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|Glucovance

Glucovance

Glucovance is used for:

Treating patients with type 2 diabetes who cannot control blood sugar levels by diet and exercise alone. It may be used alone or with other antidiabetic medicines.

Glucovance is a sulfonylurea (glyburide) and biguanide (metformin) antidiabetic combination. The glyburide works by stimulating the release of insulin from the pancreas gland and lowering blood glucose (sugar). It may also help lower blood glucose by other actions on fat and muscle cells. The metformin works by lowering blood glucose (sugar) by reducing the amount of sugar produced by the liver and the amount of sugar absorbed by the intestines; it also allows your body to use natural insulin more effectively. This combination medicine does not work in type 1 (insulin-dependent) diabetes mellitus because in this condition the pancreas gland is not capable of making or releasing insulin.

Do NOT use Glucovance if:

• you are allergic to any ingredient in Glucovance
• you are pregnant and within 2 weeks of your expected delivery date
• you have type 1 diabetes, increased ketone levels, severely increased acid levels in your bodily fluids (acidosis), a history of diabetic coma, or severe second- or third-degree burns
• you have heart failure or kidney disease
• you will be undergoing radiological testing using iodine-containing radiopaque dyes or medicines (eg, agents used in x-rays and other procedures)
• you are currently taking bosentan or you drink alcohol excessively

Contact your doctor or health care provider right away if any of these apply to you.

Before using Glucovance :

Some medical conditions may interact with Glucovance . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glyburide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide
• if you have blockage of the intestine or partial paralysis of the stomach, diarrhea, or vomiting; heart, lung, or liver problems; high fever; severe infection; or thyroid or other hormonal problems (eg, adrenal/pituitary insufficiency or excess, syndrome of inappropriate secretion of antidiuretic hormone [SIADH])
• if you have recently suffered severe burns, injury, or trauma; have undergone major surgery; or are malnourished, weak, or dehydrated
• if you have any surgery, x-ray, or scanning procedures scheduled
• if you consume alcoholic beverages

Some MEDICINES MAY INTERACT with Glucovance . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Bosentan because liver problems may occur; the effectiveness of both medicines also may be decreased
• Contrast dyes or medicines containing iodine (eg, agents used in x-rays and other procedures) because the risk of serious side effects, including sudden kidney failure and lactic acidosis, may be increased by Glucovance
• Birth control pills, certain asthma medicines (eg, albuterol), calcium channel blockers (eg, diltiazem), corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diet pills, diuretics (eg, furosemide, hydrochlorothiazide), epinephrine, estrogens, isoniazid, miconazole, niacin, phenothiazines (eg, promethazine), rifamycins (eg, rifampin), seizure medicines (eg, phenytoin), or thyroid supplements (eg, levothyroxine) because the effects of Glucovance may be decreased
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), azole antifungals (eg, ketoconazole), beta-blockers (eg, propranolol), chloramphenicol, cimetidine, clofibrate, fenfluramine and derivatives, fluoxetine, macrolide antibiotics (eg, erythromycin), maprotiline, monoamine oxidase (MAO) inhibitors (eg, phenelzine), nonsteroidal anti-inflammatory medicines (eg, ibuprofen), phenylbutazone, probenecid, quinidine, quinolone antibiotics (eg, ciprofloxacin), ranitidine, salicylates (eg, aspirin), and sulfonamides (eg, sulfamethoxazole) because side effects such as low blood sugar levels may be increased
• Blood thinners (eg, warfarin) because side effects, including risk of bleeding, may be increased by Glucovance
• Cyclosporine because side effects such as kidney harm may occur
• Gemfibrozil because side effects such as increased or decreased blood sugar levels may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Glucovance may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Glucovance :

Use Glucovance as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Glucovance by mouth with meals to decrease the risk of low blood sugar and to reduce stomach irritation.
• Drinking extra fluids while you are taking Glucovance is recommended. Check with your doctor for instructions.
• Glucovance comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Glucovance refilled.
• Avoid excessive dietary fiber while taking Glucovance unless otherwise instructed by your health care provider
• Take Glucovance on a regular schedule to get the most benefit from it.
• Taking Glucovance at the same time each day will help you remember to take it.
• Continue to take Glucovance even if you feel well. Do not miss any doses.
• If you miss a dose of Glucovance , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Glucovance .

