Glucovance is a prescription medicine used to treat the symptoms of Type 2 Diabetes Mellitus. Glucovance may be used alone or with other medications.
Glucovance belongs to a class of drugs called Antidiabetics, Sulfonylureas/Biguanides.
It is not known if Glucovance is safe and effective in children.
Glucovance
| Package | pill | Total price | Save | Order |
|---|---|---|---|---|
| 5/500mg × 60 Pills | $0.69 | $41.48 | - | Add to cart |
| 5/500mg × 120 Pills | $0.57 | $68.15 | $14.40 | Add to cart |
| 5/500mg × 240 Pills | $0.51 | $121.48 | $43.20 | Add to cart |
| 5/500mg × 300 Pills | $0.49 | $148.15 | $60.00 | Add to cart |
| Package | pill | Total price | Save | Order |
|---|---|---|---|---|
| 2.50/400mg × 60 Pills | $0.69 | $41.48 | - | Add to cart |
| Package | pill | Total price | Save | Order |
|---|---|---|---|---|
| 2.5/400mg × 120 Pills | $0.57 | $68.15 | - | Add to cart |
| 2.5/400mg × 240 Pills | $0.51 | $121.48 | $14.40 | Add to cart |
| 2.5/400mg × 300 Pills | $0.49 | $148.15 | $24.00 | Add to cart |
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Drug uses
GLUCOVANCE (Glyburide and Metformin HCl) Tablets is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Overdosage
Glyburide
Overdosage of sulfonylureas, including glyburide tablets, can produce hypoglycemia. Mild hypoglycemic symptoms, without loss of consciousness or neurological findings, should be treated aggressively with oral glucose and adjustments in drug dosage and/or meal patterns. Close monitoring should continue until the physician is assured that the patient is out of danger. Severe hypoglycemic reactions with coma, seizure, or other neurological impairment occur infrequently, but constitute medical emergencies requiring immediate hospitalization. If hypoglycemic coma is diagnosed or suspected, the patient should be given a rapid intravenous injection of concentrated (50%) glucose solution. This should be followed by a continuous infusion of a more dilute (10%) glucose solution at a rate that will maintain the blood glucose at a level above 100 mg/dL. Patients should be closely monitored for a minimum of 24 to 48 hours, since hypoglycemia may recur after apparent clinical recovery.
Metformin Hydrochloride
Overdose of metformin hydrochloride has occurred, including ingestion of amounts > 50 g. Hypoglycemia was reported in approximately 10% of cases, but no causal association with metformin hydrochloride has been established. Lactic acidosis has been reported in approximately 32% of metformin overdose cases. Metformin is dialyzable with a clearance of up to 170 mL/min under good hemodynamic conditions. Therefore, hemodialysis may be useful for removal of accumulated drug from patients in whom metformin overdosage is suspected.
Storage
Store at temperatures up to 25°C (77°F).
Dispense in light-resistant containers.
Safety information
Warnings
Metformin Hydrochloride
Lactic Acidosis
Lactic acidosis is a rare, but serious, metabolic complication that can occur due to metformin accumulation during treatment with GLUCOVANCE (Glyburide and Metformin HCl) Tablets; when it occurs, it is fatal in approximately 50% of cases. Lactic acidosis may also occur in association with a number of pathophysiologic conditions, including diabetes mellitus, and whenever there is significant tissue hypoperfusion and hypoxemia. Lactic acidosis is characterized by elevated blood lactate levels ( > 5 mmol/L), decreased blood pH, electrolyte disturbances with an increased anion gap, and an increased lactate/pyruvate ratio. When metformin is implicated as the cause of lactic acidosis, metformin plasma levels > 5 μg/mL are generally found.
