GLIBENCLAMIDE + METFORMIN

Glibenclamide: Glibenclamide, also known as glyburide, is an oral medication used primarily to treat type 2 diabetes.

Mechanism of action: Glibenclamide belongs to the class of drugs called sulfonylureas. It works by stimulating the release of insulin from the pancreas and increasing the sensitivity of peripheral tissues to insulin. This helps lower blood sugar levels by facilitating the uptake of glucose into cells and reducing glucose production in the liver.

Use: Glibenclamide is indicated for the management of type 2 diabetes when diet and exercise alone are not sufficient to control blood glucose levels. It is generally used as an adjunct to diet and exercise in combination with other antidiabetic medications like metformin or insulin, in order to achieve glycemic control.

Dose: The dosage of glibenclamide is individualized and depends on various factors, including the patient’s blood sugar levels, response to treatment, and other medications they may be taking. Typically, the starting dose is 2.5 mg once daily, which can be gradually increased if necessary. The maximum recommended daily dose is usually 20 mg.

Side effects: Like any medication, glibenclamide can cause side effects. Common side effects may include nausea, vomiting, diarrhea, dizziness, headache, and hypoglycemia (low blood sugar). Hypoglycemia is the most significant risk associated with glibenclamide use and can manifest as symptoms such as shakiness, sweating, confusion, blurred vision, and weakness. Severe hypoglycemia can lead to unconsciousness, seizures, and even death if not promptly treated. Other less common side effects may include skin rash, itching, and gastrointestinal disturbances. It is important to monitor blood sugar levels regularly while taking glibenclamide and seek medical attention if any concerning side effects occur.

Metformin: Metformin is a medication prescribed for the management of type 2 diabetes. It is also sometimes used off-label for polycystic ovary syndrome (PCOS) and gestational diabetes.

Metformin works by decreasing the amount of glucose produced by the liver and enhancing the body’s sensitivity to insulin. It belongs to a class of medications called biguanides. Unlike other diabetes medications, metformin does not increase the production of insulin in the pancreas. Instead, it improves insulin utilization in the body, leading to better control of blood sugar levels.

The usual starting dose of metformin for adults is 500 mg or 850 mg, taken orally once or twice daily with meals. The dose can be gradually increased based on blood sugar control, up to a maximum of 2,550 mg per day. Extended-release formulations are also available, which are taken once daily.

Common side effects of metformin include gastrointestinal symptoms such as diarrhea, nausea, vomiting, and abdominal discomfort. These side effects are usually mild and transient. To reduce these effects, the medication should be taken with meals. Lactic acidosis, a rare but potentially serious side effect, may occur in people with severe renal impairment or other underlying conditions. Symptoms of lactic acidosis include muscle pain, irregular heartbeat, rapid breathing, and feeling cold or dizzy.

Other infrequent side effects may include vitamin B12 deficiency, metallic taste in the mouth, and skin reactions. It is important to discuss any concerning side effects with a healthcare provider.

Metformin is generally well-tolerated and is considered a first-line therapy for the management of type 2 diabetes. However, it is important to consult with a healthcare professional for individualized advice and dosing instructions based on the specific condition and medical history.