Brand Name:

Gliformin^®

Dosage:

500/2.5 mg & 500/5 mg

Generic Name:

Metformin / Glibenclamide

Pharmacotherapeutic Group:

Antidiabetic Agent

Therapeutic Indication:

Metformin / Glibenclamide: Gliformin is indicated in patients with type 2 diabetes to control hyperglycemia that cannot be controlled by diet management, exercise, or weight reduction. (Noninsulin dependent, NIDDM)

Dosage and Administration:

No prior treatment with sulfonylurea or metformin:

Initial: 1.25 mg/250 mg once daily with a meal; patients with Hb A1c >9% or fasting plasma glucose (FPG) >200 mg/dL may start with 1.25 mg/250 mg twice daily with meals.
Adjustment: Dosage may be increased in increments of 1.25 mg/250 mg, at intervals of not less than 2 weeks; maximum daily dose: 10 mg/2000 mg (limited experience with higher doses); Note: Doses of 5 mg /500 mg should not be used as initial therapy, due to risk of hypoglycemia.

Previously treated with a sulfonylurea or metformin alone:

Initial: 2.5 mg/500 mg or 5 mg/500 mg twice daily with meals; increase in increments no greater than 5 mg/500 mg; maximum daily dose: 20 mg/2000 mg

Note:

When switching patients previously on a sulfonylurea and metformin together, do not exceed the daily dose of glibenclamide (or glibenclamide equivalent) or metformin. When adding thiazolidinedione, continue Gliformin at current dose and initiate thiazolidinedione at recommended starting dose. 

Side Effects:

• Central nervous system: Dizziness, headache
• Dermatologic: Angioedema, erythema, maculopapular eruptions, photosensitivity reaction
• Endocrine & metabolic: Disulfiram-like reaction, hypoglycemia, hyponatremia (SIADH reported with other sulfonylureas)
• Gastrointestinal: Diarrhea, nausea/vomiting, flatulence, abdominal discomfort
• Hematologic: Agranulocytosis, aplastic anemia, hemolytic anemia, leukopenia, pancytopenia, porphyria cutanea tarda, thrombocytopenia, decreased vitamin B12 levels.
• Hepatic: Cholestatic jaundice, hepatitis, transaminase increased
• Neuromuscular & skeletal: Arthralgia, myalgia, paresthe