Important safety information:

• Glucovance may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Glucovance with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol while you are using Glucovance . It can increase the risk of developing abnormally low blood sugar. Alcohol can sometimes interact with Glucovance and cause a serious reactions with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain.
• Glucovance may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Glucovance . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• Follow the diet and exercise program given to you by your health care provider.
• Diabetes patients-Carry an ID card at all times that says you have diabetes. Check your blood sugar levels as directed by your doctor. If they are often higher than they should be and you take Glucovance exactly as prescribed, tell your doctor.
• Diabetes patients-Glucovance may cause low blood sugar (eg, increased heartbeat, headache, chills, sweating, tremor, increased hunger, changes in vision, nervousness, weakness, dizziness, drowsiness, fainting). It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you do not have a reliable source of glucose available, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or nondiet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction. To prevent low blood sugar, eat meals on a regular schedule and do not skip meals.
• Glucovance is a sulfonylurea. It may increase the risk of death from heart disease. Talk with your doctor about the benefits and risks of this or other therapies to treat your condition.
• Check blood sugar levels daily. Contact your health care provider if symptoms of low blood sugar levels (eg, tiredness, nausea, confusion, agitation, excessive hunger, profuse sweating, numbness or tingling of lips, yawning, tremor, convulsions, coma) occur.
• During times of stress, such as fever, infection, injury, or surgery, it may be more difficult to control your blood sugar. Consult your doctor as a change in your medicine may be needed.
• Tell your doctor or dentist that you take Glucovance before you receive any medical or dental care, emergency care, or surgery.
• If you are scheduled to have any x-ray or scanning procedure that requires the use of a contrast dye or medicine containing iodine, tell your doctor that you are taking Glucovance . You will need to temporarily stop taking Glucovance around the time of your procedure.
• It is recommended that you attend a diabetes education program to better understand diabetes, prevention of complications, and all the important aspects of its treatment. These include meals/diet, exercise, weight loss, personal hygiene, medicines, and blood glucose monitoring, and the need for regular eye, foot, and medical exams. Follow your doctor"s instructions carefully.
• Lab tests, including liver function tests, kidney function tests, fasting blood glucose, glycosylated hemoglobin (hemoglobin A_1c), and complete blood counts, may be performed while you use Glucovance . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Glucovance with caution in the ELDERLY; they may be more sensitive to its effects, especially abnormally low blood sugar levels and risk of lactic acidosis.
• Glucovance should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Glucovance while you are pregnant. If Glucovance is taken during pregnancy, it should be stopped at least 2 weeks before the expected delivery date to minimize the risk of severe low blood sugar in the newborn infant. It is not known if Glucovance is found in breast milk. Do not breast-feed while taking Glucovance .

Possible side effects of Glucovance :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; nausea; stomach pain; upper respiratory tract infection; vomiting; weight gain.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); dark urine; easy bleeding or bruising; high blood sugar (thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, fruity breath odor); lactic acidosis (difficulty breathing; pounding in the chest; shock; general body discomfort; increased drowsiness; persistent upset stomach; feeling cold; dizziness; lightheadedness; slowed heartbeat); mental/mood changes; persistent sore throat or fever; recurrent stomach problems; seizures; severe stomach pain; swelling of the hands or feet; unusual or sudden weight gain; unusual tiredness or weakness; yellowing of eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include coma; confusion; lethargy and impaired consciousness; lightheadedness; loss of consciousness; mild stomach pain; nausea; rapid pulse; seizures (convulsions); sweating; tingling of the lips and tongue; tremor; vomiting.

Store Glucovance at 77 degrees F (25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Glucovance out of the reach of children and away from pets.

General information:

• If you have any questions about Glucovance , please talk with your doctor, pharmacist, or other health care provider.
• Glucovance is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Glucovance . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.