ZORYL MP-2

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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.