Glutowin Forte Tablets (Glibenclamide + Metformin)

• Composition :
  Each tablet contains Glibenclamide 5 mg + Metformin 500 mg SR.
• Indications :
  Non-insulin dependent diabetes mellitus patients poorly controlled with sulphonyl urea or biguanides alone.
• Pharmacodynamics :
  Glibenclamide is a second generation sulphonylurea and it causes lowering of blood glucose by stimulating the release of insulin by the pancreas, this effect being dependent on the presence of functioning beta cells in the islets of Langerhans. Metformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
• Dosage and administration :
  One tablet once daily with meals or as recommended by the physician.
• Contraindications :
  Hypersensitivity to the active substances, to other sulphonylurea(s) and sulphonamide(s) or to any of the excipients. Acute conditions with the potential to alter renal function such as: dehydration, severe infection, shock. Diabetic ketoacidosis, with or without coma. This condition should be treated with insulin. Type I diabetes mellitus.
• Precautions and warnings :
  All sulfonylureas are capable of producing severe hypoglycaemia.Increased risk of cardiovascular mortality. Treatment of patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency with sulfonylurea agents can lead to haemolyticanaemia.
• Use in pregnancy, lactation & pediatrics :
  Pregnancy Category B. In nursing mother it is not known whether glibenclamide is excreted in human milk, some sulfonylurea drugs are known to be excreted in human milk. Safety and effectiveness in paediatric patients have not been established.
• Drug interactions :
  The hypoglycaemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents and other drugs that are highly protein bound, salicylates, sulphonamides, chloramphenicol, probenecid, coumarone, monoamine oxidase inhibitors, and beta adrenergic blocking agents.Certain drugs tend to produce hyperglycaemia and may lead to loss of control. These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, oestrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid.
• Adverse reactions :
  Hypoglycaemia, Cholestatic jaundice, hepatitis, nausea, epigastric fullness, heartburn, pruritus, erythema, urticaria, morbilliform or maculopapular eruptions, Leukopenia, agranulocytosis, thrombocytopenia, hemolyticanemia, hepatic porphyria and disulfiram-like reactions
• Therapy Area :
  Anti-Diabetic agents