim®, Rifadin®, Rimactane®, Septra®, or Tequin®), an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®), a blood pressure medicine (such as atenolol, metoprolol, propranolol, nifedipine, verapamil, Corgard®, Inderal®, Lotrel®, Norvasc®, or Toprol®), or a blood thinner (such as warfarin, Coumadin®).
- Tell your doctor if you are using a diuretic or "water pill" (such as hydrochlorothiazide or HCTZ), a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®), a phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®), or a thyroid medicine (such as levothyroxine, liothyronine, Cytomel®, or Synthroid®). Make sure your doctor knows if you are also using birth control pills, estrogens (Premarin®), cyclosporine (Gengraf®, Neoral®, or Sandimmune®), disopyramide (Norpace®), fluoxetine (Prozac®), nicotinic acid (Nicobid®, Nicolar®). oral miconazole, phenytoin (Dilantin®), or probenecid (Benemid®).
- Do not drink alcohol while you are using this medicine.
- Make sure your doctor knows about all other medicines you are using for diabetes, including insulin.
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, congestive heart failure, or adrenal or pituitary gland problems. Tell your doctor if you also have a condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency.
- This medicine may not work as well if you have surgery, get hurt, or get sick. If you have severe vomiting, diarrhea, or fever, call your doctor for instructions.
- You may need to stop using this medicine several days before having surgery or medical tests. This medicine may interact with the dye used for an X-ray or CT scan.
- Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear. They usually occur when other health problems not related to the medicine are present and very severe, such as a heart attack or kidney failure. The symptoms of lactic acidosis include abdominal or stomach discomfort; decreased appetite; diarrhea; fast, shallow breathing; a general feeling of discomfort; muscle pain or cramping; and unusual sleepiness, tiredness, or weakness. If you have any symptoms of lactic acidosis, get emergency medical help right away.
- You may develop low blood sugar while you are taking this medicine. You may feel weak, drowsy, confused, anxious, or very hungry. You may have trouble seeing or have a headache that won't go away. Ask your doctor what you should do if this happens. Some things that can lead to low blood sugar are exercising more than normal or waiting too long to eat.
- If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. If you have symptoms of low blood sugar (hypoglycemia), check your blood sugar. If your blood sugar is 70 mg/dL (milligrams per deciliter) or below, do one of the following: Drink 4 ounces (one-half cup) of fruit juice, or eat 5 to 6 pieces of hard candy, or take 2 to 3 glucose tablets. Recheck your blood sugar 15 minutes later. If your blood sugar goes above 70 mg/dL, eat a snack or a meal. If your blood sugar is still below 70 mg/dL, drink one-half cup juice, or eat 5 to 6 pieces of candy, or take 2 to 3 glucose tablets. Carry candy or some type of sugar with you at all times, especially if you are away from home. You can take this if you feel that your blood sugar is too low, even if you do not have a blood glucose meter. Always carefully follow your doctor's instructions about how to treat your low blood sugar. Learn what to do if your blood sugar gets too low. Teach friends, coworkers, and family members what they can do to help if you have low blood sugar.
- Tell your doctor if you start having trouble controlling your blood sugar after you use this medicine for awhile.
- Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
- Call your doctor if you have any unusual feeling of illness, even if you don't have specific symptoms.
- This medicine is only part of a complete program for controlling diabetes. You can also help yourself by eating a healthy diet, watching your weight, and getting regular exercise.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Extreme thirst, extreme change in urination, or hot, dry skin.
- Extreme weakness, tiredness, or confusion.
- Lightheadedness, dizziness, shakiness, or hunger.
- Severe nausea, vomiting, diarrhea, or stomach pain.
- Unusual tiredness or weakness, trouble breathing, muscle aches, or stomach discomfort.
If you notice these less serious side effects, talk with your doctor:
- Cough, hoarseness, sore throat, sneezing, or stuffy nose.
- Mild nausea, vomiting, diarrhea, or stomach pain or upset.
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Review Date: 2011-02-04