Glimetes PLUS Uses

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Glimetes PLUS indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Type 2 diabetes mellitus when diet, exercise and the single agent (Glimetes PLUS) do not result in adequate glycaemic control.

Glimetes PLUS description

Each tablet contains Glimepiride (Glimetes PLUS) 2 mg and Metformin (Glimetes PLUS) HCl (in sustained-release form) 500 mg.

It also contains the following excipients: Hypromellose, sodium carboxymethyl cellulose, methacrylic acid copolymer dispersion, macrogol, povidone, magnesium stearate, purified water, sodium starch glycolate, lactose, titanium dioxide, microcrystalline cellulose, magnesium stearate and pregelatinized starch. Colors: Yellow ferric oxide and titanium dioxide.

Glimetes PLUS dosage

In principle, the dosage of Glimetes PLUS is governed by the desired blood glucose level. The starting dose of Glimetes PLUS is 1 tab once a day before or with breakfast or first main meal. The dosage of Glimetes PLUS must be the lowest which is sufficient to achieve the desired metabolic control.

During treatment with Glimetes PLUS, glucose levels in blood and urine must be measured regularly. In addition, it is recommended that regular determinations of the proportion of glycated haemoglobin be carried out.

Mistakes eg, forgetting to take a dose, must never be corrected by subsequently taking a larger dose.

Measures for dealing with such mistakes (in particular, forgetting a dose or skipping a meal) or situations where a dose cannot be taken at the prescribed time must be discussed and agreed between physician and patient beforehand.

As an improvement in control of diabetes is, in itself, associated with higher insulin sensitivity, Glimepiride (Glimetes PLUS) requirements may fall as treatment proceeds. To avoid hypoglycaemia, timely dose reduction or cessation of Glimetes PLUS therapy must therefore be considered.

The highest recommended dose per day should be Glimepiride (Glimetes PLUS) 8 mg and Metformin (Glimetes PLUS) 2000 mg.

Daily doses of Glimepiride (Glimetes PLUS) of >6 mg are more effective only in a minority of patients.

In order to avoid hypoglycaemia, the starting dose of Glimetes PLUS should not exceed the daily doses of Glimepiride (Glimetes PLUS) or Metformin (Glimetes PLUS) already being taken.

When switching from combination therapy of Glimepiride (Glimetes PLUS) plus Metformin (Glimetes PLUS) as separate tablets, Glimetes PLUS should be administered on the basis of dosage currently being taken.

Titration: The daily dose should be titrated in increments of 1 tab only, corresponding to the lowest strength (in case various strengths are available).

Duration of Treatment: Treatment with Glimetes PLUS is normally a long-term therapy.

Administration: Glimetes PLUS should be administered once per day during breakfast or at the first main meal. Due to the sustained-release formulation, Glimetes PLUS must be swallowed whole and not crushed or chewed.

Glimetes PLUS interactions

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Cimetidine: Metformin (Glimetes PLUS) interacts with cimetidine. Therefore, the dose of Metformin (Glimetes PLUS) should be reduced if cimetidine is co-prescribed.

Hyperglycemic Agents: Drugs with hyperglycemic potential (eg, thiazides, corticosteroids and others) may partly offset the antihyperglycemic action of Metformin (Glimetes PLUS), and in such cases, the glycemic control should be closely monitored.

Alcohol: Alcohol potentiates the action of Metformin (Glimetes PLUS) on lactate metabolism as well as the antihyperglycemic effect. Hence, patients treated with Metformin (Glimetes PLUS) should preferably avoid alcohol and alcoholism is a definite contraindication.

Other Interactions: Studies with furosemide and nifedipine suggest a possible interaction by increasing plasma Metformin (Glimetes PLUS) levels. However, no such changes were found with propranolol and ibuprofen.

The absorption of Metformin (Glimetes PLUS) may be reduced by acarbose and guar gum. Hypoglycemia due to interaction with Glimepiride (Glimetes PLUS) may occur when one of the following medicines is taken eg, insulin and other oral antidiabetics, angiotensin-converting enzymes (ACE) inhibitors, allopurinol, anabolic steroids and male sex hormones, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine, fenyramidol, fibrates, fluoxetine, guanethidine, isofamide, monoamine oxidase (MAO) inhibitors, miconazole, para-aminosalicylic acid, pentoxifylline (high-dose parenteral), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, sulfonamides, tetracyclines, tritoqualine, trofosfamide. Hyperglycemia due to interaction with Glimepiride (Glimetes PLUS) may occur when one of the following medicines is taken eg, acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine (adrenaline) and other sympathomimetic agents, glucagons, laxatives (after protracted use), nicotinic acid (in high doses), estrogens and progestogens, phenothiazines, phenytoin, rifampicin, thyroid hormones. H2-receptor antagonists, clonidine and reserpine may lead to either potentiation or weakening of the blood sugar-lowering effect. Beta-blockers may increase the tendency to hypoglycemia.

