Glucovance (Glyburide/Metformin)

Do’s

• Before starting Glucovance, read the Patient Information Leaflet from your pharmacist. If you have any questions, consult your healthcare provider.
• Take Glucovance by mouth with meals as directed by your healthcare provider, usually once or twice a day.
• Make sure to drink plenty of fluids while taking this medication unless otherwise directed by your healthcare provider.
• The dosage of this medication is based on your medical condition and response to treatment. To reduce the risk of side effects, your healthcare provider may direct you to start this medication at a low dose and gradually increase it. Your healthcare provider will adjust your dose based on your blood sugar levels to find the best dose for you. Follow their instructions carefully.
• If you are already taking another diabetes drug, follow your healthcare provider's instructions carefully for stopping the old drug and starting Glucovance.
• If you are also taking colesevelam, take Glucovance at least 4 hours before colesevelam.
• Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day
• It may take up to 2 weeks before you get the full benefit of this drug. Inform your healthcare provider if your condition does not improve or if it worsens (your blood sugar is too high or too low).

Common Side Effects:

• Low blood sugar
• Nausea
• Diarrhea
• Upset stomach
• Headache

Severe Side Effects:

• Lactic acidosis: Symptoms include unusual muscle pain, trouble breathing, stomach pain, vomiting, irregular heart rate, dizziness, feeling cold, or feeling very weak or tired 

This is not a complete list of side effects, and others may occur. If you experience any unusual symptoms or side effects, consult your healthcare provider for medical advice. 

There is a risk of lactic acidosis associated with metformin therapy. Patients should be advised to discontinue Glucovance immediately and promptly notify their health practitioner if unexplained hyperventilation, myalgia, malaise, unusual somnolence, or other nonspecific symptoms occur.

Patients with severe kidney disease should not use Glucovance. Additionally, in patients taking Glucovance whose estimated glomerular filtration rate (eGFR) falls below certain levels, the benefit-risk of continuing therapy should be assessed, and the medication may need to be discontinued.

Glucovance should be discontinued at the time of, or prior to, iodinated contrast imaging procedures in certain patients. The eGFR should be re-evaluated 48 hours after the imaging procedure, and Glucovance may be restarted if renal function is stable.

Patients should be informed about the potential risks and benefits of Glucovance and alternative modes of therapy. They should also be informed about the importance of adherence to dietary instructions, a regular exercise program, and regular testing of blood glucose, glycosylated hemoglobin, renal function, and hematologic parameters.

Alcohol is known to potentiate the effect of metformin on lactate metabolism. Patients should be warned against excessive alcohol intake while taking Glucovance.

Properly discard Glucovance when it is expired or no longer needed. Patients should consult their healthcare provider for guidance on proper disposal.

Be aware of these warnings and precautions and consult a healthcare provider for personalized advice and guidance on the safe and appropriate use of Glucovance.