Ziglim M 2

Glimepiride 2 mg + Metformin hydrochloride (SR) 500 mg tablets

Type 2 diabetes mellitus (adult) when diet and exercise alone or single-agent therapy do not provide adequate glycaemic control

Glimepiride is a sulfonylurea that stimulates insulin release from pancreatic beta cells and improves peripheral insulin sensitivity. Metformin reduces hepatic glucose production and improves insulin sensitivity, lowering intestinal glucose absorption. Together they help control fasting and post‑meal blood glucose.

Oral tablet. Take exactly as prescribed, usually once daily with the first main meal (or as advised). Swallow whole; do not crush/chew (SR metformin). Monitor blood glucose regularly; avoid skipping meals to reduce risk of hypoglycaemia.

Hypoglycaemia, nausea, vomiting, diarrhoea, abdominal discomfort, loss of appetite, metallic taste, headache, dizziness, weight gain, skin rash

Risk of hypoglycaemia (especially with missed meals, alcohol, excessive exercise or dose changes). Metformin may rarely cause lactic acidosis—risk increases with severe kidney impairment, dehydration, sepsis, hypoxia, liver disease or heavy alcohol intake. Check renal function before starting and periodically; not recommended in severe renal impairment. Temporarily stop metformin around iodinated contrast studies or major surgery as advised by doctor. Use caution in elderly and in patients with G6PD deficiency (risk of haemolysis) and in those with heart failure or conditions causing poor oxygenation.

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

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

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