The reported incidence of lactic acidosis in patients receiving metformin hydrochloride is very low (approximately 0.03 cases /1000 patient-years, with approximately 0.015 fatal cases /1000 patient-years ). In more than 20,000 patient-years exposure to metformin in clinical trials, there were no reports of lactic acidosis. Reported cases have occurred primarily in diabetic patients with significant renal insufficiency, including both intrinsic renal disease and renal hypoperfusion, often in the setting of multiple concomitant medical/surgical problems and multiple concomitant medications. Patients with congestive heart failure requiring pharmacologic management, in particular those with unstable or acute congestive heart failure who are at risk of hypoperfusion and hypoxemia, are at increased risk of lactic acidosis. The risk of lactic acidosis increases with the degree of renal dysfunction and the patient's age. The risk of lactic acidosis may, therefore, be significantly decreased by regular monitoring of renal function in patients taking metformin and by use of the minimum effective dose of metformin. In particular, treatment of the elderly should be accompanied by careful monitoring of renal function. GLUCOVANCE treatment should not be initiated in patients ≥ 80 years of age unless measurement of creatinine clearance demonstrates that renal function is not reduced, as these patients are more susceptible to developing lactic acidosis . In addition, GLUCOVANCE should be promptly withheld in the presence of any condition associated with hypoxemia, dehydration, or sepsis. Because impaired hepatic function may significantly limit the ability to clear lactate, GLUCOVANCE should generally be avoided in patients with clinical or laboratory evidence of hepatic disease. Patients should be cautioned against excessive alcohol intake, either acute or chronic, when taking GLUCOVANCE, since alcohol potentiates the effects of metformin hydrochloride on lactate metabolism. In addition, GLUCOVANCE should be temporarily discontinued prior to any intravascular radiocontrast study and for any surgical procedure.
The onset of lactic acidosis often is subtle, and accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, increasing somnolence, and nonspecific abdominal distress. There may be associated hypothermia, hypotension, and resistant bradyarrhythmias with more marked acidosis. The patient and the patient's physician must be aware of the possible importance of such symptoms and the patient should be instructed to notify the physician immediately if they occur. GLUCOVANCE should be withdrawn until the situation is clarified. Serum electrolytes, ketones, blood glucose, and if indicated, blood pH, lactate levels , and even blood metformin levels may be useful. Once a patient is stabilized on any dos e level of GLUCOVANCE, gastrointestinal symptoms , which are common during initiation of therapy with metformin, are unlikely to be drug related. Later occurrence of gastrointestinal symptoms could be due to lactic acidosis or other serious disease.
Levels of fasting venous plasma lactate above the upper limit of normal but less than 5 mmol/L in patients taking GLUCOVANCE do not necessarily indicate impending lactic acidosis and may be explainable by other mechanisms, such as poorly controlled diabetes or obesity, vigorous physical activity, or technical problems in s ample handling.
Lactic acidosis should be suspected in any diabetic patient with metabolic acidosis lacking evidence of ketoacidosis (ketonuria and ketonemia).
Lactic acidosis is a medical emergency that must be treated in a hospital setting. In a patient with lactic acidosis who is taking GLUCOVANCE, the drug should be discontinued immediately and general supportive measures promptly instituted. Because metformin hydrochloride is dialyzable (with a clearance of up to 170 mL/min under good hemodynamic conditions ), prompt hemodialysis is recommended to correct the acidosis and remove the accumulated metformin. Such management often results in prompt reversal of symptoms and recovery.
SPECIAL WARNING ON INCREASED RISK OF CARDIOVASCULAR MORTALITY
The administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. This warning is based on the study conducted by the University Group Diabetes Program (UGDP), a long-term prospective clinical trial designed to evaluate the effectiveness of glucoselowering drugs in preventing or delaying vascular complications in patients with non-insulindependent diabetes. The study involved 823 patients who were randomly assigned to 1 of 4 treatment groups (Diabetes 19 (Suppl. 2):747-830, 1970).
UGDP reported that patients treated for 5 to 8 years with diet plus a fixed dose of tolbutamide (1.5g per day) had a rate of cardiovascular mortality approximately 2½ times that of patients treated with diet alone. A significant increase in total mortality was not observed, but the use of tolbutamide was discontinued based on the increase in cardiovascular mortality, thus limiting the opportunity for the study to show an increase in overall mortality. Despite controversy regarding the interpretation of these results , the findings of the UGDP study provide an adequate bas is for this warning. The patient should be informed of the potential risks and benefits of glyburide and of alternative modes of therapy.
Although only 1 drug in the sulfonylurea class (tolbutamide) was included in this study, it is prudent from a safety standpoint to consider that this warning may also apply to other hypoglycemic drugs in this class, in view of their close similarities in mode of action and chemical structure.
Disclaimer
The information on this page is not intended to be a substitute for professional medical advice. Do not use this information to diagnose or treat your problem without consulting your doctor.
