Metaglip

Metaglip is used for:

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Lowering blood sugar levels in combination with diet and exercise in patients with type 2 diabetes. It may also be used for other conditions as determined by your doctor.

Metaglip is a combination sulfonylurea and biguanide. The sulfonylurea works by stimulating the release of your body's natural insulin from the pancreas. The biguanide works by reducing the amount of sugar that the liver produces and the intestine absorb. It also helps to make your body more sensitive to the insulin that you naturally produce.

Do NOT use Metaglip if:

• you are allergic to any ingredient in Metaglip
• you have kidney disease or kidney problems that may result from conditions such as severe heart problems, heart attack, or severe infection
• you have congestive heart failure that requires treatment with medicine, liver problems, serious infection (eg, sepsis), low levels of oxygen in your blood, or severe dehydration
• you are having a heart attack or stroke
• you have excessive acid levels in your body (eg, active or long-term metabolic acidosis, including diabetic acidosis with or without coma; lactic acidosis), diabetic coma, severe burns, or type 1 diabetes
• you drink large amounts of alcohol
• you will be undergoing surgery or certain medical tests (radiologic testing) using intravenous (IV) contrast materials
• you are in the late stages of pregnancy (at least 1 month before the expected delivery date)
• you are 80 years old or older and have not had a kidney function test

Contact your doctor or health care provider right away if any of these apply to you.

Before using Metaglip :

Some medical conditions may interact with Metaglip . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have heart, blood vessel, breathing, or thyroid problems; high blood pressure; stomach or intestinal problems (eg, blockage, narrowing, paralysis); adrenal problems (eg, hypercorticoidism); or pituitary problems; or you have a history of heart attack or stroke
• if you have low levels of calcium or vitamin B₁₂ in your blood, you do not absorb calcium or vitamin B₁₂ properly from food, or you have abnormal levels of other electrolytes in your blood (eg, potassium)
• if you have recently been injured, have burn wounds or an infection, are in shock, or will be having a medical procedure
• if you are very ill or weak, are dehydrated, have not had proper nutrition, or have diarrhea, fever, or vomiting
• if you regularly drink alcohol

Some MEDICINES MAY INTERACT with Metaglip . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticonvulsants (eg, phenytoin), calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diazoxide, diuretics (eg, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), insulin, isoniazid, niacin, nicotinic acid, phenothiazine (eg, chlorpromazine), rifampin, sympathomimetics (eg, albuterol, epinephrine, pseudoephedrine), or thyroid hormones (eg, levothyroxine) because the risk of high blood sugar and loss of glucose control may be increased
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), anticoagulants (eg, warfarin), azole antifungals (eg, ketoconazole), beta-blockers (eg, propranolol), cimetidine, chloramphenicol, clofibrate, fenfluramine and derivatives, miconazole, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), or sulfonamides (eg, sulfamethoxazole) because the risk of low blood sugar may be increased
• Gemfibrozil because increased or decreased blood sugar levels may occur
• Amiloride, cimetidine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin because they may increase the risk of Metaglip 's side effects
• Medicines that may harm the kidney (eg, aminoglycoside antibiotics [eg, gentamicin], amphotericin B, cyclosporine, tacrolimus, vancomycin) because the risk of their side effects may be increased by Metaglip ; ask your doctor if you are unsure if any of your medicines might harm the kidney

This may not be a complete list of all interactions that may occur. Ask your health care provider if Metaglip may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Metaglip :

Use Metaglip as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Metaglip . Talk to your pharmacist if you have questions about this information.
• Take Metaglip by mouth with food.
• Take Metaglip on a regular schedule to get the most benefit from it. Taking Metaglip at the same time each day will help you remember to take it.
• Continue to take Metaglip even if you feel well. Do not miss any doses.
• If you miss a dose of Metaglip , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Metaglip .

Important safety information:

• Metaglip may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Metaglip with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Avoid alcoholic beverages while using Metaglip because they can increase the risk of developing hypoglycemia (low blood sugar). Rarely, alcohol can interact with Metaglip and cause a serious reaction (disulfiram-like reaction) with symptoms, such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Talk to your doctor before drinking alcohol while you are taking Metaglip .
• Tell your doctor or dentist that you take Metaglip before you receive any medical or dental care, emergency care, or surgery.
• Use of similar medicines has been associated with an increased risk of heart problems. If you experience chest pain, irregular heartbeat, swelling in your hands or feet, or unusual or sudden weight gain, contact your doctor immediately. Talk to your doctor if you have any questions or concerns about taking Metaglip .
• Metaglip may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Metaglip . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• Risk of high or low blood sugar may be increased if you are exposed to periods of stress (eg, fever, infection, surgery, trauma) or during heavy exercise. Contact your health care provider if any of these situations occur. Check with your doctor before beginning any exercise program.
• Monitor blood or urine sugar levels as instructed. If your blood sugars have been under control and then become difficult to manage, contact your doctor as soon as possible.
• Metaglip may cause low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
• Proper diet, regular exercise, and blood sugar testing are important for best results. Metaglip is not a substitute for them. Eat meals on a regular schedule and do not skip meals. Follow the diet and exercise program given to you by your health care provider.
• Be careful not to become dehydrated, especially during hot weather, while you are being active, or if you have vomiting or diarrhea. Dehydration may increase the risk of Metaglip 's side effects.
• Carry an ID card at all times that says you have diabetes and that you take Metaglip .
• Lab tests, including kidney function tests, fasting blood glucose, glycosylated hemoglobin, or complete blood cell counts, may be performed while you use Metaglip . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Metaglip with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sugar (hypoglycemia).
• Metaglip should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Use of Metaglip is not recommended during pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Metaglip while you are pregnant. Do not use Metaglip for at least 1 month before delivery due to the potential for fetal harm. It is not known if Metaglip is found in breast milk. Do not breast-feed while taking Metaglip .

Possible side effects of Metaglip :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; gas; headache; indigestion; nausea; taste changes; vomiting; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; chest pain or discomfort; cold skin; confusion; dark urine; decreased or loss of sensation in the fingers or toes; depression; difficult or rapid breathing; excessive hunger or thirst; fainting; feeling of being cold; fever, chills, or persistent sore throat; general body discomfort; increased drowsiness; increased sweating; leg cramps; lightheadedness; mental or mood changes; muscle pain or weakness; numbness or tingling of the hands, feet, or skin; pounding in the chest; seizure; severe dizziness; shock; slowed, fast, or irregular heartbeat; stomach pain; swelling of the hands or feet; tremor; unusual bruising or bleeding; unusual or sudden weight gain; unusual tiredness or weakness; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http: / / www.aapcc.org / dnn / Resources / FindLocalPoisonCenters / tabid / 130 / Default.aspx), or emergency room immediately. Symptoms may include confusion; dizziness; feeling cold; general body discomfort; increased drowsiness; increased sweating; lightheadedness; muscle pain or weakness; rapid or difficult breathing; severe or persistent nausea or vomiting; slow, fast, or irregular heartbeat; stomach pain; tremor.

Store Metaglip between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Metaglip out of the reach of children and away from pets.

General information:

• If you have any questions about Metaglip , please talk with your doctor, pharmacist, or other health care provider.
• Metaglip is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Metaglip . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

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