What is this medicine?

It is a combination medicine for Type 2 Diabetes.
It contains two drugs:

1. Glimepiride (0.5 mg) – helps the pancreas release more insulin.
2. Metformin (500 mg) – reduces the amount of sugar made by the liver and helps the body use insulin better.

This combination helps control blood sugar throughout the day.

How does it work?

1. Glimepiride

• Makes the pancreas release more insulin.
• Helps lower blood sugar especially after meals.

2. Metformin

• Reduces sugar production in the liver.
• Improves insulin sensitivity.
• Slows absorption of sugar from food.
• Helps control blood sugar throughout the day.

When these two medicines work together, they give better sugar control than using one alone.

Why do doctors prescribe it?

Doctors use this combination when:

• Metformin alone is not enough.
• Blood sugar is still high (fasting or after meals).
• You need stable sugar control all day.
• To reduce long-term diabetes complications (heart, kidney, nerve issues).

How to take it

• Take once or twice daily, with food (usually breakfast and/or dinner).
• Swallow whole with water.
• Try to take it at the same time every day.

Important:
Do not skip meals because 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, headache, dizziness, fast heartbeat
• Mild weight gain

From Metformin

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

These usually improve after a few days.

Serious but rare side effects

• Very low blood sugar
  (especially if meal is skipped)
• Lactic acidosis (rare, but serious side effect of Metformin)
  Symptoms: severe weakness, fast breathing, muscle pain
  → Get immediate medical help.
• Allergic reaction (rash, swelling, breathing trouble)

Who should avoid it or use with caution

• People with severe kidney problems
• Liver disease
• Heavy alcohol users
• People with heart failure
• Pregnant or breastfeeding women (use only if doctor says)
• People who get sick often with vomiting/diarrhea

What to monitor

• Daily blood sugar levels
• HbA1c every 3 months
• Kidney function tests
• Signs of low blood sugar

Important precautions

• Eat meals on time.
• Limit alcohol.
• Drink enough water.
• Tell your doctor before:
  • Surgery
  • CT scan with contrast dye
  • Any new illness (vomiting, dehydration)