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Tripride 1 Tablets (Glimepiride +Pioglitazone + Metformin)

  • Each uncoated bilayered tablet contains Glimepiride 1 mg + Pioglitazone 15 mg + Metformin 500 mg (in sustained-release form).
  • Indicated for treatment of type-2 diabetes mellitus (T2DM) when diet, exercise along with monotherapy and dual therapy does not achieve glycaemic target.
  • The primary mechanism of action of glimepiride in lowering blood glucose appears to be dependent on stimulating the release of insulin from functioning pancreatic beta cells. Pioglitazone selectively stimulates the nuclear receptor peroxisome proliferator activated receptor gamma (PPAR-γ) and to a lesser extent PPAR. It modulates the transcription of the insulin-sensitive genes involved in the control of glucose and lipid metabolism in the muscle, adipose tissue, and the liver. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.Sustained-release metformin improves GI tolerability, allows once-daily dosing.
  • The initial recommended dose is one tablet once daily orally or as recommended by physician.
  • Renal impairment. Metabolic acidosis, including diabetic ketoacidosis. In patients with known hypersensitivity to the drug.
  • The administration of oral hypoglycaemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. In view of close similarities between the oral hypoglycemic drugs, this warning also applies for glimepiride. It is recommended that patients treated with Tripride undergo periodic monitoring of liver enzymes.
  • Pregnancy Category B. Safety and effectiveness studies have not been conducted in nursing mothers. Paediatric Use: Safety and effectiveness in children younger than 18 years of age have not been established.
  • Miconazoleand Phenylbutazone: Increases hypoglycaemic effect of glimepiride. Interactions between thiazide diuretics and oral antidiabetic agents decreases insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Hence diabetic patients should be monitored closely. Careful patient monitoring and dose adjustment of metformin/cationic drug is recommended.
  • Nausea, diarrhoea, abdominal pain, constipation, vomiting, metallic taste in mouth have been reported with metformin therapy. Adverse events such as oedema, headache, upper respiratory tract infection, myalgia, sinusitis, and pharyngitis have been reported.
  • Anti-Diabetic agents