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INTRODUCTION
GEMER DS 2MG TABLET is a combination of Glimepiride and Metformin which belongs to a group of medicines called Antidiabetic agents. GEMER DS 2MG TABLET is used to treat type 2 diabetes mellitus when diet, exercise and the single agent does not result in adequate glycemic control.
Type 2 diabetes is a chronic medical condition in which the body does not make enough insulin, or the produced insulin does not work well. Symptoms include excessive urination, excessive thirst, hunger, fatigue and blurred vision.
Along treatment with GEMER DS 2MG TABLET follow regular exercise and diet plan as advised by your doctor to achieve better results.
Before taking GEMER DS 2MG TABLET inform your doctor if you have type 1 diabetes mellitus, diabetic ketoacidosis, severe liver or kidney disease, acute heart problems. Inform your doctor if you are pregnant or breastfeeding. It is not suitable for use in children and adolescents under 18 years of age.
Avoid consumption of alcohol during treatment with GEMER DS 2MG TABLET as it may increase or decrease the blood sugar lowering action of GEMER DS 2MG TABLET and increases the risk of lactic acidosis.
The most common side effects of taking GEMER DS 2MG TABLET are taste disturbance, nausea, diarrhea, stomachache and vomiting. Contact your doctor if any of the side effects worsen.
USES OF GEMER DS 2MG TABLET
- Treats type 2 diabetes mellitus (when diet, exercise and the single agent does not result in adequate glycemic control)
HOW GEMER DS 2MG TABLET WORKS
GEMER DS 2MG TABLET controls blood glucose levels, where glimepiride works by increasing the amount of insulin released by the pancreas in order to lower the blood glucose. Metformin works by lowering glucose production in the liver, delaying glucose absorption from intestine and increasing the body's sensitivity to insulin.
DIRECTIONS FOR USE
Take GEMER DS 2MG TABLET as advised by your physician. Swallow GEMER DS 2MG TABLET with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. Do not stop taking GEMER DS 2MG TABLET without informing your doctor.
SIDE EFFECTS OF GEMER DS 2MG TABLET
COMMON
- taste disturbance
- nausea
- diarrhea
- vomiting
- stomach pain
- loss of appetite
RARE
- low blood sugar levels (hypoglycemia)
- signs of reduced number of red blood cells (skin pale and weakness or breathlessness), platelets (easy bleeding or bruising) or white blood cells (repeated infections)
- skin rashes, redness, itching and hives
Stop taking GEMER DS 2MG TABLET and contact your doctor immediately if you experience any of the following side effects:
- lactic acidosis
- inflammation of the liver which may result in jaundice (yellowing of skin or eyes)
- severe allergic reactions (such as skin rash, hives, and increased sensitivity to sun, inflammation of blood vessels which may develop into serious reactions with difficulty in breathing, fall in blood pressure and sometimes progressing to shock)
- severe low blood sugar levels including loss of consciousness, seizures or coma
HOW TO MANAGE SIDE EFFECTS
Loss Of Appetite
Eat when you feel hungry. Eat smaller meals frequently than usual. Snack only when you're hungry. Consult your doctor if the symptom did not improve.
Diarrhea
Drink lot of fluids such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for treating diarrhea. Consult your doctor if the symptom did not improve.
Nausea And Vomiting
Stick to simple meals. Avoid eating oily, fried and spicy foods. Do not perform any strenuous activities immediately after eating. Consult your doctor if the symptom did not improve.
Stomach Pain
Rest and relax. Eat and drink slowly or try to have smaller and frequent meals. Keep a heat pad on your stomach. Consult your doctor if the symptom did not improve.
WARNING & PRECAUTIONS
PREGNANCY
ContraindicatedGEMER DS 2MG TABLET should not be taken during pregnancy. Consult your doctor before taking GEMER DS 2MG TABLET if you are planning to become pregnant.
BREASTFEEDING
ContraindicatedGEMER DS 2MG TABLET should not be taken during breastfeeding as it may pass through breast milk. Consult your doctor for advice before taking GEMER DS 2MG TABLET.
DRIVING AND USING MACHINES
Use with CautionDo not drive or handle any machines if you experience low or high blood sugar levels (symptoms include dizziness, tiredness, shaking or trembling) or if you develop visual problems due to altered blood sugar levels.
ALCOHOL
Consult your doctorAvoid consumption of alcohol during treatment with GEMER DS 2MG TABLET as it may increase or decrease the blood sugar lowering action of GEMER DS 2MG TABLET and increases the risk of lactic acidosis. Consult your doctor for advice before taking GEMER DS 2MG TABLET.