Side effects
Glucovance may cause serious side effects including:
- hives,
- difficulty breathing,
- swelling of your face, lips, tongue, or throat,
- swelling,
- rapid weight gain,
- shortness of breath,
- extreme weakness,
- blurred vision,
- sweating,
- trouble speaking,
- tremors,
- stomach pain,
- confusion,
- seizures,
- unusual muscle pain,
- trouble breathing,
- stomach pain,
- vomiting,
- irregular heart rate,
- dizziness,
- feeling cold,
- weakness, and
- tiredness
Get medical help right away, if you have any of the symptoms listed above.
The most common side effects of Glucovance include:
- low blood sugar,
- nausea,
- diarrhea,
- upset stomach, and
- headache
Tell the doctor if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of Glucovance. For more information, ask your doctor or pharmacist.
The antibiotic produced by Streptomyces lincolniensis, has a bacteriostatic effect. Suppresses protein synthesis of bacteria due to reversible binding to the 50S subunit of ribosomes, disrupts the formation of peptide bonds.
It is active against gram-positive cocci Streptococcus spp., including Streptococcus pneumoniae); Haemophilus influenzae; Bacillus anthracis, Mycoplasma spp., Bacteroides spp., Corynebacterium diphtheriae, Clostridium perfringens, Clostridium tetani.
Viagra Soft Flavored - chewing tablet viagra, which has a mint taste and differs from usual viagra by mode of administration and speed of effect. Unlike usual viagra - Viagra Soft Flavored should be resolved or chewed. So at administration of drug it is possible to take alcohol and greasy food that is not recommended at taking of any other type of viagra. The effect of Viagra Soft Flavored comes in 30 minutes after reception, and lasts for 4 hours.
Viagra Soft Tabs - chewable tablets, containing 100 mg of a sildenafil. Difference of Viagra Software from usual Viagra is that its action begins much quicker. Viagra Software is chewed and easily dissolved under the tongue that allows to receive the result in 10-15 minutes.
Duricef - bactericidal drug from cephalosporin antibiotic of the first level. It is prescribed perorally, works through disturbance of synthesis of a cell wall of gram-positive and gram-negative microorganisms.
FML (Fluorometholone) Forte is a topical drug that belongs to the corticosteroid group of medicines. Its aim is to cure various eye problems connected with injury and inflammation. It is effective in case of bulbar conjunctiva and palpebral conjunctiva. The suspension remedies eye swelling, itching, irritation, and redness. These eye drops are not recommended to people who wear contact lenses daily. If a patient must use the drops, it’s necessary to replace contact lenses with glasses or just not to wear them during the medication.
Aristocort - glucocorticoid drug (the adrenal hormone influencing carbohydrate and protein metabolism). Renders prominent antiinflammatory, antiallergic and immunodepressive (suppressing immunity - body defences of an organism) effect. It is prescribed at rheumatism, allergic reactions, multiform erythema (variously proceeding skin disease which occurs with rubefaction of affected area of skin), pseudorheumatism (the infectious and allergic disease from a group of collagenoses which is characterized by chronic progressing inflammation of joints); systemic lupus erythematosus and other collagenoses.
Antidepressant; a specific inhibitor of serotonin reuptake by neurons of the brain. Has no stimulating or sedative effect, does not affect choline, muscarin-, histamine- and adrenergic processes. The therapeutic effect develops 1-4 weeks after the initiation of therapy.
Tofranil is a drug that is very sensitive to the form of depressive disorder (glycoem depressive disorder, depressive phase of bipolar infections, depressive disorder, migraine, depression, dysthymia;
Endep - tricyclic antidepressant. The mechanism of antidepressive action is connected with increase in concentration of noradrenaline in synapses and/or serotonin in CNS (decrease in return absorption). Accumulation of these neurotransmitters results from inhibition of their return capture by membranes of presynaptic neurons.
An oral hypoglycemic means, which inhibiting the intestinal alpha-glycosidase, reduces the enzymatic conversion of di-, oligo - and polysaccharides to mono-saccharides, thereby reducing the absorption of glucose from the intestine and postprandial hyperglycemia. It is used to treat diabetes, of type 2 under the ineffective diet, the course of which shall not be less than 6 months, type 1diabetes within the combination therapy.
