Zoryl M D 2/1000 Tab

Tablet

Type 2 diabetes mellitus in adults, to improve blood glucose control along with diet and exercise when single therapy is inadequate

Glimepiride (a sulfonylurea) increases insulin release from pancreatic beta cells and improves insulin sensitivity. Metformin (a biguanide) reduces hepatic glucose production and improves peripheral glucose uptake, lowering insulin resistance.

Oral tablet. Take exactly as prescribed, usually once daily with the first main meal (to reduce stomach upset and risk of low sugar). Swallow whole; do not crush/chew if SR/ER. Monitor blood glucose regularly.

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

Risk of hypoglycaemia (especially with missed meals, alcohol, heavy exercise, elderly); carry glucose. Metformin can rarely cause lactic acidosis—risk increases with severe kidney disease, dehydration, sepsis, hypoxia, heart failure, liver disease, or excess alcohol; stop and seek care if rapid breathing, severe weakness, abdominal pain occur. Assess renal function before and during therapy; avoid if eGFR very low as per doctor. Temporarily stop metformin around iodinated contrast procedures or major surgery as advised. Use caution in G6PD deficiency (hemolysis risk with sulfonylureas).

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

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

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