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Type 2 diabetes mellitus (adult) to improve blood glucose control when diet and exercise alone are inadequate; used when combination therapy is required.

Glimepiride (a sulfonylurea) increases insulin release from pancreatic beta cells and improves peripheral insulin sensitivity. Metformin (a biguanide) decreases hepatic glucose production and reduces intestinal glucose absorption while improving insulin sensitivity.

Oral tablet. Take exactly as prescribed, usually once daily with food (preferably with/after breakfast) to reduce stomach upset and risk of low sugar. Swallow whole; do not crush/chew (ER component). Monitor blood glucose regularly.

Hypoglycaemia, nausea, vomiting, diarrhoea, abdominal pain, loss of appetite, headache, dizziness, weight gain, metallic taste

Risk of hypoglycaemia (higher with missed meals, strenuous exercise, alcohol, elderly, kidney/liver impairment). Metformin may rarely cause lactic acidosis—seek urgent care for rapid breathing, severe weakness, muscle pain, unusual sleepiness. Avoid/use with caution in renal impairment; kidney function should be assessed before and during therapy. Temporary discontinuation may be needed around major surgery or iodinated contrast studies. Use caution in hepatic disease, heart failure, dehydration; monitor HbA1c and glucose.

Alcohol (increases hypoglycaemia and lactic acidosis risk), iodinated contrast media, other antidiabetics/insulin (additive hypoglycaemia), beta-blockers (mask hypoglycaemia), corticosteroids/diuretics (reduce glucose control), ACE inhibitors (may increase hypoglycaemia), rifampicin (may reduce effect), azole antifungals/macrolides (may increase sulfonylurea effect), NSAIDs (may increase hypoglycaemia risk), cimetidine (may increase metformin levels)

Store below 25°C in a dry place, protected from moisture and light. Keep in original blister pack and out of reach of children.

Glimestar M1 Tablet, Glycomet-GP 1 Tablet, Glimy M 1 Tablet, Amaryl M 1 Tablet, Zoryl M 1 Tablet