Uses/Indications

• This combo tablet is given to people with type 2 diabetes mellitus when diet, exercise, or a single drug isn't enough to keep their blood sugar levels in check.

Uses in medicine:

• Helps keep blood sugar levels in the usual range.
• Lowers the chance of long-term diabetes problems such as nephropathy, neuropathy, and retinopathy.
• Makes the body more sensitive to insulin and better at using it.

Roles and Active Ingredients:

• Glimepiride (2 mg): It makes the pancreas release insulin.
• Pioglitazone (15 mg) makes peripheral tissues more sensitive to insulin.
• Metformin (SR) 500 mg lowers the amount of glucose made by the liver and raises the amount of glucose taken up by muscles.

 How It Works

• Glimepiride, which is a sulfonylurea, makes pancreatic beta cells produce more insulin, which lowers blood sugar levels.
• Pioglitazone (a thiazolidinedione) works on muscle, fat, and liver cells to make the body respond better to insulin. This makes it use more glucose.
• Metformin (SR) (a biguanide) lowers the amount of glucose made in the liver, slows down the absorption of glucose in the intestines, and makes cells more sensitive to insulin.
• These three parts work together to keep blood sugar levels stable around the clock and lower insulin resistance effectively.

How to Use

• Take one tablet every day, ideally with or after meals, just like your doctor told you to.
• Do not crush or chew the tablet; just swallow it whole with water.
• To keep your blood sugar levels steady, take your medicine at the same time every day.
• Stick to a healthy diet and activity regimen for those with diabetes.
• If you forget to take a dose, do it as soon as you remember. If it's close to the time for your next dose, skip it.

Side effects

• Low blood sugar (hypoglycemia)
• Feeling sick, throwing up, or having stomach pain
• Headache and feeling dizzy
• A little bit of weight gain
• Swelling of the ankles or feet (due to pioglitazone)
• Diarrhea or gas (associated to metformin)
• Serious but not very common:
• Lactic acidosis (from Metformin)
• Problems with the liver (Pioglitazone)
• Problems with vision
• Skin responses that are allergic
• If you feel very weak, have trouble breathing, have muscle discomfort, your eyes or skin turn yellow, or you swell up, see a doctor at once.

 Pregnancy interaction

• Category C (use with caution): There isn't much research on people, but studies on animals reveal that there may be a risk.
• Glimepiride and Pioglitazone may cross the placenta and have an effect on the development of the fetus.
• Not suggested during pregnancy unless a doctor says so after carefully weighing the risks and benefits.
• If you get pregnant while taking this prescription, call your doctor right away. Insulin is usually better for pregnant women.
• Don't use it while breastfeeding because glimepiride and pioglitazone can get into breast milk and harm the baby.

Medicines interaction

• Drinking alcohol raises the risk of lactic acidosis and hypoglycemia.
• Steroids like prednisolone and dexamethasone may make blood sugar levels go up.
• Beta-blockers: They might hide signs of low blood sugar.
• Diuretics and birth control pills can change how well your body controls glucose.
• ACE inhibitors or NSAIDs: These drugs may make the effect of decreasing blood sugar stronger.
• Insulin or other diabetes medications: May increase the risk of low blood sugar.
• Before you start taking this prescription, make sure to provide your doctor a full list of all the medications and supplements you use.

Expert advice

• Never skip meals. Always eat after taking this pill to keep your blood sugar from dropping too low.
• Check your blood sugar and HbA1c readings on a regular basis.
• Don't drink or smoke.
• Stay hydrated; not drinking enough water might make lactic acidosis worse.
• While on therapy, you should have regular tests to see how well your liver and kidneys are working.
• Eat a lot of fiber and keep your weight in check by limiting your carbs.
• If you have severe heart failure, liver illness, or bladder cancer, don't use this medicine (pioglitazone caution).

FAQs for medicine?

Q1. Is it okay to take this medicine without eating?

No, you should always take it with food to lower the risk of hypoglycemia.

Q2: Is it safe to use for a long time?

Yes, but only if blood sugar stays steady and kidney and liver function is checked on a regular basis.

Q3: What if I forget to take a dose?

Take it as soon as you remember, but don't take it if it's close to when you were supposed to take it next. Don't ever double up.

Q4. Is it okay to drink alcohol while taking this tablet?

Stay away from alcohol because it can make your blood sugar levels drop and cause lactic acidosis.

Q5. Will this medicine make me gain weight?

Yes, pioglitazone or glimepiride may cause modest weight gain. This effect is lessened by eating well and working out.

Q6. Is it safe for persons who have kidney problems?

Use with caution and under the care of a doctor, as the dose may need to be changed based on how well the kidneys are working.

Q7. Is it safe to consume with insulin?

Only with a doctor's permission if oral medication alone doesn't manage blood sugar.