Drug Interaction:
Sulfonylureas- include-
First generation - Acetohexamide, Chlorpropamide, Tolazamide, Tobutamide
Second generation - Glipizide, Glyburide ( Glibenclamide ), GlimepIride,Gliclazide
Refer Chlorpropamide
Interacting drugs - summary
+ Metformin
Alcohol
Alcohol potentiates the effect of metformin on lactate metabolism.
Warn patients against excessive alcohol intake, while receing metformin
Cationic drugs
Cationic drugs( eg amiloride, digoxin, morphine, procainamide,
quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin) eliminated by renal tubular secretion, have the potential for interaction with
metformin careful patient monitoring and dose adjustment of metformin recommended
Cimetidine
Cimetidine caused a 60% increase in peak metformin plasma and
whole blood concentrations and a 40% increase in plasma and
whole blood AUC
Furosemide + Metformin
Furosemide increased the metformin plasma and blood Cmax and
blood AUC , without any significant change in metformin renal clearance
Metformin +Furosemide
When administered with metformin, the Cmax and AUC of
furosemide were smaller than administered alone, and the terminal
half-life decreased, without any significant change in furosemide
renal clearance.
Iodinated contrast material
Parentral contrast studies with iodinated materials can lead to
acute renal failure and have been associated with lactic acidosis
in patients receiving metformin. Therefore withhold metformin for
at least 48 hours prior to and 48 hours subsequent to the procedure
Nifedipine
Co-administration increased plasma metformin Cmax and AUC
respy, and increased the amount excreted in the urine. Nifedipine
appears the absorption of metformin
Indication:
LIST OF DRUGS DURING 2006
Sr.No- 107
Name of the Drug- Glicazide 40mg/80mg+
Metformin Hcl 500mg
Rosiglitazone 2mg tablet Pharmacological Classification- Anti-diabetic
Date of Approval- 22-08-2006
Approved by U.S.FDA on 30-12-2006 (Ref- FDA approved List)
Type II -non insulin dependent diabetes not responsive to diet alone
Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
1.Gliclazide Anti-diabetic November 1988
2.Glicazide 40mg/80mg 19-07-2010
+ Metformin 500mg
+ Pioglitazone 15mg
(Addl.Stgth.)
Anti-diabetic
3. Glicazide 40mg/80mg 22-08-2006
+ Metformin Hcl 500mg
+ Rosiglitazone 2mg tablet
Anti-diabetic
FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
1.Gliclazide MR 30mg/60mg/80mg + 27-04-2005
Metformin Hcl 500mg/500mg/500mg ER tablet
For Type II Diabetes
Sulfonylureas- include- First generation - Acetohexamide, Chlorpropamide, Tolazamide, Tobutamide
Second generation - Glipizide, Glyburide ( Glibenclamide ), GlimepIride,Gliclazide
Refer Chlorpropamide
Adverse Reaction:
Severe hypoglycaemia,brain damage and death in the presence of renal/hepatic damage, malnutrition, anorexia, senility, alcohol intoxification, adrenal and pitutary insufficiency. Hypoglycaemia, GI disturbances, skin reactions, leucopenia, thrombocytopenia, agranulocytosis, hemolytic anaemia, chloestatic jaundice and GI haemorrhage.
Contra-Indications:
Juvenile onset diabetes,diabetes compilcated with ketosis,and acidosis, hypersens to other sulphonylureas, severe renal and hepatic impairment.
Unstable or brittle diabetes. Pregnancy and lactation.
Special precautions: Hypoglycaemia. May require insulins during metabolic stress. care when transfering from combination therapy.