KIDNEY
Consult your doctorGEMER DS 2MG TABLET is not recommended for use in patients with severe kidney disease and it should be used with caution in patients with kidney disease and your dose will be adjusted if needed depending upon kidney function. Consult your doctor before taking GEMER DS 2MG TABLET.
LIVER
Consult your doctorGEMER DS 2MG TABLET is not recommended if you have severe liver disease and it should be used with caution in patients with liver disease and your dose will be adjusted if needed depending upon liver function. Consult your doctor before taking GEMER DS 2MG TABLET.
ALLERGY
ContraindicatedDo not take GEMER DS 2MG TABLET if you are allergic (hypersensitive) to Glimepiride or Metformin or other sulfonylureas (such as glipizide, glibenclamide) or sulfonamides (such as sulfamethoxazole).
HEART DISEASE
ContraindicatedGEMER DS 2MG TABLET is not recommended for use in patients with acute heart problems or recently had a heart attack or have severe circulatory problems or breathing difficulties (signs of heart failure). Consult your doctor before taking GEMER DS 2MG TABLET.
USE IN PEDIATRICS
ContraindicatedGEMER DS 2MG TABLET is generally not recommended for use in children and adolescents (under 18 years of age). Consult your child’s doctor for advice.
USE IN GERIATRICS
Consult your doctorGEMER DS 2MG TABLET is not recommended for use in elderly patients (aged 75 years and above) and it should be used with caution in elderly patients (aged 65 years or above), especially in patients with impaired kidney function. Your doctor may assess your kidney function more frequently during treatment with GEMER DS 2MG TABLET. Consult your doctor before taking GEMER DS 2MG TABLET.
OTHERS
GEMER DS 2MG TABLET is not recommended for use, if you have:
- type 1 diabetes mellitus
- diabetic ketoacidosis
- diabetic coma
- uncontrolled diabetes with nausea, vomiting, rapid weight loss, diarrhea, lactic acidosis (lactic acid build up in the bloodstream) or ketoacidosis (ketone bodies accumulate in the blood)
- dehydration
- severe infection (such as infection affecting lungs or kidneys)
Before taking GEMER DS 2MG TABLET, inform your doctor if you:
- are recovering from injury, operation, infections with fever or from other forms of stress
- have glucose-6-phosphate dehydrogenase (G6PD) deficiency
- have various factors which could increase the risk of low blood sugar levels (such as undernourishment, irregular mealtime, missed or delayed meal or period of fasting, change in diet, hormone-induced disorders)
INTERACTIONS
A. Drug-Drug interactions:
Before taking GEMER DS 2MG TABLET inform to your doctor, if you are taking any of these medicines:
- other sulphonylureas such as glibenclamide, insulin (used to lower blood sugar levels)
- anabolics (supports muscle build up)
- warfarin (treats blood clot)
- fenfluramine (used to reduce weight)
- phenylbutazone, azopropazone, oxyphenbutazone (treats pain and inflammation)
- disopyramide (treats heart problems)
- fibrates such as fenofibrate, nicotinic acid, colesevelam (lowers high cholesterol level)
- angiotensin-converting enzyme (ACE) inhibitors such as captopril, lisinopril, diuretics such as furosemide, chlorthalidone, hydrochlorothiazide or diazoxide (treats blood pressure)
- fluoxetine, monoamine oxidase inhibitors such as isocarboxazid, selegiline and chlorpromazine (used to treat mental disorders)
- allopurinol, probenecid, sulfinpyrazone (treats gout)
- cyclophosphamide, ifosfamide, trofosfamide (treats cancer)
- tetracyclines (Ex. minocycline, doxycycline), chloramphenicol, fluconazole, miconazole, quinolones (Ex. moxifloxacin, ciprofloxacin), clarithromycin, rifampicin (treats bacterial and fungal infections)
- tritoqualine, glucocorticoids (Ex. beclomethasone, hydrocortisone) (treats nasal allergies)
- pentoxifylline in high doses of intravenous infusion (used to improve blood flow)
- sulfonamides such as sulfamethoxazole (treats urinary infections)
- medicines used for male sex hormone replacement therapy (Ex. testosterone) and medicines containing female sex hormones (Ex. oestrogens, progestogens)
- sympatholytics such as clonidine, methyldopa (treats high blood pressure, heart failure or prostate symptoms)
- levothyroxine (used to stimulate thyroid gland)
- adrenaline and sympathomimetics such as phenylephrine, norepinephrine (treats life-threatening cardiac arrest and low blood pressure)
- laxatives such as bisacodyl (treats constipation)
- phenytoin (treats fits)
- glucagon (used to treat severely low blood sugar)
- barbiturates such as pentobarbital, amobarbital (treats nervousness and sleep problems)
- acetazolamide (treats increased pressure in the eye)
Overdosage:
If you or anyone else accidentally takes too much of GEMER DS 2MG TABLET, contact your doctor immediately or go to a nearest hospital straight away. Overdosage symptoms of GEMER DS 2MG TABLET includes risk of low blood sugar levels (in severe cases it may lead to loss of consciousness and coma) and it may cause life-threatening lactic acidosis. Symptoms of lactic acidosis include vomiting, bellyache with muscle cramps, general feeling of not being well with severe tiredness, reduced body temperature, low heartbeat and difficulty in breathing.