The effect of coumarin derivatives may be potentiated or weakened.

Glimetes PLUS side effects

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Metformin (Glimetes PLUS) may provoke or augment lactic acidosis particularly if it is present in high concentrations in the blood. Some of the symptoms of lactic acidosis may mimic certain adverse effects of Metformin (Glimetes PLUS).

Physicians should instruct their patients to recognize the onset of symptoms of lactic acidosis to avoid this adverse reaction.

There is a great potential risk for hypoglycemia to occur due to the sulfonylurea component of Glimetes PLUS.

Possible symptoms include headache, ravenous hunger, nausea, vomiting, lassitude, sleepiness, disordered sleep, restlessness, aggressiveness, impaired concentration, impaired alertness and reactions, depression, confusion, speech disorders, aphasia, visual disorders, tremor, pareses, sensory disturbances, dizziness, helplessness, loss of self-control, delirium, cerebral convulsions, somnolence, and loss of consciousness up to and including coma, shallow respiration and bradycardia.

Reported Adverse Events to Metformin (Glimetes PLUS) are as Follows: Gastrointestinal: Adverse effects appear to be dose-related and include diarrhea, nausea, vomiting, abdominal discomfort (eg, abdominal cramps or pain), abnormal stools, constipation, abdominal distention, dyspepsia, epigastric discomfort, flatulence, viral gastroenteritis, taste disturbance specifically metallic taste in the mouth, toothache, tooth abscess. Most of these reactions are transient and can be controlled by taking Metformin (Glimetes PLUS) with meals or by a temporary reduction in dosage.

Body as a Whole: Chills, flu syndrome, fatigue, lethargy, asthenia, accidental injury, headache, infection

Cardiovascular: Chest discomfort/pain, hypertension, palpitations

Hematologic: Vitamin B12 and folate malabsorption, thrombocytopenia, neutropenia and rare reports of megaloblastic anemia

Hepatic: Severe acute hepatitis associated with liver function tests abnormalities and cholestasis have been associated with long-term Metformin (Glimetes PLUS) therapy resolving upon discontinuation of Metformin (Glimetes PLUS).

Endocrine Effects: Hypoglycemia may occur when Metformin (Glimetes PLUS) is given concomitantly with sulfonylureas and/or alcohol; hyperglycemia (NOS) and sexual dysfunction.

Musculoskeletal: Asthenia, muscle cramp, muscle strain, myalgia, pain in limb.

Nervous System: Agitation, dizziness, migraine, paresthesia, syncope, sinus headache, hypoesthesia, lightheadedness, tremor.

Respiratory: Dyspnea, flu syndrome, nasal congestion, sinus congestion, rhinorrhea, rhinitis, tonsillitis, upper respiratory infection.

Skin and Appendages: Rash, erythema, pruritus, urticaria, increased sweating, contusion.

Others: Pneumonitis with vasculitis, aggravated edema, peripheral edema, ear pain, blurred vision, fungal infection, flushing, nail disorder and seasonal allergy.

The profile of adverse reactions in pediatric patients is similar to those observed in adults.

Laboratory Findings: Decreased blood glucose, abnormal liver function tests and increased white blood cell count.

Reported Adverse Events to Glimepiride (Glimetes PLUS) are as Follows: Metabolic-Nutritional: Hypoglycemia, hyperglycemia, hyponatremia, increased appetite, dyspepsia, anorexia.

Gastrointestinal (GI): Diarrhea, nausea, vomiting, abdominal discomfort, abdominal distention, sensation of fullness.

Cardiovascular: Hypertension, tachycardia, bradycardia, palpitations, angina pectoris, cardiac arrhythmias, vasodilation.

Hematologic: Hemolytic and aplastic anemia, leukopenia, agranulocytosis, thrombocytopenia, thrombocytopenic purpura, pancytopenia due to myelosuppression, eosinophilia, erythrocytopenia, granulocytopenia.