The antifungal agent which has activity against dermatophytes, yeasts, dimorphic fungi and eumycetes. It is also active against staphylococci and streptococci. The therapeutical indications of the drug include: mycoses of the gastrointestinal tract, eyes, genital organs, chronic recurrent vaginal candidiasis, dermatomycosis, onychomycosis, Candida, folliculitis, dermatophytosis, systemic fungal infections (blastomycosis, candidiasis, paracoccidioides, coccidioidomycosis, cryptococcosis, histoplasmosis, hromomikoz, sporotrichosis, paronychia, fungal sepsis, fungal pneumonia); leishmaniasis; tinea versicolor, prevention of fungal infections in patients with a high risk of their development. The mechanism of action is inhibition of fungal membrane ergosterol synthesis and the violation of the cell wall permeability.
Famvir - antiviral medicine which is taken for prevention and treatment of herpes at primary infection, post-herpetic neuralgia, recurrent genital herpes. Pro-medicine; represents a 6-deoxysidiacetil analog of active antiviral agent of a penciclovir.
Amoxil - is a semi-synthetic aminopenicillin antibiotic of broad spectrum effects for oral administration. Suppresses the synthesis of the cell wall of the following bacteria: Corynebacteriumdiphtheriae, Enterococcus faecalis, Listeria monocytogenes, Streptococcus agalactiae, Streptococcus bovis, Streptococcus pyogenes; Helicobacter pylori; Peptostreptococcus; Borrelia.
Cephalexin - antibacterial agents for systemic use. Cephalosporins of the first generation. Used in the treatment of infections caused by microorganisms susceptible to cefalexin: ENT organs and respiratory tract, genitourinary system, skin and soft tissues, bone tissue and joints.
Trimox has an active ingredient called amoxicillin. It is an antibiotic of penicillin, which fights bacteria. Trimox is used to treat many different types of infection caused by bacteria such as tonsillitis, bronchitis, pneumonia, gonorrhea and infections of the ear, nose, throat, skin or urinary tract. This remedy is sometimes used together with another antibiotic called clarithromycin (Biaxin) to treat stomach ulcers caused by Helicobacter pylori infection. This combination is sometimes used with a gastric acid reducer, called lansoprazole (Prevacid).
Sumycin - An antibiotic based on tetracycline, a brand of such pharmaceutical companies as Bristol-Myers Squibb, Apothecon, Par Pharmaceutical.
A thiazide diuretic of the average intensity, applied in arterial hypertension, edema syndrome of different origin, gestosis and diabetes insipidus. Reduces reabsorption of Na+ at the level of the Henle loop cortical segment, without affecting its segment lying in the medulla of the kidney that detects a weaker diuretic effect compared with furosemide.
Zetia contains ezetrol as an active ingredient, which is a selective representative of a new class of lipid-lowering drugs that reduce the absorption of cholesterol in the intestine, including cholesterol from plant fats.
Caverta - another affordable version of Indian Viagra created by Ranbaxy, released as Caverta 100mg and Caverta 50mg.
Blocks the final stage of HCl secretion, reducing basal and stimulated secretion, regardless of the nature of the stimulus. Prescribed for gastric ulcer and duodenal ulcer in acute phase, erosive-ulcerative esophagitis, reflux esophagitis, Zollinger-Ellison syndrome, stress ulcers of the gastrointestinal tract; eradication of Helicobacter pylori within a combination therapy, non-ulcer dyspepsia.
Aciphex - the medicine, normalizing acidity of a stomach, inhibitor of a proton pomp. It is prescribed at gastroduodenal ulcer in the exacerbation phase, gastroesophageal reflux disease; states which are characterized by pathological hyper secretion including Zollinger-Ellison syndrome. In combination with bactericide - Helicobacter pylori eradication at patients with gastric ulcer or chronic gastritis; treatment and prevention of recurrence of an ulcer at patients with gastric ulcer related to Helicobacter pylori.
Antiepileptic agent; binds to the additional subunit (a2-delta protein) of the potential-dependent Ca2 + -channels in the CNS, which promotes the manifestation of analgesic and anticonvulsant action. Reduction in the frequency of seizures begins within the first week.
Dilantin - antiepileptic drug without the expressed somnolent effect; it has membrane stabilizing, antiarrhytmic and hypotensive effect. It is taken if it is diagnosed activated epilepsy, supraventricular and ventricular disturbances of a heart rhythm caused by intoxication cardiac glycosides.
