GLIMSHIL M

GLIMSHIL M 0.5/M1/M2
Each uncoated bylared tablet contains :
GLIMSHIL M 0.5
( Glimepiride 0.5mg & ER Metformin HCI 500mg)
GLIMSHIL M 1
( Glimepiride 1mg & ER Metformin HCI 500mg)
GLIMSHIL M 2
( Glimepiride 2mg & ER Metformin HCI 500mg)
Indication

For the management of patients with type 2 diabetes mellitus ( T2DM ) when diet, exercise and single agent (glimepiride or metformin alone) do not result in adequate glycemic control.

Dosage and Administration

GLIMSHIL M is to be administered once per day during breakfast or the first main meal. The highest recommended dose per day should be 8mg of glimepiride and 2000mg of metformin. Daily doses of glimepiride of more than 6mg are more effective only in a minority of patients. In order to avoid hypoglycemia the starting dose of GLIMSHIL M should not exceed the daily doses of glimepiride or metformin already being taken. When switching from combination therapy of glimepiride plus metformin as separate tablets, GLIMSHIL M should be administered on the basis of dosage currently being taken.

Titration:

The daily dose should be titrated based on the glycemic control ,in increments of 1 tablet only, corresponding to the lowest strength.

Duration of therapy:

Treatment with GLIMSHIL M is normally a long-term therapy.

ContraIndications
For Glimepiride:
  • In patients hypersensitive to glimepiride, other sulfonylureas, other sulfonamides, or any of the excipients of GLIMSHIL M
  • In pregnant women.
  • In breast-feeding women.

No experience has been gained concerning the use of glimepiride in patients with severe impairment of liver function and in dialysis patients. In patients with severe impairment of hepatic function, change-over to insulin is indicated, not least to achieve optimal metabolic control.

For Metformin:
    • Hypersensitivity to metformin or any of the excipients.
    • Any type of acute metabolic acidosis (such as lactic acidosis,diabetic ketoacidosis, diabetic pre-coma).
    • Severe renal failure (GFR˂30ml/min)
    • Acute conditions with the potential to alter renal function such as:
      • – Dehydration
      – Severe infection
      – Shock
      – Intravascular administration of iodinated contrast agents.
    • Acute or chronic disease which may cause tissue hypoxia such as :
      • – Cardiac or respiratory failure
      – Recent myocardial infarction
      – Shock
    • Hepatic insufficiency.
    • Acute alcohol intoxication, alcoholism.
    • Lactation.