Glimepiride/pioglitazone (By mouth)

Introduction

Glimepiride (GLYE-me-pye-ride), Pioglitazone Hydrochloride

Treats type 2 diabetes. Used together with proper diet and exercise to help control your blood sugar.

Brand Name(s)

Duetact

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to glimepiride or pioglitazone. This medicine should not be used in patients with type 1 diabetes, diabetic ketoacidosis (ketones in the blood), or severe heart failure.

How to Use This Medicine

Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• It is best to take this medicine with food or milk. Take this medicine with the first meal of the day.
• Carefully follow your doctor's instructions about any special diet.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• There are many other drugs that can interact with glimepiride or pioglitazone. Make sure your doctor knows about all other medicines you are using. These especially include other medicines to treat your diabetes, beta-blocker medicines (such as metoprolol, propranolol, Inderal®, Lopressor®, or Tenormin®), pain or arthritis medicines (such as aspirin, Advil®, or Celebrex®), isoniazid, nicotinic acid, cotrimoxazole (such as Bactrim®, Cotrim®, or Septra®), or midazolam (Versed®).
• Make sure your doctor knows if you are using chloramphenicol, warfarin (Coumadin®), probenecid, phenytoin (Dilantin®), steroids (such as methylprednisolone, prednisone, or Medrol®), or phenothiazines (such as prochlorperazine, Compazine®, Phenergan®, or Thorazine®). Tell your doctor if you are also using gemfibrozil (Lopid®), miconazole (Lotrimin® AF, Monistat® 3), fluconazole (Diflucan®), rifampin (Rifadin®, Rimactane®), hormone replacement therapy, thyroid replacement therapy, diuretics or "water pills" (such as Lasix® or Dyazide®), birth control pills, or a MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate®.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney problems, liver disease, heart or blood vessel disease, an adrenal or pituitary gland problem, or edema (problems with fluid retention and swelling).
• If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. If you have symptoms of low blood sugar (hypoglycemia), check your blood sugar. If your blood sugar is 70 mg/dL (milligrams per deciliter) or below, do one of the following: Drink 4 ounces (one-half cup) of fruit juice, or eat 5 to 6 pieces of hard candy, or take 2 to 3 glucose tablets. Re-check your blood sugar 15 minutes later. If your blood sugar is above 70 mg/dL, eat a snack or a meal. If your blood sugar is still below 70 mg/dL, drink one-half cup juice, or eat 5 to 6 pieces of candy, or take 2 to 3 glucose tablets. Carry candy or some type of sugar with you at all times, especially if you are away from home. You can take this if you feel that your blood sugar is too low, even if you do not have a blood glucose meter. Always carefully follow your doctor's instructions about how to treat your low blood sugar. Learn what to do if your blood sugar gets too low. Teach friends, co-workers, and family members what they can do to help if you have low blood sugar.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
• If your symptoms do not improve or if they get worse, call your doctor.
• Women: If you have had problems ovulating before, this medicine may cause you to ovulate. This could increase your chance of becoming pregnant. Talk with your doctor if you have questions or concerns about this.
• Check with your doctor if blurred vision, decreased vision, or any other change in vision occurs during your treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
• This medicine may increase the risk of bone fractures in women. Ask your doctor about ways to keep your bones strong to help prevent fractures.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
• This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blurred vision or other changes in vision.
• Burning or painful urination.
• Dark-colored urine or pale stools.
• Fever, chills, runny or stuffy nose, cough, sore throat, and body aches.
• Lightheadedness, dizziness, shakiness, or hunger.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Pain or swelling in arms or legs without any injury.
• Rapid weight gain.
• Shortness of breath, cold sweats, and bluish-colored skin.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea, mild nausea or vomiting.
• Headache.
• Muscle pain.
• Problems with your teeth.