Tablets
Chemical Name: GLIPIZIDE (GLIP-I-zide) and METFORMIN (met-FOR-min)

Common uses
This medicine is a sulfonylurea and biguanide combination used along with a diet and exercise program to control high blood sugar in diabetic patients. Controlling high blood sugar helps prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (impotence).

Before using
WARNING: Metformin can cause a condition called lactic acidosis. Though occurring rarely, lactic acidosis can be fatal. Stop using this drug and seek immediate medical help if you develop any of the following symptoms of lactic acidosis: unusual tiredness (fatigue), weakness, or stomach discomfort; muscle pain, breathing trouble; feeling cold (low body temperature), dizzy or lightheaded; or a slow or irregular heartbeat. Lactic acidosis is more likely to occur in patients who: have heart failure, kidney or liver problems; are elderly; use alcohol excessively; are seriously dehydrated (lack body fluids); will undergo x-ray procedures that require an injectable contrast drug; will have surgery; develop a serious infection, heart attack or stroke; are over 80 years of age and have not had kidney and liver tests. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking other diabetes drugs (e.g., insulin, rosiglitazone), beta-blockers (e.g., propranolol), "water pills" (diuretics such as hydrochlorothiazide, furosemide), cimetidine, birth control pills, estrogens, corticosteroids (e.g., prednisone), niacin, phenytoin, decongestants (e.g., pseudoephedrine), calcium channel blockers (e.g., nifedipine), phenothiazines (e.g., chlorpromazine), isoniazid, thyroid drugs, aspirin-like drugs, non-steroidal anti-inflammatory drugs (NSAIDs), azole antifungals (e.g., fluconazole, ketoconazole), warfarin, MAO inhibitors, probenecid, chloramphenicol, diazoxide, clofibrate, rifampin, sulfonamides (e.g., sulfa antibiotics), fenugreek, ginseng. Inform your doctor of any other medical conditions including blood disorders (e.g., anemia, vitamin B-12 deficiency), high blood pressure, scheduled upcoming surgery, alcohol use, allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you are being treated for heart failure, or have a history of acidosis, Type I diabetes (insulin-dependent diabetes), liver or kidney disease. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions
Follow the directions for using this medicine provided by your doctor. This medicine comes with a patient information leaflet. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. TAKE THIS MEDICINE with a meal. STORE THIS MEDICINE at room temperature between 68 and 77 degrees F (20 and 25 degrees C) in a tightly-closed container, away from heat, moisture, and light. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. CONTINUE TO TAKE THIS MEDICINE even if you feel well. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do NOT take 2 doses at once.

Cautions
DO NOT STOP USING THIS MEDICINE without first checking with your doctor. DO NOT EXCEED THE RECOMMENDED DOSE without checking with your doctor. FOLLOW THE DIETARY PLAN provided by your doctor. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS (e.g., liver and kidney function tests, fasting blood glucose, glycosylated hemoglobin, complete blood counts) while you are using this medicine. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, LABORATORY TESTS, OR SURGERY, tell the doctor or dentist that you are using this medicine. DO NOT DRINK ALCOHOL without first discussing it with your doctor. THIS MEDICINE MAY CAUSE increased sensitivity to the sun. Avoid exposure to the sun or sunlamps until you know how you react to this medicine. Use a sunscreen or protective clothing if you must be outside for a prolonged period. DURING TIMES OF STRESS, such as fever, infection, injury or surgery, it may be more difficult to control your blood sugar. Consult your doctor, as a change in your medicine may be required. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. CAUTION IS ADVISED WHEN USING THIS MEDICINE in the elderly because they may be more sensitive to the effects of the drug. FOR WOMEN: THIS MEDICINE MAY CAUSE HARM to the human fetus. IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. IT IS UNKNOWN IF THIS MEDICINE IS EXCRETED in breast milk. DO NOT BREAST-FEED while taking this medicine.

Possible side effects
SIDE EFFECTS, that may go away during treatment, include metallic taste in mouth, nausea, vomiting, diarrhea, or stomach upset. If stomach symptoms recur later (after you are on the same dose for several days or more), tell your doctor immediately. A late recurrence of stomach symptoms may be due to lactic acidosis. (see Before Using This Medicine section). Headache, back pain, joint pain, weight gain, increased sensitivity to sunlight, cough or fever may also occur. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience unusual tiredness or weakness, trouble breathing, stomach pain, yellowing eyes or skin, dark urine, unusual bleeding or bruising, persistent sore throat or fever, unusual change in the amount of urine. This medication can cause low blood sugar (hypoglycemia). The symptoms include chills, cold sweat, dizziness, drowsiness, shaking, rapid heart rate, weakness, headache, fainting, tingling of the hands or feet, or hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you are in a situation where you don't have these reliable forms of glucose, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or non-diet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction. To help prevent hypoglycemia, eat meals on a regular schedule and do not skip meals. Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor. If these symptoms occur, tell your doctor immediately. Your medication dosage may need to be increased. AN ALLERGIC REACTION TO THIS MEDICINE IS UNLIKELY, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other.

If you take too much
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include sweating, shakiness, vision changes, rapid or trouble breathing, severe drowsiness, or slow or irregular heartbeat.

Additional information
Proper diet, regular exercise, and regular testing of blood sugar are important for best results when using this medicine. Follow your doctor's instructions carefully. It is recommended you attend a diabetes education program to better understand diabetes, prevention of complications, and all the important aspects of its treatment. These include meals/diet, exercise, weight loss, personal hygiene, medications and blood glucose monitoring, and the need for regular eye, foot, and medical exams. Carry an identification card at all times that says you are diabetic. Monitor your blood sugar levels regularly according to your doctor's directions. If you blood sugar level is often higher than it should be and you are taking this medicine according to directions, check with your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.
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