What is this medicine?

This is a combination tablet for Type 2 Diabetes.
It contains:

1. Glimepiride (2 mg) – increases insulin release from the pancreas.
2. Metformin (850 mg) – reduces sugar production in the liver and helps your body use insulin better.

This dose is considered strong, especially because Glimepiride is 2 mg and Metformin is 850 mg.

How does it work?

1. Glimepiride (2 mg)

• Helps your pancreas release more insulin.
• Controls blood sugar mainly after eating.
• Works fast to lower high sugar.

2. Metformin (850 mg)

• Reduces liver sugar production.
• Improves insulin sensitivity (your body uses insulin better).
• Slows sugar absorption from food.
• Does not cause weight gain.

Together, they control fasting sugar + post-meal sugar effectively.

Why do doctors prescribe this combination?

Doctors choose this dose when:

• Lower doses (like 1 mg glimepiride or 500/750 mg metformin) are not enough.
• Blood sugar is moderately or strongly high.
• A patient needs better full-day sugar control.
• To reduce long-term complications of diabetes:
  • Heart problems
  • Kidney damage
  • Nerve damage
  • Eye problems

This dose gives stronger sugar control due to the higher glimepiride (2 mg).

How to take it

• Usually once or twice daily with food.
• Most common:
  • Once daily with breakfast
    OR
  • Twice daily (breakfast + dinner)
• Swallow tablet whole with water.

Important:
Do NOT skip meals.
Glimepiride may cause low blood sugar if you take it but do not eat.

Common side effects

From Glimepiride (2 mg)

• Low blood sugar (hypoglycemia)
  Symptoms:
  • Sweating
  • Shaking
  • Hunger
  • Dizziness
  • Headache
  • Fast heartbeat
• Mild weight gain

From Metformin (850 mg)

• Stomach upset:
  • Gas
  • Nausea
  • Loose stools
  • Stomach discomfort
• Metallic taste

Side effects usually reduce after a few days of use.

Serious but rare side effects

• Severe low blood sugar, especially if meals are skipped.
• Lactic acidosis (rare but serious, related to Metformin)
  Symptoms: severe tiredness, fast breathing, muscle pain → urgent medical help required.
• Allergic reaction (rash, swelling, difficulty breathing)

Who should avoid or use this with caution

• People with severe kidney problems
• Severe liver disease
• Heavy alcohol drinkers
• Pregnant or breastfeeding women (use only if doctor approves)
• People who vomit often or have dehydration
• Those undergoing CT scan with contrast dye (may need temporary stop)

What to monitor

• Fasting blood sugar
• Post-meal sugar
• HbA1c (every 3 months)
• Kidney function tests
• Symptoms of low blood sugar

Important precautions

• Eat meals on time; do not skip food.
• Limit or avoid alcohol.
• Stay hydrated.
• Inform doctor before surgery or scan with contrast dye.
• Do not stop the medicine suddenly.