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Diabold Plus SpecificationRequires Prescription (YES/NO)YesGenericsGlimepiride, Metformin HClUsed ForDiabetesHow it worksGlimepiride: Glimepiride is a third generation sulphonylurea. The primary mechanism of action of glimepiride appears to be dependent on stimulating the release of insulin from functioni ng pancreatic beta cells. In addition, extrapancreatic effects (e.g. reduction of basal hepatic glucose production and increased peripheral tissue sensitivity to insulin and glucose uptake) may also play role in the activity of glimepiride.Metformin HCl: Metformin hydrochloride is a biguanide anti-diabetic, which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Its mode of action is thought to be multifactoral and includes delayed uptake of glucose from the intestinal tract, increased peripheral glucose utilization mediated by increased insulin sensitivity and inhibition of increased hepatic and renal gluconeogenesis.Diabold Plus Usage And SafetyDosageGlimepiride, Metformin HClSide EffectsDiarrhea, vomiting, metallic taste, rash, isolated transaminase elevations, cholestatic jaundice, allergic skin reactions, photosensitivity reactions, leukopenia, agranulocytosis, thrombocytopenia, hemolyticanemia, aplastic anemia, pancytopenia and blurred vision. Glimepiride appears to be associated with a low incidence of hypoglycemia.Drug InteractionsGlimepiride: Salicylates, sulfonamides, chloramphenicol, coumarins, probenecid, monoamine oxidase inhibitors , thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics and isoniazid , rifampicin, fluconazole, amiodarone, tolbutamide, diclofenac, ibuprofen, naproxen , clonidine and reserpine. Metformin HCl: Phenprocoumon, hyperglycemic agent (e.g. - thiazides, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channelblocking drugs and isoniazid), alcohol, furosemide, nifedipine and cationic drugs (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim and cimetidine, vancomycin). IndicationGlimepiride + Metformin HCl is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes whose diabetes is not adequately controlled with glimepiride or metformin HCl alone, or for those patients who have initially responded to glimepiride or metformin HCl alone and require additional glycemic control.When not to UseGlimepiride + Metformin HCl combination is contraindicated in:- Patients with known hypersensitivity to sulfonylurea or biguanide or any component of the drug.- Insulin-dependent diabetes mellitus.- Renal or hepatic failure.- Alcoholism.- NIDDM complicated by severe ketosis and acidosis.- Diabetic pre-coma and coma.- Patients undergoing surgery, after severe trauma or during infections.- Chronic obstructive pulmonary disease.- Coronary heart disease, cardiac failure.Diabold Plus PrecautionsPrecautionHypoglycemia may occur if the patient's dietary intake is reduced or after accidental or deliberate overdose or after severe exercise, trauma and stress. Hypoglycemic symptoms can be reduced byprescribing a diabetic meal plan. Immediate intervention should be done if signs and symptoms of hypoglycemia occur. Adjust dose of drug according to blood and urinary glucose levels during the first few months.Diabold Plus WarningsWarning 1Lactic acidosis is rare, but serious metabolic complication that can occur due to metformin accumulation. The incidence of lactic acidosis can and should be reduced by assessing also other associated risk factors such as poorly controlled diabetes, ketosis, prolonged fasting, excessive alcohol intake, hepatic insufficiency and any condition associated with hypoxia.Warning 2As metformin is excreted by the kidney, serum creatinine levels should be determined before initiating treatment and regularly thereafter.Warning 3Safety and effectiveness of the drug in children have not been established.Diabold Plus Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.

Diabold Tablets SpecificationRequires Prescription (YES/NO)YesGenericsGlimepirideUsed ForDiabetesHow it worksThe primary mechanism of action of glimepiride in lowering blood glucose is by stimulating pancreatic beta cells to produce more insulin and induce increased activity of peripheral insulin intracellular receptor. However, as with other sulfonylureas, the mechanism by which glimepiride lowers blood glucose during long-term administration has not been clearly established.Diabold Tablets Usage And SafetyDosageGlimepirideSide EffectsHypoglycaemin: Hypoglycaemia is one of the most widely reported adverse events with glimepiride in many clinical studies. The usual adverse events, other than hypoglycemia. considered to be possibly or probably related to more than 1% of patients treated with glimepiride are as follows: hypoglycemia, dizziness, asthenia, headache, and nausea.Other adverse events observed were: Gastrointestinal reactions: vomiting, gastrointestinal pain, and diarrhea have been reported, but the incidence in placebo-controlled trials was less than 1%. In rare cases, there may be an elevation of liver enzyme levels. Dermatologic reactions: Allergic skin reactions, e.g., pruritus, erythema, urticarial, and morbilliform or maculopapu ar eruptions, occur in less than 1% of treated patients. Drug InteractionsSalicylates, sulfonamides, chloramphenicol, coumarins, probenecid, monoamine oxicase inhibitors, and beta adrenergic blocking agents , thiazides and their diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid.IndicationIt is indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus. It should not be used for the treatment of type-1diabetes mellitus or diabetic ketoacidosis, as it would not be effective in these settings.When not to UseGlimepiride is contraindicated in patients who have known hypersensitivity to the drug and also in diabetic treated with insulin. Do not use in patients who have a history of an allergic ketoacidosis, with or without come. This condition should be reaction to sulphonamide derivatives.Diabold Tablets PrecautionsPrecautionHypoglycemia may be severe. Ensure proper patient selection, dosing and instructions, particularly in at-risk populations (e.g., elderly, renally impaired) and when used with other anti-diabetic medications.Diabold Tablets WarningsWarning 1Hemolytic Anemia can occur if glucose 6-phosphate dehydrogenase (G6PD) deficient. Consider a non sulfonylurea alternative.Warning 2Potential Increased Risk of Cardiovascular Mortality with Sulfonylureas: Inform patient of risks, benefits and treatment alternatives.Warning 3Hypersensitivity Reactions: Postmarketing reports include anaphylaxis, angioedema and Stevens-Johnson Syndrome. Promptly discontinue Econid, assess for other causes , institute appropriate monitoring and treatment, and initiate alternative treatment for diabetes.Diabold Tablets Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.