Duotrol SR Tab 10s

Side Effects of Duotrol SR Tab 10s

Hypoglycaemia; cholestatic jaundice; agranulocytosis; aplastic anaemia; haemolytic anaemia. Blood dyscrasias (reversible), liver dysfunction, hypoglycaemia, GI symptoms, allergic skin reactions. Metformin: Lactic acidosis with alcohol and potentiation of hypoglycaemic effect. Cimetidine and furosemide may increase plasma-metformin levels. Drugs eliminated via renal tubular secretion may increase metformin levels. Potentially Fatal: Glibenclamide: Prolonged hypoglycaemia seen in elderly or debilitated patients with hepatic or renal diseases. Metformin: Lactic acidosis in presence of renal failure and alcoholism.

Drug Interactions

Glibenclamide: Adrenaline, aminoglutethimide, chlorpromazine, corticosteroids, diazoxide, OC and thiazide diuretics diminish hypoglycaemic effect of glibenclamide. ACE inhibitors, alcohol, some analgesics, azole antifungals, coumarin, MAOIs, octreotide, tetracyclines, tricyclic antidepressants increase hypoglycaemic effects of glibenclamide. Metformin: Additive effect with sulphonylureas. Antagonistic effects with diuretics, corticosteroids, phenothiazines, thyroid products, oestrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, Ca channel blockers and isoniazid. Potentially Fatal: Glibenclamide: Warfarin, salicylates, sulphonamides and alcohol potentiate hypoglycaemic effect. Glucocorticoids, diuretics and oestrogen reduce hypoglycaemic effect. Beta-blockers mask early symptoms of hypoglycaemia.

Contraindications

Severe or life-threatening hyperglycaemia; liver disease; severe renal failure; juvenile diabetes, ketoacidosis, pre-coma and diabetic coma; adrenocortical insufficiency. Pregnancy and lactation. Hypersensitivity, cardiac failure, recent MI, CHF. IDDM; severe infection; acute or chronic metabolic acidosis with or without coma; stress, trauma; severe impairment of thyroid function; dehydration, acute or chronic alcoholism.

Mechanism of Action

Glibenclamide stimulates insulin secretion from pancreatic β-cells, reduces hepatic gluconeogenesis and lowers blood-glucose concentrations. Metformin improves glucose tolerance in patients with type 2 DM, lowering both basal and postprandial blood glucose. It decreases hepatic gluconeogenesis, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilisation. Distribution: Glibenclamide: Extensively bound to serum proteins. Metformin: Negligible binding to serum proteins. Excretion: Glibenclamide: Terminal half-life: About 10 hr; excreted in urine and bile (approx 50% by each route).

Special Precautions

Overdosage; elderly; dietary errors; mild to moderate renal and hepatic disorders. Impaired alertness. Avoid alcohol. Carefully monitor blood-glucose concentration.

How to Use

Take orally with food and water, as directed by your physician.

How to Store

Keep in a cool, dry place away from sunlight and moisture.

Safety Concerns

• Alcohol: Avoid during treatment.
• Breastfeeding: Not recommended.
• Pregnancy: Contraindicated.
• Liver/Kidney: Use with caution.

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