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INTRODUCTION
OBIMET is a combination of Glimepiride and Metformin which belongs to a group of medicines called Antidiabetic agents. OBIMET 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.
Glimepiride lowers blood sugar by causing the pancreas to produce more insulin and helps the body use insulin efficiently. Metformin is a biguanide which effectively reduces the total amount of sugar released into the blood by the liver. Along treatment with OBIMET follow regular exercise and diet plan as advised by your doctor to achieve better results.
Before taking OBIMET 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 OBIMET as it may increase or decrease the blood sugar lowering action of OBIMET and increases the risk of lactic acidosis. The most common side effects of taking OBIMET are taste disturbance, nausea, diarrhea, stomachache, and vomiting. Contact your doctor if any of the symptoms worsen.
USES OF OBIMET
- Treats type 2 diabetes mellitus (when diet, exercise and the single agent does not result in adequate glycemic control)
HOW OBIMET WORKS
OBIMET 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 OBIMET as advised by your physician. Swallow OBIMET 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 OBIMET without informing your doctor.
SIDE EFFECTS OF OBIMET
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)
- decreased vitamin b12 levels
- skin rashes, redness, itching and hives
Stop taking OBIMET 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
Diarrhoea:
Drink lots 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.
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.
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.
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.
WARNING & PRECAUTIONS
PREGNANCY
OBIMET should not be taken during pregnancy. Consult your doctor before taking OBIMET if you are planning to become pregnant.
BREASTFEEDING
OBIMET should not be taken during breastfeeding as it may pass through breast milk. Consult your doctor before taking OBIMET for advice.
DRIVING AND USING MACHINES
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.
ALCOHOL
Avoid consumption of alcohol during treatment with OBIMET as it may increase or decrease the blood sugar lowering action of OBIMET and increases the risk of lactic acidosis. Consult your doctor for advice before taking OBIMET.
KIDNEY
OBIMET 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 OBIMET.
LIVER
OBIMET 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 OBIMET.
ALLERGY
Do not take OBIMET if you are allergic (hypersensitive) to Glimepiride or Metformin or other sulfonylureas (such as glipizide, glibenclamide) or sulfonamides (such as sulfamethoxazole).
HEART DISEASE
OBIMET 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 OBIMET.
OTHERS
OBIMET 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 OBIMET 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)
Use in pediatrics:
OBIMET is generally not recommended for use in children and adolescents (under 18 years of age). Consult child’s doctor for advice.
Use in geriatrics:
OBIMET is not recommended for use in elderly patients (aged 75 years or 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 OBIMET. Consult your doctor before taking OBIMET.
INTERACTIONS
A. Drug-Drug interactions:
Before taking OBIMET 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 take too much of OBIMET, contact your doctor immediately or go to a nearest hospital straight away. Overdosage symptoms of OBIMET 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 |
MORE INFORMATION
- Keep OBIMET out of reach of children
- Store at temperature below 25°C
FAQs ABOUT OBIMET
What is OBIMET used for?
OBIMET 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 OBIMET follow regular exercise and diet plan as advised by your doctor to achieve better results.
Can I drive or handle machines after taking OBIMET?
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 OBIMET.
Can I consume alcohol while taking OBIMET?
Avoid consumption of alcohol during treatment with OBIMET as it may increase or decrease the blood sugar lowering action of OBIMET and increases the risk of lactic acidosis. Consult your doctor for advice before taking OBIMET.
Is OBIMET safe to use in patients with kidney problems?
OBIMET 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 OBIMET.
What are the common side effects of GBNKEYWORD]?
The most common side effects of taking OBIMET 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 July 24th 2021] 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 July 24th 2021] 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 July 24th 2021] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2642.pdf
5. Sanofi-aventis group. Amaryl M. Glimepiride + Metformin. [Revised in May 2015] [Accessed on July 24th 2021] 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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