Metglip Plus
Generic Name
Metformin Hydrochloride + Glimepiride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metglip plus 25 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Metglip Plus is a combination oral antidiabetic medication containing Metformin and Glimepiride, used to improve glycemic control in adults with type 2 diabetes mellitus when diet and exercise alone do not provide adequate control.
Uses & Indications
Dosage
Adults
Usually 1 tablet once or twice daily with meals. Dosage should be individualized based on the patient's current regimen, effectiveness, and tolerability, up to a maximum daily dose specified for individual components.
Elderly
Initial dosage should be conservative, starting with the lowest effective dose due to potential decreased renal function.
Renal_impairment
Contraindicated in severe renal impairment (eGFR < 30 mL/min/1.73 m²). For moderate impairment (eGFR 30-45 mL/min/1.73 m²), reduce dose and monitor renal function closely. Not recommended to initiate if eGFR is <45 mL/min/1.73 m².
How to Take
Take orally with meals to reduce gastrointestinal side effects and ensure optimal absorption, especially the first meal of the day.
Mechanism of Action
Metformin reduces hepatic glucose production, decreases intestinal glucose absorption, and improves insulin sensitivity. Glimepiride stimulates insulin release from the pancreatic beta cells.
Pharmacokinetics
Onset
Glucose-lowering effect of Metformin typically begins within hours. Glimepiride's effect starts within 2-3 hours.
Excretion
Metformin is excreted unchanged in the urine. Glimepiride metabolites are excreted in urine and feces.
Half life
Metformin has an elimination half-life of approximately 6.2 hours. Glimepiride has a half-life of 5-9 hours.
Absorption
Metformin is slowly and incompletely absorbed from the GI tract (absolute bioavailability ~50-60%). Glimepiride is completely absorbed from the GI tract.
Metabolism
Metformin is not metabolized. Glimepiride is completely metabolized in the liver by CYP2C9.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Diabetic ketoacidosis
- Hypersensitivity to Metformin, Glimepiride, or other sulfonylureas
- Acute or chronic metabolic acidosis, including lactic acidosis
- Severe hepatic impairment
Drug Interactions
Alcohol
Increases risk of lactic acidosis with Metformin and hypoglycemia with Glimepiride.
Iodinated Contrast Agents
Temporarily discontinue Metformin before or at the time of an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73 m².
Cationic Drugs (e.g., Cimetidine, Ranitidine, Amiloride)
May increase Metformin levels.
Corticosteroids, Diuretics, Estrogens, Oral Contraceptives, Phenytoin, Thyroid Hormones
May decrease the hypoglycemic effect of Glimepiride.
Certain NSAIDs, Salicylates, Sulfonamides, Chloramphenicol, Coumarins, Probenecid, Beta-blockers
May potentiate the hypoglycemic effect of Glimepiride.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose can lead to severe hypoglycemia (due to Glimepiride) and lactic acidosis (due to Metformin). Treatment involves symptomatic and supportive measures. Glucose should be administered for hypoglycemia. Hemodialysis can be used to remove Metformin.
Pregnancy & Lactation
Not recommended during pregnancy due to potential fetal harm; insulin is preferred. Caution during lactation as Metformin is excreted in breast milk. Glimepiride's effect on infants is unknown.
Side Effects
Contraindications
- Severe renal impairment (eGFR < 30 mL/min/1.73 m²)
- Diabetic ketoacidosis
- Hypersensitivity to Metformin, Glimepiride, or other sulfonylureas
- Acute or chronic metabolic acidosis, including lactic acidosis
- Severe hepatic impairment
Drug Interactions
Alcohol
Increases risk of lactic acidosis with Metformin and hypoglycemia with Glimepiride.
Iodinated Contrast Agents
Temporarily discontinue Metformin before or at the time of an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73 m².
Cationic Drugs (e.g., Cimetidine, Ranitidine, Amiloride)
May increase Metformin levels.
Corticosteroids, Diuretics, Estrogens, Oral Contraceptives, Phenytoin, Thyroid Hormones
May decrease the hypoglycemic effect of Glimepiride.
Certain NSAIDs, Salicylates, Sulfonamides, Chloramphenicol, Coumarins, Probenecid, Beta-blockers
May potentiate the hypoglycemic effect of Glimepiride.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose can lead to severe hypoglycemia (due to Glimepiride) and lactic acidosis (due to Metformin). Treatment involves symptomatic and supportive measures. Glucose should be administered for hypoglycemia. Hemodialysis can be used to remove Metformin.
Pregnancy & Lactation
Not recommended during pregnancy due to potential fetal harm; insulin is preferred. Caution during lactation as Metformin is excreted in breast milk. Glimepiride's effect on infants is unknown.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by health authorities (e.g., DGDA, FDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Metformin and Glimepiride as monotherapies and in combination for type 2 diabetes management.
Lab Monitoring
- HbA1c levels (every 3-6 months)
- Fasting and postprandial blood glucose levels
- Renal function (eGFR) periodically
- Liver function tests
- Hematological parameters (e.g., Vitamin B12 levels)
Doctor Notes
- Emphasize patient education on hypoglycemia symptoms and management.
- Regularly monitor renal function, especially in elderly and patients with pre-existing renal impairment.
- Advise patients about the risk of lactic acidosis and symptoms requiring immediate medical attention.
- Consider Vitamin B12 supplementation for long-term Metformin users.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Take it with a meal to reduce stomach upset.
- Be aware of symptoms of hypoglycemia and know how to treat them.
- Do not skip meals and maintain a regular diet.
- Avoid excessive alcohol consumption.
- Inform your doctor if you experience any unusual symptoms or side effects.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine can cause hypoglycemia, which may impair your ability to drive or operate machinery. Exercise caution and monitor blood glucose levels before driving.
Lifestyle Advice
- Maintain a healthy and balanced diet as advised by your healthcare provider.
- Engage in regular physical activity suitable for your health condition.
- Monitor your blood glucose levels regularly as instructed.
- Maintain a healthy weight.
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