What is this medicine?

This is a combination tablet for Type 2 Diabetes.
It contains two medicines:

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

This dose is considered stronger because the Glimepiride is at 2 mg.

How does it work?

1. Glimepiride

• Increases insulin release from the pancreas.
• Mainly controls blood sugar after meals.
• Works quickly to lower high sugar.

2. Metformin

• Reduces the amount of sugar your liver produces.
• Helps your cells use insulin better.
• Slows sugar absorption from food.
• Does not cause weight gain.

Together, they give better blood sugar control than each medicine alone.

Why do doctors prescribe it?

Doctors give this combination when:

• Blood sugar remains high with lower doses.
• Metformin alone is not enough.
• You need stronger control of both fasting and post-meal sugar.
• There is risk of long-term diabetes complications (kidney, nerves, heart).

This specific dose is often used if:

• You have moderate to high blood sugar levels.
• You need more insulin support (because Glimepiride is 2 mg).

How to take it

• Usually once or twice daily with food.
• Often taken with breakfast or breakfast + dinner.
• Swallow whole with water.

Very 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 (2 mg is a stronger dose)

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

From Metformin

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

These usually improve after a few days.

Serious but rare side effects

• Severe low blood sugar (more likely at 2 mg if meals are skipped)
• Lactic acidosis (rare but very serious, due to Metformin)
  Symptoms: fast breathing, severe tiredness, muscle pain → urgent medical help needed.
• Allergic reactions (rash, swelling)

Who should avoid it or use with caution

• People with severe kidney problems
• Liver disease
• Heavy alcohol drinkers
• Pregnant or breastfeeding women (only if doctor recommends)
• People who get dehydrated or vomit often
• During certain tests like CT scan with dye (temporary stop required)

What to monitor

• Fasting blood sugar
• Post-meal sugar
• HbA1c (every 3 months)
• Kidney function (once or twice a year)
• Signs of low blood sugar

Important precautions

• Eat meals on time. Never skip meals.
• Avoid too much alcohol.
• Drink enough water.
• Inform doctor before surgery or scan with contrast dye.
• Don’t suddenly stop the medicine without doctor advice.