GEMERDAPA XR 10/2/500

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Type 2 diabetes mellitus: to improve blood sugar control in adults, as an adjunct to diet and exercise, when combination therapy is appropriate.

Dapagliflozin (SGLT2 inhibitor) lowers blood glucose by increasing urinary glucose excretion via the kidneys. Metformin (biguanide) reduces hepatic glucose production and improves insulin sensitivity. Glimepiride (sulfonylurea) increases insulin release from pancreatic beta cells.

Oral tablet (XR). Take exactly as prescribed, usually once daily with food (preferably with the evening meal) to reduce stomach upset and lower hypoglycaemia risk. Swallow whole; do not crush, break, or chew. Monitor blood glucose regularly.

Hypoglycaemia, dizziness, headache, nausea, diarrhoea, abdominal discomfort, decreased appetite, increased urination, urinary tract infection, genital fungal infection, dehydration, weakness

Risk of hypoglycaemia (higher with sulfonylurea), especially with missed meals/exercise/alcohol; monitor sugars. Metformin may rarely cause lactic acidosis—higher risk in kidney impairment, dehydration, severe infection, shock, liver disease, or heavy alcohol use; stop and seek care if rapid breathing, severe weakness, drowsiness occur. Dapagliflozin can cause genital infections, UTIs, volume depletion/low BP and may precipitate ketoacidosis (sometimes with near-normal sugars); seek urgent care for nausea/vomiting, abdominal pain, fast breathing. Kidney function should be assessed before and during treatment; not recommended in severe renal impairment. Temporarily withhold around major surgery or during acute illness/poor intake and before iodinated contrast procedures as advised by doctor.

Insulin/other antidiabetics (increased hypoglycaemia), diuretics (increased dehydration/low BP), ACE inhibitors/ARBs (may enhance BP lowering), corticosteroids and sympathomimetics (raise glucose), beta-blockers (mask hypoglycaemia symptoms), rifampicin/phenytoin/other enzyme inducers (may reduce sulfonylurea effect), azole antifungals/macrolides (may increase sulfonylurea effect), alcohol (increases hypoglycaemia and lactic acidosis risk), iodinated contrast media (risk of lactic acidosis—hold metformin as directed)

Store at room temperature (below 25°C), protected from moisture and direct light. Keep in original blister pack and out of reach of children.

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