Gliclazide +Metformin

Indications & Dose:

Non-insulin dependent diabetes mellitus; diabetes with or without obesity in adults.

BY MOUTH 1-2 tablets once or twice daily with meals to a maximum of 4 tablets/day.

Contraindications:

Insulin-dependent diabetes mellitus, renal or hepatic failure, alcoholism, NIDDM complicated by  severe ketosis and acidosis, diabetic precoma and coma, patients undergoing surgery, after  severe trauma or during infections, chronic obstructive pulmonary disease, coronary heart disease, cardiac failure, peripheral vascular disease,pregnancy, known hypersensitivity to any of the ingredients. 

Side Effects:

Cautions:

Precautions:

Adjust dose of combination according to blood and urinary glucose levels during the first few months. However, there have been few reports of lactic acidosis in patients of renal or liver disease. Usage in pregnancy Contraindicated. Pediatric use Safety and effectiveness in children have not been established. 

Interaction:

DRUG
Diuretics, barbiturates, phenytoin, rifampicin, corticosteroids, estrogens, estroprogestogens and pure progestogens may reduce the glycaemic control. Its hypoglycaemic action may be potentiated by salicylates, phenylbutazone, sulphonamides, beta-blockers, clofibric acid, vitamin k antagonist, allopurinol, theophylline, caffeine and monoamine oxidase inhibitors. Concomitant administration of miconazole, perhexiline or cimetidine with gliclazide may result in hypoglycaemia. Concomitant administration of gliclazide with agents that increase blood glucose levels should not be considered without careful monitoring of blood glucose levels to avoid hyperglycaemia. Acarbose and guar gum has been shown to decrease the oral bioavailability of  metformin significantly. 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Gastrointestinal disturbances - Nausea, diarrhoea, gastric pain, constipation, vomiting, metallic taste in mouth. Dermatological effects - Rash, pruritus, urticaria, erythema and flushing. Miscellaneous - Headache and dizziness. 

Patient And Carer Advice: