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Metaglip

Metaglip is an oral antidiabetic that helps to improve glycemic control in patients with type 2 diabetes mellitus when the patient is unresponsive to monotherapy. The medication is recommended for patients over the age of 18.

Other names for this medication:
Glynase MF

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Active Ingredient:
Glipizide, Metformin

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Also known as:  Glucovance SR.

Description

Metaglip is an antidiabetic medication indicated for the treatment of type 2 diabetes mellitus in patients who cannot improve glycemic control with monotherapy. It consists of two active ingredients - Glipizide and Metformin - which work on lowering blood glucose levels by using different modes that complement each other’s actions.

Glipizide elevates postprandial insulin response of the peripheral tissues and stimulates insulin secretion from the pancreas. Metformin belongs to biguanides and it provides a hypoglycemic effect by reducing the production of hepatic glucose, delaying glucose absorption by the intestine and improving insulin sensitivity.

In order to achieve a full effect of Metaglip, it is recommended to combine the treatment with a healthy diet and regular physical activity.

Indications

Management of non-insulin-dependent diabetes mellitus (NIDDM) in patients whose response to monotherapy is inadequate.

MOA (mechanism of action)

Glipizide is an insulin secretagogue that belongs to the second generation of sulfonylureas. It binds to ATP-sensitive potassium channel receptors on the pancreatic cell surface which results in the reduction of potassium conductance and depolarization of the membrane. This action provokes calcium ion influx through voltage-sensitive calcium channels which raises intracellular concentrations of calcium ions and results in the induction of insulin secretion.

Metformin lowers both basal and postprandial plasma glucose. It operates on AMP-activated protein kinase (AMPK) enhancing the reduction of glucose produced by the liver. By increasing peripheral utilization and uptake of glucose, Metformin lowers levels of glucose absorbed by the intestine and enhances insulin-response of the cells.

Dosage

Metaglip should be taken orally with meals in order to avoid any gastrointestinal disorders. The tablet should be swallowed whole with some water. The accurate dosage should be prescribed by a doctor for each patient individually.

Maximum dose must not exceed 20 mg Glipizide/2000 mg Metformin a day.

Missed dose

If you miss a dose you should take it as soon as you remember about your missing. If it is the time for the next dose you should continue your regular dosing schedule. Do not take a double dose to make up for a forgotten one.

Overdose

An excessive dose of Metaglip can lead to lactic acidosis or hypoglycemia.

If you are experiencing symptoms of hypoglycemia, you should raise your blood sugar right away by consuming oral glucose (e.g., a small bar of sugar cubes, sweet juice, sweetened tea).

If you are experiencing some of the lactic acidosis symptoms (which include vomiting, abdominal pain, muscle cramps, severe tiredness, feeling sick, difficulty in breathing, reduced heartbeat, etc.), contact your healthcare provider immediately, as this condition may lead to a coma.

Storage

Store at room temperature between 20°C and 25°C (68°F and 77°F) away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Metaglip are:

  • hypoglycemia
  • lactic acidosis
  • nausea
  • diarrhea
  • abdominal pain
  • constipation
  • vomiting
  • metallic taste in the mouth
  • skin reactions (e.g., rash, pruritus, urticaria, erythema, flushing)
  • headache
  • dizziness
  • leukopenia
  • agranulocytosis
  • thrombocytopenia
  • hemolytic or aplastic anemia
  • pancytopenia
  • hepatic porphyria reactions
  • low levels of vitamin B12

Side effect occurrence does not only depend on medication you are taking but also on your overall health and other factors.

Contraindications

Do not take Metaglip if:

  • allergic to Glipizide or Metformin or any other ingredients in the formulation;
  • you have a severe hepatic or renal impairment;
  • you suffer from acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma;
  • you’re going to undergo surgery, going to have an injection of a dye or a contrast agent for an X-ray imaging or you’re suffering from dehydration, severe infection, or shock;
  • you suffer from acute alcohol intoxication or alcoholism;
  • you’re pregnant or breastfeeding.

Metaglip is not recommended for use in patients under the age of 18.

Other medicines

Co-administration of Metaglip with insulin, oral Antidiabetics, ACE inhibitors, allopurinol, anabolic steroids and male-sex-hormones, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine, fenyramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAO-inhibitors, miconazole, para-aminosalicylic acid, pentoxifylline (high dose parenteral), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, sulfonamides, tetracyclines, tritoqualine, trofosfamide may lead to hypoglycemia.

Such drugs as acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine (adrenaline) and other sympathomimetic agents, glucagon, laxatives (after protracted use), nicotinic acid (in high doses), estrogens and progestogens, phenothiazines, phenytoin, rifampicin, Thyroid hormones may weaken the blood-lowering effect of Metaglip.

Co-administration of Metaglip with such drugs as phenylbutazone, furosemide, nifedipine, danazol, thiazide, angiotensin enzyme inhibitors (captopril, enalapril), other antidiabetic drugs, beta-blockers, fluconazole, monoamine oxidase inhibitors (MAOIs), sulphonamides and NSAIDs needs to be used with caution and close monitoring in order to avoid undesirable effects.

Consult a doctor before starting the treatment with Metaglip if you’re taking cationic medications that are eliminated by renal tubular secretion.

Q: What is Metaglip used for?

A: Metaglip helps to improve glycemic control in patients with type 2 diabetes mellitus when the patient is unresponsive to monotherapy.

Q: How should I take Metaglip?

A: Metaglip should be taken orally with meals in order to avoid any gastrointestinal disorders. The tablet should be swallowed whole with some water. The accurate dosage should be recommended by a doctor for each patient individually.

Q: Can Metaglip be taken by pregnant or breastfeeding women?

A: Metaglip is not recommended for use in pregnant or breastfeeding women.

Q: Can Metaglip be taken by children?

A: Metaglip is not recommended for use in patients under the age of 18.

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