Central Nervous System: Disulfiram-like reactions, headache, dizziness, lassitude, sleepiness, disordered sleep, restlessness, aggressiveness, impaired concentration, alertness and reaction time, depression, confusion, aphasia, tremor, paresis, sensory disturbance, helplessness, loss of self-control, delirium, cerebral convulsions, somnolence and loss of consciousness up to and including coma.

Hepatobiliary: Cholestasis, jaundice, abnormal liver function, hepatitis which may lead to liver failure or hepatic dysfunction, hepatic porphyria reactions, increased liver enzyme levels, granulomatous hepatitis, bilirubinemia.

Skin and Subcutaneous Tissue Disorders: Allergic or pseudo-allergic skin reactions (eg, pruritus, erythema, urticaria, vasculitis, and morbilliform or maculopapular eruptions). Such mild reactions may develop into serious reactions with dyspnea and hypotension, sometimes progressing to shock. These may be transient and may disappear despite continued use of Glimepiride (Glimetes PLUS). If skin reactions persist, the drug should be discontinued. Porphyria cutanea tarda, photosensitivity reactions and clammy skin were also observed.

Miscellaneous: Asthenia, allergic vasculitis, sweating, impaired speech disorder, visual disturbance/abnormal vision, dyspnea, increased urinary frequency.

Glimetes PLUS contraindications

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Patients hypersensitive to Glimepiride (Glimetes PLUS), Metformin (Glimetes PLUS), other sulfonylureas, other sulfonamides or any of the excipients of Glimetes PLUS.

Glimepiride (Glimetes PLUS): No experience has been gained concerning the use of Glimepiride (Glimetes PLUS) in patients with severe impairment of liver function and in dialysis patients. In patients with severe impairment of hepatic function, changeover to insulin is indicated, not least to achieve optimal metabolic control.

Metformin (Glimetes PLUS): Diabetic ketoacidosis, diabetic pre-coma.

Renal failure or renal dysfunction (eg, serum creatinine levels >135 micromol/L in males and >110 micromol/L in females).

Acute conditions with the potential to alter renal function eg, dehydration, severe infection, shock, intravascular administration of iodinated contrast agents.

Acute or chronic disease which may cause tissue hypoxia eg, cardiac or respiratory failure, recent myocardial infarction, shock.

Hepatic insufficiency; acute alcohol intoxication, alcoholism.

Use in pregnancy & lactation: Glimepiride (Glimetes PLUS): Glimepiride (Glimetes PLUS) must not be taken during pregnancy. Otherwise, there is risk of harm to the child. The patient must changeover to insulin during pregnancy.

Patients planning a pregnancy must inform their physician. It is recommended that such patients changeover to insulin.

To prevent possible ingestion with the breast milk and possible harm to the child, Glimepiride (Glimetes PLUS) must not be taken by breastfeeding women. If necessary, the patient must changeover to insulin or must stop breastfeeding.

Metformin (Glimetes PLUS): To date, no relevant epidemiological data are available. Animal studies do not indicate harmful effects with respect to pregnancy, embryonal or fetal development, parturition or postnatal development.

When the patient plans to become pregnant and during pregnancy, diabetes should not be treated with Metformin (Glimetes PLUS) but insulin should be used to maintain blood glucose levels as close to normal as possible in order to lower the risk of fetal malformations associated with abnormal blood glucose levels.

Metformin (Glimetes PLUS) is excreted into milk in lactating rats. Similar data are not available in humans and a decision should be made whether to discontinue nursing or to discontinue Metformin (Glimetes PLUS), taking into account the importance of the compound to the mother.



Active ingredient matches for Glimetes PLUS:

Glimepiride/Metformin


Unit description / dosage (Manufacturer)Price, USD
GLIMETES PLUS 1MG/500MG TABLET 1 strip / 10 tablets each (Mova Pharmaceutical Pvt Ltd)$ 0.64

List of Glimetes PLUS substitutes (brand and generic names):

