Generic Name: glimepiride and pioglitazone (glye MEP ir ide and PYE oh GLI ta zone)Brand Names: Duetact
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. Glimepiride and pioglitazone is sometimes given with other diabetes medications when greater blood sugar control is needed.
This medication is not for treating type 1 diabetes.
Glimepiride and pioglitazone may also be used for other purposes not listed in this medication guide.What is the most important information I should know about glimepiride and pioglitazone?You should not use this medication if you are allergic to glimepiride or pioglitazone, if you have severe heart failure, or if you are in a state of diabetic ketoacidosis.
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.Taking certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of treating your diabetes with glimepiride and pioglitazone. Know the signs of low blood sugar (hypoglycemia) and how to recognize them, including hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma (severe hypoglycemia can be fatal). Always keep a source of sugar available in case you have symptoms of low blood sugar.What should I discuss with my health care provider before taking glimepiride and pioglitazone?You should not use this medication if you are allergic to glimepiride (Amaryl, Avandaryl) or pioglitazone (Actos), or if you have:
severe heart failure; or
if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
If you have any of these other conditions, you may need a dose adjustment or special tests to safely take glimepiride and pioglitazone:
congestive heart failure or heart disease;
a history of heart attack or stroke; or
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. Follow the directions on your prescription label. 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. Do 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.Know the signs of low blood sugar (hypoglycemia) and how to recognize them:
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.If your blood sugar gets too high (hyperglycemia), you may feel very thirsty or hungry. You may also urinate more than usual. Call your doctor right away if you have any symptoms of hyperglycemia. Store glimepiride and pioglitazone at room temperature, protected from moisture, heat, and light.
See also: Glimepiride and pioglitazone dosage in more detail
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.
Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).
swelling in your feet, rapid weight gain, feeling short of breath (even with mild exertion);
pale skin, easy bruising or bleeding;
pain or burning when you urinate; or
dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
nausea, vomiting, weakness, loss of appetite, feeling restless or irritable, confusion, hallucinations, muscle pain or weakness, and/or seizure.
Less serious side effects may include:
sneezing, stuffy nose, cough, sore throat, or other cold symptoms;
gradual weight gain;
mild nausea, diarrhea;
headache, dizziness, blurred vision;
tooth problems; or
mild itching or skin rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Diabetes Mellitus Type II:
The initial dosage of glimepiride recommended for this patient with diabetes mellitus type II is based on the patient's current regime of pioglitazone and /or sulfonylurea.For patients currently on glimepiride monotherapy, glimepiride-pioglitazone may be initiated at 30 mg/2 mg or 30 mg/4 mg tablet strengths once daily, and adjusted after assessing adequacy of therapeutic response.For patients currently on pioglitazone monotherapy, glimepiride-pioglitazone may be initiated at 30 mg-2 mg or 30 mg-4 mg tablet strengths once daily, and adjusted after assessing adequacy of therapeutic response.For patients currently on a different sulfonylurea monotherapy or switching from combination therapy of pioglitazone plus a different sulfonylurea (e.g. glyburide, glipizide, chlorpropamide, tolbutamide, acetohexamide), glimepiride-pioglitazone should be limited initially to a starting dose of 30 mg/2 mg once daily, and adjusted after assessing adequacy of therapeutic response.For patients switching from combination therapy of pioglitazone plus glimepiride as separate tablets, glimepiride-pioglitazone may be initiated with 30 mg/2 mg or 30 mg/4 mg tablet strengths based on the dose of pioglitazone and glimepiride already being taken. Patients who are not controlled with 15 mg of pioglitazone in combination with glimepiride should be carefully monitored when switched to glimepiride-pioglitazone.
Before taking glimepiride and pioglitazone, tell your doctor if you are taking:
nicardipine (Cardene) or nifedipine (Adalat, Procardia); or
rifampin (Rifadin, Rimactane, Rifater); or
fluconazole (Diflucan), ketoconazole (Nizoral).
Using certain medicines can make it harder for you to tell when you have low blood sugar. Tell your doctor if you use any of the following:
albuterol (Proventil, Ventolin);
beta-blockers such as atenolol (Tenormin), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others.
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:
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:
some nonsteroidal anti-inflammatory drugs (NSAIDs);
aspirin or other salicylates (including Pepto-Bismol);
sulfa drugs (Bactrim, Gantanol, Septra, and others); and
a monoamine oxidase inhibitor (MAOI).
This list is not complete and there may be other drugs that can interact with 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.