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Generic Name: glimepiride and pioglitazone (GLYE me pye ride and pye oh GLI ta zone)
Brand Names: Duetact

What is glimepiride and pioglitazone?

Glimepiride and pioglitazone is a combination of two oral diabetes medicines that help control blood sugar levels.

Glimepiride and pioglitazone is for people with type 2 diabetes who do not use daily insulin injections. This medication is not for treating type 1 diabetes.

Glimepiride and pioglitazone may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about glimepiride and pioglitazone?

Before taking glimepiride and pioglitazone, tell your doctor if you have congestive heart failure or heart disease, a history of heart attack or stroke, liver disease, or kidney disease.

Glimepiride and pioglitazone is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

What should I discuss with my health care provider before taking glimepiride and pioglitazone?

Before taking glimepiride and pioglitazone, tell your doctor if you are allergic to any drugs, or if you have:

• congestive heart failure or heart disease;

• a history of heart attack or stroke;

• liver disease; or

• kidney disease.

If you have any of these conditions, you may not be able to use glimepiride and pioglitazone, or you may need a dosage adjustment or special tests during treatment.

How should I take glimepiride and pioglitazone?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take glimepiride and pioglitazone with your first meal of the day.

Glimepiride and pioglitazone is only part of a complete program of treatment that also includes diet, exercise, and weight control. It is important to use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested, and you may need regular eye exams. It is important that you not miss any scheduled visits to your doctor.

Your medication needs may change if you become sick or injured, if you have a serious infection, or if you have any type of surgery. Your doctor may want you to stop taking glimepiride and pioglitazone for a short time if any of these situations affect you.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

• hunger, headache, confusion, irritability;

• drowsiness, weakness, dizziness, tremors;

• sweating, fast heartbeat;

• seizure (convulsions); or

• fainting, coma (severe hypoglycemia can be fatal).

Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

What happens if I miss a dose?

Take the missed dose as soon as you remember (be sure to take the medicine with food). If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

What should I avoid while taking glimepiride and pioglitazone?

Glimepiride and pioglitazone side effects

• feeling short of breath, even with mild exertion;

• swelling in your feet, rapid weight gain;

• pain or burning when you urinate; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Other less serious side effects may be more likely to occur, such as:

• sneezing, runny nose, cough, sore throat, or other signs of a cold;

• muscle pain;

• pale skin, easy bruising;

• headache, blurred vision;

• dizziness, weakness;

• mild nausea, vomiting, diarrhea, stomach pain; or

• mild itching or skin rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect glimepiride and pioglitazone?

Before taking glimepiride and pioglitazone, tell your doctor if you are taking:

• gemfibrozil (Lopid);

• nifedipine (Adalat, Procardia); or

• rifampin (Rifadin, Rimactane, Rifater).

You may be more likely to have hyperglycemia (high blood sugar) if you are taking glimepiride and pioglitazone with other drugs that raise blood sugar. Drugs that can raise blood sugar include:

• isoniazid;

• diuretics (water pills);

• steroids (prednisone and others);

• phenothiazines (Compazine and others);

• thyroid medicine (Synthroid and others);

• birth control pills and other hormones;

• seizure medicines (Dilantin and others); and

• diet pills or medicines to treat asthma, colds or allergies.

You may be more likely to have hypoglycemia (low blood sugar) if you are taking glimepiride and pioglitazone with other drugs that lower blood sugar. Drugs that can lower blood sugar include:

• nonsteroidal anti-inflammatory drugs (NSAIDs);

• aspirin or other salicylates (including Pepto-Bismol);

• sulfa drugs (Bactrim and others);

• a monoamine oxidase inhibitor (MAOI);

• beta-blockers (Tenormin and others); or

• probenecid (Benemid).

There may be other drugs not listed that can affect glimepiride and pioglitazone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about glimepiride and pioglitazone written for health professionals that you may read.

What does my medication look like?

Glimepiride and pioglitazone is available with a prescription under the brand name Duetact. Other brand or generic forms may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Duetact 30 mg/2mg--white, round tablet, "30/2" imprint

• Duetact 30 mg/4mg--white, round tablet, "30/4" imprint

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.