Tablet, Extended Release; Oral; Glimepiride 4 mg; Metformin Hydrochloride 850 mg
GLIMETONE M 1MG/500MG TABLET 1 strip / 10 tablets each (Maneesh Pharmaceuticals Ltd)$ 0.94
GLIMETONE M TABLET 1 strip / 10 tablets each (Maneesh Pharmaceuticals Ltd)$ 1.19
Glimetone M 1 mg/500 mg Tablet (Maneesh Pharmaceuticals Ltd)$ 0.09
Glimetone M Tablet (Maneesh Pharmaceuticals Ltd)$ 0.12
Glimetop M 1+500 Tablet (RPG Life Sciences Ltd)$ 0.06
Glimetop M 2+500 Tablet (RPG Life Sciences Ltd)$ 0.11
GLIMETOP M-1 TABLET 1 strip / 10 tablets each (RPG Life Sciences Ltd)$ 0.84
GLIMETOP M-2 TABLET 1 strip / 10 tablets each (RPG Life Sciences Ltd)$ 1.34
Glimetop-M Glimepiride 1mg, Metformin/ SR 500mg TAB / 10 (RPG LS)$ 0.63
Glimetop-M Glimepiride 2mg, Metformin/ SR 500mg TAB / 10 (RPG LS)$ 1.11
10's (RPG LS)$ 1.11
GLIMETOP-M tab 10's (RPG LS)$ 1.11
Glimetop-MP Glimepiride 1 mg, Metformin/ SR 500 mg, Pioglitazone 15mg. TAB / 10 (RPG LS)$ 0.95
Glimetop-MP Glimepiride 2 mg, Metformin/ SR 500 mg, Pioglitazone 15mg. TAB / 10 (RPG LS)$ 1.19
10's (RPG LS)$ 1.19
GLIMETOP-MP tab 10's (RPG LS)$ 1.19
GLIMEX M 1MG/500MG TABLET 1 strip / 10 tablets each (Icon Life Sciences)$ 0.76
GLIMEX M 2MG TABLET 1 strip / 10 tablets each (Icon Life Sciences)$ 0.94
Glimex M 2 mg/500 mg Tablet (Icon Life Sciences)$ 0.09
Glimex-M Glimepiride 2mg, Metformin/ SR 500mg TAB / 10 (Elmex)$ 0.89
Glimex-M Glimepiride 1mg, Metformin/ SR 500mg TAB / 10 (Elmex)$ 0.57
GLIMEX-M tab 10's (Elmex)$ 0.89
GLIMFIRST M 1 FORTE TABLET 1 strip / 10 tablets each (Zyphar's Pharmaceuticals Pvt Ltd)$ 0.84
GLIMFIRST M -1 TABLET 1 strip / 10 tablets each (Zyphar's Pharmaceuticals Pvt Ltd)$ 0.87
GLIMFIRST M 2 FORTE TABLET 1 strip / 10 tablets each (Zyphar's Pharmaceuticals Pvt Ltd)$ 1.16
GLIMFIRST M -2 TABLET 1 strip / 10 tablets each (Zyphar's Pharmaceuticals Pvt Ltd)$ 1.19
Glimfirst M 1 Tablet (Sinsan Pharmaceuticals)$ 0.09
Glimfirst M 2 Forte Tablet (Sinsan Pharmaceuticals)$ 0.12
Glimfirst M 2 Tablet (Sinsan Pharmaceuticals)$ 0.13
GLIMGOLD MF 1 MG/500 MG TABLET 1 strip / 10 tablets each (Gold Line)$ 0.95
GLIMGOLD MF 2 MG/500 MG TABLET 1 strip / 10 tablets each (Gold Line)$ 1.11
Glimgold MF 2 mg/500 mg Tablet (Gold Line)$ 0.11
GLIMGOLD MF FORTE 1 MG/1000 MG TABLET SR 1 strip / 10 tablet srs each (Gold Line)$ 1.03
GLIMGOLD MF FORTE 2 MG/1000 MG TABLET SR 1 strip / 10 tablet srs each (Gold Line)$ 1.19
Glimgold MF Forte 2 mg/1000 mg Tablet SR (Gold Line)$ 0.12
Glimi DM Forte Glimepiride 2mg, Metformin/ ER 500mg TAB / 10 (Shrrishti Health Care Products Pvt Ltd)$ 0.79
10's (Shrrishti Health Care Products Pvt Ltd)$ 0.79
Glimi DM Forte 2+500 Tablet (Shrrishti Health Care Products Pvt Ltd)$ 0.08
GLIMI DM FORTE 2 MG/500 MG TABLET 1 strip / 10 tablets each (Shrrishti Health Care Products Pvt Ltd)$ 1.04

References

  1. DailyMed. "GLIMEPIRIDE; PIOGLITAZONE HYDROCHLORIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "metformin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. PubChem. "glimepiride". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).

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