SYNOPSIS
| Drug | : | Glimepiride, Metformin |
| Pharmacological Category | : | Sulfonylureas, Biguanides |
| Therapeutic Indication | : | Type-2 Diabetes mellitus |
| Dosage Forms | : | Tablet, Capsule |
MORE INFORMATION
- Keep the medicine out of reach of children
- Store at temperature below 25°C
FAQs ABOUT GEMER DS 2MG TABLET
Q: What is GEMER DS 2MG TABLET used for?
A: GEMER DS 2MG TABLET is used to treat type 2 diabetes mellitus when diet, exercise and the single agent alone does not result in adequate glycemic control. Along treatment with GEMER DS 2MG TABLET follow regular exercise and diet plan as advised by your doctor to achieve better results.
Q: Can I drive or handle machines after taking GEMER DS 2MG TABLET?
A: Do not drive or handle any machines if you experience low or high blood sugar levels (symptoms include dizziness, tiredness, shaking or trembling) or if you develop visual problems due to altered blood sugar levels. Consult your doctor before taking GEMER DS 2MG TABLET.
Q: Can I consume alcohol while taking GEMER DS 2MG TABLET?
A: Avoid consumption of alcohol during treatment with GEMER DS 2MG TABLET as it may increase or decrease the blood sugar lowering action of GEMER DS 2MG TABLET and increases the risk of lactic acidosis. Consult your doctor for advice before taking GEMER DS 2MG TABLET.
Q: Is GEMER DS 2MG TABLET safe to use in patients with kidney problems?
A: GEMER DS 2MG TABLET is not recommended for use in patients with severe kidney disease and it should be used with caution in patients with kidney disease and your dose will be adjusted if needed depending upon kidney function. Consult your doctor before taking GEMER DS 2MG TABLET.
Q: What are the common side effects of GBNKEYWORD]?
A: The most common side effects of taking GEMER DS 2MG TABLET are taste disturbance, nausea, vomiting, diarrhea, loss of appetite and stomach pain. Contact your doctor if any of the symptoms worsen.
REFERENCES
1. KD Tripathi MD. Hormones and related drugs. Essentials of medical pharmacology. Seventh edition. New Delhi, May 2013. Page – 274.
2. Rakesh Kumar Sahay, Vinod Mittal, G Raja Gopal, Sunil Kota, Ghanshyam Goyal, Mahesh Abhyankar, Santosh Revenkar. Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence. September 2020 [Accessed on 24th December 2022] https://www.cureus.com/articles/37779-glimepiride-and-metformin-combinations-in-diabetes-comorbidities-and-complications-real-world-evidence
3. Sanofi. Efficacy and Safety Comparison of Metformin/Glimepiride Combination Versus Each Compound Alone in New Diagnosed Type 2 Diabetes Patients (RECOMMEND). NIH U.S. National Library of Medicine. ClinicalTrials.gov. [Revised in January 2015] [Accessed on 24th December 2022] https://clinicaltrials.gov/ct2/show/NCT01459809
4. Torrent pharmaceuticals Ltd. Azulix MF. Metformin Hydrochloride Prolonged Release and Glimepiride Tablets I.P. [Revised in July 2019] [Accessed on 24th December 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2642.pdf
5. Sanofi-aventis group. Amaryl M. Glimepiride + Metformin. [Revised in May 2015] [Accessed on 24th December 2022] http://pharm.cals.am/pharm/data/drug_124396/1470300364248.pdf
USEFUL DIAGNOSTIC TESTS
- Glucose-Fasting Blood
- Glucose-Postprandial Blood
- Glycosylated Hemoglobin
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