What is this medicine?

This is a combination tablet used to control Type 2 Diabetes.
It contains two medicines:

1. Glimepiride (1 mg) – helps the pancreas release more insulin.
2. Metformin (1000 mg) – reduces sugar made by the liver and helps the body use insulin better.

This combination helps keep blood sugar under control throughout the day.

How does it work?

1. Glimepiride

• Helps your pancreas release more insulin.
• Mainly lowers blood sugar after meals.
• Works quickly.

2. Metformin

• Reduces the liver’s sugar production.
• Helps your body respond better to insulin.
• Slows sugar absorption from food.
• Does not cause weight gain.

Together, they improve blood sugar control better than taking only one medicine.

Why do doctors prescribe it?

Doctors use this combination when:

• Metformin alone is not enough.
• You need stronger sugar control.
• Blood sugar is high in both fasting and post-meal readings.
• To reduce long-term diabetes complications (kidney, nerve, eye, and heart problems).

How to take it

• Usually once or twice daily, with meals.
• Most commonly taken with breakfast or dinner.
• Swallow the tablet whole with water.

Important:
Do NOT skip meals.
Glimepiride can cause low blood sugar if you take the tablet but do not eat.

Common side effects

From Glimepiride

• Low blood sugar (hypoglycemia)
  Symptoms:
  • Sweating
  • Shaking
  • Hunger
  • Dizziness
  • Fast heartbeat
  • Weakness
• Mild weight gain

From Metformin

• Stomach upset
  (gas, nausea, loose stools, stomach pain)
• Metallic taste

Most side effects improve after a few days.

Serious but rare side effects

• Very low blood sugar (more likely with 1 mg dose if meals skipped)
• Lactic acidosis (rare but serious with Metformin)
  Symptoms: severe weakness, breathing fast, muscle pain, feeling very tired
  → Seek urgent medical care.
• Allergic reaction (rash, swelling, difficulty breathing)

Who should avoid it

• Severe kidney problem patients
• Severe liver disease
• Heavy alcohol users
• Pregnant or breastfeeding women (only if doctor recommends)
• People with frequent vomiting/dehydration
• Those undergoing CT scan with dye (temporary stop of medicine may be needed)

What to monitor

• Fasting blood sugar
• Post-meal sugar
• HbA1c every 3 months
• Kidney function tests
• Signs of low blood sugar

Important precautions

• Eat meals on time.
• Avoid excessive alcohol.
• Drink enough water.
• Tell your doctor if you are unwell, vomiting, or dehydrated.
• Do not stop the medicine without your doctor’s advice.