Glucovance: Comprehensive Guide to Uses, Dosage, and Side Effects
Glucovance is an oral medication designed for the treatment of type 2 diabetes. It contains two active ingredients: metforminklorid (a biguanide) and glibenklamid (a sulfonylurea). This combination helps control blood sugar levels in adults who require both medications for effective management of diabetes.
Composition
Each film-coated tablet of Glucovance contains:
- 500 mg metforminklorida (equivalent to 390 mg metformin)
- 2.5 mg or 5 mg glibenklamida
Other ingredients include microcrystalline cellulose, povidon K30, magnezijev stearat, and Opadry film coating components.
Indications
Glucovance is prescribed for adults with type 2 diabetes when diet, exercise, and previous oral treatments with metforminklorid and glibenklamid separately have successfully controlled blood sugar levels. It is taken orally to help lower blood glucose to normal levels.
Contraindications: When Not to Use Glucovance
Do not take Glucovance if you:
- Are allergic to metforminklorid, glibenklamid, or any sulfonamides.
- Have significantly reduced kidney function.
- Suffer from liver disorders.
- Have type 1 diabetes.
- Have uncontrolled diabetes with severe hyperglycemia [high blood sugar], nausea, vomiting, diarrhea, or rapid weight loss.
- Have lactic acidosis [a dangerous condition caused by lactic acid buildup in the blood].
- Have ketoacidosis [a life-threatening condition where excessive ketones accumulate in the blood].
- Have severe infections or dehydration.
- Have severe circulatory or breathing problems, including recent heart failure or heart attack.
- Have porphyria [a rare hereditary disorder affecting hemoglobin production].
- Consume excessive amounts of alcohol.
- Are pregnant or breastfeeding.
Warnings and Precautions
Risk of Lactic Acidosis
Lactic acidosis is a rare but serious side effect of Glucovance, especially in cases of kidney impairment, dehydration, alcohol consumption, or oxygen deprivation. Symptoms include:
- Vomiting
- Abdominal pain
- Muscle cramps
- Severe fatigue
- Shortness of breath
- Slowed heart rate
If you experience these symptoms, stop taking Glucovance immediately and seek medical attention.
Risk of Hypoglycemia
Glucovance can cause hypoglycemia [low blood sugar], leading to symptoms such as:
- Sweating
- Pale skin
- Dizziness
- Headache
- Rapid heartbeat
- Intense hunger
- Blurred vision
- Fatigue
To prevent hypoglycemia, ensure regular meals, avoid excessive alcohol consumption, and monitor your blood sugar levels.
Special Considerations
- If undergoing a radiological examination involving iodine-based contrast agents, Glucovance must be stopped before the procedure.
- If planning surgery under general anesthesia, Glucovance should be discontinued beforehand.
- Elderly patients and those with kidney problems require careful dose adjustments.
Dosage and Administration
- The initial dose depends on prior metforminklorid and glibenklamid intake.
- The usual starting dose is one tablet per day, adjusted based on blood glucose levels.
- The maximum daily dosage:
- Glucovance 500 mg/2.5 mg: 6 tablets
- Glucovance 500 mg/5 mg: 3–4 tablets
How to Take Glucovance
- Take Glucovance with meals to reduce digestive side effects.
- Do not chew or crush tablets; swallow them whole with water.
- If taking Glucovance with bile acid sequestrants (cholesterol-lowering medications), wait at least 4 hours between doses.
Missed Dose
- If you forget a dose, take it at the next scheduled time.
- Do not double the dose to compensate for a missed one.
Overdose
Taking too much Glucovance may cause lactic acidosis or severe hypoglycemia. Seek immediate medical attention if symptoms arise.
Possible Side Effects
Like all medications, Glucovance may cause side effects.
Common Side Effects
- Digestive issues: Nausea, vomiting, diarrhea, abdominal pain, loss of appetite.
- Taste disturbances
- Vitamin B12 deficiency, which may cause fatigue, numbness, and pale skin.
Uncommon Side Effects
- Abnormal kidney function tests
- Porphyria crisis in susceptible individuals
Rare and Very Rare Side Effects
- Severe blood disorders: Low white blood cell count, low platelets, anemia.
- Liver disorders: Hepatitis, jaundice, abnormal liver function tests.
- Severe skin reactions: Rash, sun sensitivity, allergic reactions.
- Alcohol intolerance: Flushing, nausea, palpitations.
- Low sodium levels: Weakness, confusion, muscle spasms, seizures.
Drug Interactions
Avoid using Glucovance with:
- Miconazole (antifungal medication)
- Diuretics (increase urine output)
- NSAIDs (e.g., ibuprofen, celecoxib)
- Beta-blockers (heart medication)
- Certain asthma medications (e.g., salbutamol)
- Bosentan (for pulmonary hypertension)
- Corticosteroids (for inflammation)
- Fluconazole (antifungal treatment)
- Chlorpromazine (antipsychotic drug)
- Danazol (for endometriosis)
Always inform your doctor about all medications you are taking.
Storage Instructions
- Keep Glucovance out of reach of children.
- Store at room temperature.
- Do not use beyond the expiration date.
- Dispose of unused medication safely—ask your pharmacist how to do so.
Additional Information
- Glucovance 500 mg/2.5 mg: Orange, capsule-shaped tablet with “2.5” imprint.
- Glucovance 500 mg/5 mg: Yellow, capsule-shaped tablet with “5” imprint.
- Packaged in blister packs of 30 tablets.
- Manufactured by Merck Santé, France.
Conclusion
Glucovance is an effective combination therapy for type 2 diabetes. It helps regulate blood sugar levels when metforminklorid and glibenklamid are required together. However, it carries risks such as hypoglycemia and lactic acidosis, requiring careful monitoring. Always follow your doctor’s instructions and report any unusual symptoms promptly.
References: Glucovance Package Insert
جلوكوفانس: الفوائد والآثار الجانبية ونصائح الخبراء لإدارة مرض السكري
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