Zoryl Mp-2

Glimepiride 2 mg + Metformin Hydrochloride 500 mg (Sustained Release) + Pioglitazone 15 mg (tablet)

Type 2 diabetes mellitus in adults (when diet and exercise alone or dual therapy is not adequate) to improve blood glucose control

Glimepiride (sulfonylurea) increases insulin release from pancreatic beta cells. Metformin SR reduces glucose production in the liver and improves insulin sensitivity. Pioglitazone (PPAR-gamma agonist) increases insulin sensitivity in muscle and fat, improving glucose uptake.

Take by mouth as prescribed, usually once daily with the first main meal. Swallow whole; do not crush or chew (SR tablet). Monitor blood glucose regularly and follow diet/exercise advice.

Hypoglycaemia, nausea, vomiting, diarrhoea, abdominal discomfort, flatulence, headache, dizziness, weight gain, oedema (swelling), upper respiratory tract infection

Risk of hypoglycaemia (especially with missed meals, alcohol, or increased exercise); carry glucose. Metformin: rare risk of lactic acidosis—avoid in severe kidney impairment, severe dehydration, sepsis, hypoxia; stop temporarily before/after iodinated contrast or major surgery as advised. Pioglitazone: can cause fluid retention and worsen heart failure; not recommended in NYHA III/IV heart failure; monitor for weight gain/oedema and breathlessness. Possible increased fracture risk; monitor for visual changes (macular oedema). Avoid/use caution in liver disease; periodic liver function tests. Not for type 1 diabetes or diabetic ketoacidosis.

Alcohol (increases hypoglycaemia and lactic acidosis risk), insulin/other antidiabetics (additive hypoglycaemia), beta-blockers (mask hypoglycaemia symptoms), corticosteroids and thiazide/loop diuretics (raise glucose), rifampicin (reduces pioglitazone effect), gemfibrozil (increases pioglitazone levels), miconazole/fluconazole (increase sulfonylurea effect), ACE inhibitors (may enhance glucose-lowering), iodinated contrast media (metformin—lactic acidosis risk), cationic drugs eliminated by renal tubular secretion e.g., cimetidine (increase metformin levels)

Store below 25°C, protect from moisture and light, keep in original strip/container. Keep out of reach of children.

Glycomet GP 2 Forte, Glimestar MP 2, Amaryl M 2, Glimepiride+Metformin+Pioglitazone 2/500/15 tablets (generic equivalents), Gluconorm PG 2 (brand variants)