Uses of Mefoglip: - Type 2 diabetes mellitus Type 2 DM Hypersensitivity. Type 2 diabetes mellitus; ketoacidosis; severe renal or hepatic insufficiency, diabetic coma, cardiac failure, recent MI, CHF. IDDM; severe infection; acute or chronic metabolic acidosis with or without coma; stress, trauma; severe impairment of thyroid function; dehydration, acute or chronic alcoholism. Pregnancy, lactation.

Combination Oral hypoglycemic preparations

Metformin is a biguanide antihyperglycemic agent, which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Its pharmacological mechanisms of action are different from other classes of oral antihyperglycemic agents. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylurea, metformin does not produce hypoglycemia in either patient with type 2 diabetes or normal subjects and does not cause hyperinsulinemia.Glipizide is a sulfonylurea which appears to lower blood glucose by stimulating the release of insulin from the pancreas, an effect dependent upon functioning beta cells in the pancreatic islets. Extrapancreatic effects may play a part in the mechanism of action of oral sulfonylurea hypoglycemic drugs.

How to use Glipizide + Metformin Hydrochloride: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Glipizide + Metformin Hydrochloride is to be taken with food. Administration: Should be taken with food. Adult Dose: Type 2 Diabetes Mellitus Initial treatment: start at 2.5 mg/250 mg (glipizide/metformin) PO qDay with food If fasting plasma glucose = 280-320 mg/dL: 2.5/500 mg PO q12hr May adjust daily dose in increments of 1 tab every 2 wk. Max: Glipizide 10 mg and metformin 2,000 mg daily. Type 2 DM Inadequately Controlled on Sulfonylurea &/or Metformin 2nd-line treatment: Start at 2.5/500 mg or 5/500 mg PO q12hr with food May adjust daily dose in increments of not more than 5 mg/500 mg. Max: Glipizide 20 mg and metformin 2,000 mg daily. Hepatic impairment: Contraindicated. Renal Dose: Renal impairment: Serum creatinine (SCr) >1.5 mg/dL (males) or >1.4 mg/dL (females) Obtain eGFR before starting metformin eGFR <30 mL/min/1.73 m²: Contraindicated eGFR 30-45 mL/min/1.73 m²: Not recommended to initiate treatment Monitor eGFR at least annually or more often for those at risk for renal impairment (eg, elderly) If eGFR falls below 45mL/min/1.73 m² while taking metformin, risks and benefits of continuing therapy should be evaluated If eGFR falls below 30 mL/min/1.73 m²: while taking metformin, discontinue the drug

Glipizide: Decreased effect with beta-blockers, cholestyramine, hydantoins, thiazide diuretics and urinary alkalinizers. Metformin: Additive effect with sulphonylureas. Antagonistic effects with diuretics, corticosteroids, phenothiazines, thyroid products, oestrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, Ca channel blockers and isoniazid. Potentially Fatal: Glipizide: Increased glipizide levels and effects with fluconazole, gemfibrozil, ketoconazole, NSAIDs, pioglitazone and sulfonamides. Increased hypoglycaemic effects with H2 antagonists, anticoagulants, androgens, cimetidine, salicylates, tricyclic antidepressants, probenecid, MAOIs, methyldopa, digitalis glycosides and urinary acidifiers. Metformin: Lactic acidosis with alcohol and potentiation of hypoglycaemic effect. Cimetidine and furosemide may increase plasma-metformin levels. Drugs eliminated via renal tubular secretion may increase metformin levels.

Hypersensitivity. Type 2 diabetes mellitus; ketoacidosis; severe renal or hepatic insufficiency, diabetic coma, cardiac failure, recent MI, CHF. IDDM; severe infection; acute or chronic metabolic acidosis with or without coma; stress, trauma; severe impairment of thyroid function; dehydration, acute or chronic alcoholism. Pregnancy, lactation.

Common - Hypoglycemia (low blood glucose level) - Taste change - Nausea - Stomach pain - Diarrhea - Headache - Upper respiratory tract infection Glipizide: GI upsets, diarrhoea, nausea; allergic skin reactions, leucopaenia, thrombocytopaenia, agranulocytosis, hyponatraemia; jaundice; haemolytic anaemia, pancytopaenia. Metformin: Anorexia, nausea, vomiting, diarrhoea, wt loss, flatulence, occasional metallic taste; weakness; hypoglycaemia; rash, malabsorption of Vitamin Potentially Fatal: Glipizide: Hypoglycaemia in presence of renal or hepatic damage and alcohol. Metformin: Lactic acidosis in presence of renal failure and alcoholism.

Contraindicated during Pregnancy & Lactation

Precaution: Hypoglycaemia, stress, elderly. Thyroid impairment, monitor blood-glucose conc and renal function regularly. Lactation: enters breast milk; not recommended

Store below 25ºC in a cool and dry place.

Combination Oral hypoglycemic preparations

Glipizide stimulates insulin release from pancreatic beta-cells and reduces gluconeogenesis in liver cells. It also increases insulin sensitivity at target sites. Metformin decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilisation).

Contraindicated during Pregnancy & Lactation