Voglibose+Glimepiride+Metformin Hydrochloride

When should one not use Voglibose+Glimepiride+Metformin Hydrochloride

• If you are allergic to this medicine or any of the ingredients of this medicine.
• If you are pregnant or breastfeeding.
• If you have severe kidney or liver problems.
• If you have metabolic acidosis (too much acid in the body fluids) like lactic acidosis, diabetic ketoacidosis or diabetic pre-coma.
• If you have a history of any kind of heart condition like shock, heart failure, etc.
• If you are an alcoholic.
• If you have a history of severe infection pre or post-surgery.
• If you have stomach or intestinal obstruction or disorder.

Common side effects of this drug are:

• Low blood sugar levels can present with headache, dizziness, restlessness, difficulty concentrating, loss of consciousness, sweating, fast heartbeat.
• Nausea, vomiting, diarrhoea, loss of appetite, stomach ache. These symptoms show at the beginning of treatment and settle gradually.
• Altered taste
• Bloating
• Flatulence

Other General Warnings

• You have been advised CT scan or MRI with contrast media then inform the hospital that you are on Voglibose+Glimepiride+Metformin Hydrochloride. Your doctor will advise you to stop the medicine a few days before the investigation.
• You experience diarrhoea, vomiting, dehydration or less fluid intake.
• Prolonged fasting should be avoided.
• Never miss your meals.
• You are taking other medicines for diabetes then caution is needed as a fall in blood glucose can occur.
• You are taking any antihypertensive medicines, painkillers or water pills.
• You have an upcoming surgery, then the doctor may adjust the dose or replace the medicine for few days.
• You have pre-existing medical conditions such as intestinal diseases like Roemheld syndrome (epigastric pressure in the gastrointestinal tract), severe hernia, and obstruction or ulcers in the intestine, etc.
• You have a kidney or liver disorder or thyroid disorder or G6PD deficiency.
• Monitoring of vitamin B12 is recommended if you are on long-term treatment with this medicine.

How Does It Work?

• This combination is known to control blood sugar to a greater extent than metformin, voglibose or glimepiride alone.
• Insulin moves sugar (glucose) from the blood into the cells. Glimepiride lowers the blood sugar level increasing release of insulin hormone from the pancreas.
• Metformin works by decreasing the amount of glucose absorbed from the intestine, lowering the amount of sugar created by the liver and facilitating the entry of sugar into the cells.
• Voglibose delays digestion and absorption of carbohydrates in the intestines and thereby prevents a spike in blood glucose levels that occur after a meal.

Interactions with other medicines

• Voglibose+Glimepiride+Metformin Hydrochloride may interact with other medicines if taken at the same time. Always inform your doctor about all the medicine you are taking, that includes all prescribed or non-prescribed herbal medicines, dietary supplements as well as other treatment if you are taking for any disorder.
• In particular, if you are taking medicines for brain and heart-related disorders, tuberculosis, acidity, fungal infections, painkillers, antihypertensive medicines, etc.
• You may have symptoms of high blood sugar if you are taking oral contraceptives, water pills, rifampicin (anti-tuberculosis medicine), medicines for constipation, phenytoin (anti-epileptic medicine), medicines for thyroid disorders.
• Voglibose+Glimepiride+Metformin Hydrochloride may alter the way blood thinners work like phenprocoumon.
• Other medicines like oral contraceptives, other anti-diabetics, etc can affect blood glucose levels. Therefore, concomitant use should be undertaken with caution.

Interactions with food items

Overdose

• An overdose of this medicine may cause hypoglycaemia (excessively low blood sugar) and may present with extreme weakness, confusion, tremors, fast heart rate, nausea, rapid breathing. You must immediately take sugar, if possible in the form of glucose. Seek emergency medical attention if you think you have used too much of this medicine.

Missed a Dose

• If you have missed any dose, take it as soon as you remember. If it is time for the next dose, skip the missed dose and continue your regular dosing schedule.
• Do not take a double dose of medicine to compensate for a missed one. Taking double doses can be harmful as it can drop the glucose level.