Glimepiride (glye-MEP-ir-ide), Pioglitazone Hydrochloride
Used together with proper diet and exercise to help control blood sugar in adults 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 glimepiride (Amaryl®) or pioglitazone (Actos®). You should not use this medicine if you have type 1 diabetes, diabetic ketoacidosis (ketones in the blood), or severe heart failure.
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. Take this medicine with the first meal of the day.
- To best manage your diabetes, carefully follow your doctor's instructions about any special diet, exercise, or weight loss. Test your blood sugar regularly.
- Carefully follow your doctor's instructions about any special diet.
- This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.
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. Keep the medicine in its original container.
- 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.
- There are many other drugs that can interact with glimepiride or pioglitazone. Make sure your doctor knows about all other medicines you are using. These especially include other medicines to treat your diabetes (such as insulin), a blood pressure medicine (such as metoprolol, propranolol, Inderal®, Lopressor®, or Tenormin®), pain or arthritis medicines (such as aspirin, Advil®, or Celebrex®), isoniazid (Nydrazid®), nicotinic acid (Nicobid®, Nicolar®), cotrimoxazole (Bactrim®, Cotrim®, Septra®), or midazolam (Versed®).
- Make sure your doctor knows if you are using chloramphenicol (Chloromycetin®, Chloroptic®), phenytoin (Dilantin®), probenecid (Benemid®), a blood thinner (such as warfarin, Coumadin®), a steroid medicine (such as methylprednisolone, prednisone, or Medrol®), or a phenothiazine medicine (such as prochlorperazine, Compazine®, Phenergan®, or Thorazine®). Tell your doctor if you are also using gemfibrozil (Lopid®), miconazole (Lotrimin® AF, Monistat® 3), fluconazole (Diflucan®), rifampin (Rifadin®, Rimactane®), hormone replacement therapy, thyroid replacement therapy, diuretics or "water pills" (such as Dyazide® or Lasix®), birth control pills, or an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®).
- Do not drink alcohol while you are using this medicine.
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding. This medicine can increase your chance of getting pregnant, even if you have irregular periods. Talk to your doctor about effective birth control while you are using this medicine.
- Make sure your doctor knows if you have kidney problems, liver disease, heart or blood vessel disease, an adrenal or pituitary gland problem, or edema (problems with fluid retention and swelling). Tell your doctor if you have an eye disease such as macular edema (swelling of the back of the eye), fragile bones (especially women), or if you recently had a fever, infection, trauma, or surgery. Also, tell your doctor if you 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.
- 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.
- 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.
- If your symptoms do not improve or if they get worse, call your doctor.
- Check with your doctor if blurred vision, decreased vision, or any other change in vision occurs during your treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
- This medicine may increase the risk of bone fractures in women. Ask your doctor about ways to keep your bones strong to help prevent fractures.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
- This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
- 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.
- Blurred vision or other changes in vision.
- Burning or painful urination, change in how much or how often you urinate.
- Dark-colored urine or pale stools.
- Fever, chills, runny or stuffy nose, cough, sore throat, and body aches.
- Lightheadedness, dizziness, shakiness, or hunger.
- Nausea, vomiting, loss of appetite, or pain in your upper stomach.
- Pain or swelling in arms or legs without any injury.
- Rapid weight gain.
- Shortness of breath, cold sweats, and bluish-colored skin.
- Swelling in your hands, ankles, or feet.
- Unusual bleeding or bruising.
- Unusual tiredness or weakness.
- Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
- Diarrhea, mild nausea, or vomiting.
- Muscle pain.
- Problems with your teeth.
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