Flexeril - medicine acting against muscular spasms. It possesses sedative action, it is not recommended to be engaged in potentially dangerous types of activity if a person takes Flexeril. As well as in a case with narcotic analgetics, Flexeril is not recommended to take longer than seven days as in case of a long taking there can be a dependence.
An antispasmodic drug, which removes pain and reduces the tone of smooth muscles: gastrointestinal tract, biliary tract, uterus, it also relaxes the detrusor (direct antispasmodic and m-anticholinergic effect). Increases bladder capacity, reduces the frequency of detrusor contractions, hinders urination. Well tolerated when appointed for a long term. Used in neurogenic bladder (including detrusor hyperreflexia, multiple sclerosis or spina bifida), urinary incontinence (of idiopathic origin), nocturnal enuresis (in children older than 5 years).
Arava - a basic medicine with antirheumatic effect. Action is happened due to active metabolite of leflunomid. It has the inhibiting action on degidrorotate-dehydrogenase. Taking the medicine the progression of rheumatoid arthritis is slowed down, it is stopped the affection of arthral layers. Development of therapeutic effect is observed in a month. Increase of effect is noted within half a year.
is given to patients for treating severe acne that do not respond to other medicines
Zestril is an angiotensin-converting enzyme inhibitor (ACE). It works by relaxing the blood vessels. This helps lower blood pressure. It is used in the treatment of high blood pressure, alone or in conjunction with other medicines.
Atorlip-5 is a drug which purpose is to lower the level of so-called bad cholesterol in the human organism. Its amount is identified due to the blood testing. The accumulation of low-density lipoprotein can lead to atherosclerosis. As the result, arteries are getting narrow causing cardiovascular complications as strokes, heart attacks, hypertonia, and peripheral artery disease. Liver fat can be also reduced thanks to the drugs. The other benefit is that the medicine increases the level of high-density lipoprotein.
Hytrin refers to the group of pharmaceutical products intended to cure the sexual/urinary maladies and sex hormone medical preparations. Its composition includes Terazozin - a medical mean for the normalization of the prostate gland in benign hypertrophy.
Benemid - an anti-gout agent. It prevents formation of uric acid. It is used for treatment of symptomatic hyperuricemia (gouty arthritis) at patients who cannot take other medicine decrease hyperuricemia.
NSAIDs; has an anti-inflammatory, analgesic and antipyretic effect associated with the suppression of COX1 and COX2 that regulate the synthesis of Pg. Used to inhibit miosis during surgery of cataracts in the treatment of inflammatory processes caused by surgery. It is also used in the prevention and treatment of cystoid edema of macular retina after surgical removal of cataracts.
Arcoxia - analgesic and anti-inflammatory drug of a group of highly selective cyclooxygenase-2 inhibitors. The drug has anti-inflammatory, analgesic and antipyretic effect.
Elavil - antidepressive medicine. Renders also some analgesic, H2-histamineblocking and antiserotonin action, promotes elimination of bedwetting and reduces appetite. It is taken at Depressions (especially with anexiety, agitation and sleep disorders, including children's age, endogenous, involutional, reactive, neurotic, medicinal, at organic lesions of a brain, alcoholic abstinence), schizophrenic psychoses, mixed emotional frustration, behavior disorders, night enuresis, nervous bulimia, chronic pain syndrome.
Shallaki offers a herbal cure for sore joints and is based on an extract from Boswellia serrate. Completely natural origin of the medicine guarantees its safety and pure benefits for the body. It is a powerful auxiliary remedy applied in the treatment of arthritis as well as prevention of joint conditions. Shallaki alleviates pain and swelling in areas of inflammation and lowers the overall level of triglyceride and cholesterol with high efficiency. Its health-promoting behavior makes it a great aid for weight reduction.
Cartidin is a medicine which has only two indications: primary or secondary osteoarthrosis. It belongs to non-steroidal anti-inflammatory drugs. Cartidin is a derivative anthraquinoline, diacetylated derivative of rhine. It is well soaked up from GIT. Bioavailability is increased at meal by 25%.
Paroxetine is used to treat depression, panic attacks, obsessive-compulsive disorder (OCD), anxiety disorders, and post-traumatic stress disorder.
