Friday 24 June 2011

Duetact


Generic Name: glimepiride and pioglitazone (glye MEP ir ide 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. 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 purposes not listed in this medication guide.


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


Do not take glimepiride and pioglitazone for longer than recommended. Taking this medication for longer than 1 year (12 months) may increase your risk of developing bladder cancer. Talk with your doctor about your specific risk.

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


Take care not to let your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.


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.

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;




  • active bladder cancer; or




  • if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).



To make sure you can safely take glimepiride and pioglitazone, tell your doctor if you have any of these other conditions:



  • congestive heart failure or heart disease;




  • a history of heart attack or stroke; or




  • liver or kidney disease.




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. Some women using glimepiride and pioglitazone have started having menstrual periods, even after not having a period for a long time due to a medical condition. You may be able to get pregnant if your periods restart. Talk with your doctor about the need for birth control. Women may also be more likely than men to have bone fractures in the upper arm, hand, or foot while taking medicine that contains pioglitazone. Talk with your doctor if you are concerned about this possibility. Do not take glimepiride and pioglitazone for longer than recommended. Taking this medication for longer than 1 year (12 months) may increase your risk of developing bladder cancer. Talk with your doctor about your specific risk. FDA pregnancy category C. It is not known whether glimepiride and pioglitazone will harm an unborn baby. Similar diabetes medications have caused severe hypoglycemia in newborn babies whose mothers had used the medication near the time of delivery. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether this medication passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking glimepiride and pioglitazone.

How should I take glimepiride and pioglitazone?


Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results


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. Use this medication regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.


Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office. Visit your doctor regularly.


Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating.

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.


Also watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.


Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, drink alcohol, or skip meals. These things can affect your glucose levels and your dose needs may also change. Your doctor may want you to stop taking the medicine for a short time if you become ill, have a fever or infection, or if you have surgery or a medical emergency.


Ask your doctor how to adjust your glimepiride and pioglitazone dose if needed. Do not change your medication dose or schedule without your doctor's advice. Store at room temperature, protected from moisture, heat, and light.

See also: Duetact dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember (be sure to take the medicine with food). Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A glimepiride and pioglitazone overdose can cause life-threatening hypoglycemia. Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

What should I avoid while taking glimepiride and pioglitazone?


Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment. Avoid exposure to sunlight or tanning beds. Glimepiride and pioglitazone can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Glimepiride and pioglitazone side effects


Stop using glimepiride and pioglitazone and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

  • stomach pain, blood in your urine, painful urination;




  • 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; or




  • tooth problems.



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.


What other drugs will affect glimepiride and pioglitazone?


Tell your doctor about all other medicines you use, especially:



  • gemfibrozil (Lopid);




  • 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);




  • clonidine (Catapres);




  • reserpine; or




  • 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 take glimepiride and pioglitazone with:



  • isoniazid;




  • diuretics (water pills);




  • steroids (prednisone and others);




  • niacin (Advicor, Niaspan, Niacor, Niaspan, Simcor, Slo-Niacin, 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 take glimepiride and pioglitazone with:



  • exenatide (Byetta);




  • probenecid (Benemid);




  • some nonsteroidal anti-inflammatory drugs (NSAIDs);




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




  • a blood thinner such as warfarin (Coumadin, Jantoven);




  • sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others);




  • a monoamine oxidase inhibitor (MAOI); and




  • other oral diabetes medications, especially acarbose (Precose), metformin (Glucophage), miglitol (Glyset), pioglitazone (Actos), or rosiglitazone (Avandia).



These lists are not complete and there are many other medicines that can increase or decrease the effects of glimepiride and pioglitazone on lowering your blood sugar. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More Duetact resources


  • Duetact Side Effects (in more detail)
  • Duetact Dosage
  • Duetact Use in Pregnancy & Breastfeeding
  • Duetact Drug Interactions
  • Duetact Support Group
  • 0 Reviews for Duetact - Add your own review/rating


  • Duetact Prescribing Information (FDA)

  • Duetact Advanced Consumer (Micromedex) - Includes Dosage Information

  • Duetact MedFacts Consumer Leaflet (Wolters Kluwer)

  • Duetact Consumer Overview



Compare Duetact with other medications


  • Diabetes, Type 2


Where can I get more information?


  • Your pharmacist can provide more information about glimepiride and pioglitazone.

See also: Duetact side effects (in more detail)


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