Generic Name: Glucovance
What is Glucovance?
Fenfluramine and dexfenfluramine may potentiate the actions of some antidiabetic agents via increasing glucose uptake by muscle cells. Monitor patients taking either of these drugs in combination with glyburide for hypoglycemia. Sympathomimetics may increase blood sugar. Patients receiving antidiabetic agents should be closely monitored for loss of diabetic control when therapy with sympathomimetic agents is instituted.
Pseudoephedrine may increase blood sugar via stimulation of beta2 receptors which leads to increased glycogenolysis. A pharmacodynamic interaction with antidiabetic agents may occur.
Patients receiving antidiabetic agents should be closely monitored for loss of diabetic control when therapy with pseudoephedrine is instituted. Sympathomimetics may increase blood sugar via stimulation of beta2-receptors which leads to increased glycogenolysis. Patients should be closely monitored for changes in glycemic control while receiving propoxyphene in combination with antidiabetic agents.
Acetazolamide: Carbonic anhydrase inhibitors may alter blood sugar. Both hyperglycemia and hypoglycemia have been described in patients treated with acetazolamide. This should be taken into consideration in patients with impaired glucose tolerance or diabetes mellitus who are receiving antidiabetic agents.
Hypoglycemia may be difficult to recognize in the elderly and people who are taking beta-adrenergic blocking drugs. Treatment of patients with glucose-6-phosphate dehydrogenase G6PD deficiency with sulfonylurea agents can lead to hemolytic anemia.
Because Glucovance belongs to the class of sulfonylurea agents, caution should be used in patients with G6PD deficiency and a non-sulfonylurea alternative should be considered. In postmarketing reports, hemolytic anemia has also been reported in patients who did not have known G6PD deficiency. Metformin is known to be substantially excreted by the kidney, and the risk of metformin accumulation and lactic acidosis increases with the degree of impairment of renal function.
Thus, patients with serum creatinine levels above the upper limit of normal for their age should not receive Glucovance. In patients with advanced age, Glucovance should be carefully titrated to establish the minimum dose for adequate glycemic effect, because aging is associated with reduced renal function.
Before initiation of Glucovance therapy and at least annually thereafter, renal function should be assessed and verified as normal. In patients in whom development of renal dysfunction is anticipated, renal function should be assessed more frequently and Glucovance discontinued if evidence of renal impairment is present. Therefore, in patients in whom any such study is planned, Glucovance should be temporarily discontinued at the time of or prior to the procedure, and withheld for 48 hours subsequent to the procedure and reinstituted only after renal function has been reevaluated and found to be normal.
Cardiovascular collapse shock from whatever cause, acute congestive heart failure, acute myocardial infarction, and other conditions characterized by hypoxemia have been associated with lactic acidosis and may also cause prerenal azotemia. When such events occur in patients on Glucovance therapy, the drug should be promptly discontinued. Glucovance therapy should be temporarily suspended for any surgical procedure except minor procedures not associated with restricted intake of food and fluids and should not be restarted until the patient's oral intake has resumed and renal function has been evaluated as normal.
Alcohol is known to potentiate the effect of metformin on lactate metabolism.
How should I take Glucovance?
The hypoglycemic effect induced by IGF-1 activity may be exacerbated. The amino acid sequence of mecasermin rh-IGF-1 is approximately 50 percent homologous to insulin and cross binding with either receptor is possible. Treatment with mecasermin rh-IGF-1 has been shown to improve insulin sensitivity and to improve glycemic control in patients with either Type 1 or Type 2 diabetes mellitus when used alone or in conjunction with insulins.
Patients should be advised to eat within 20 minutes of mecasermin administration. Glucose monitoring is important when initializing or adjusting mecasermin therapies, when adjusting concomitant antidiabetic therapy, and in the event of hypoglycemic symptoms.
Monitor glucose when initializing or adjusting mecasermin therapies, when adjusting concomitant antidiabetic therapy, and in the event of hypoglycemic symptoms.
What should I avoid while taking Glucovance?
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects. If you are an elderly person over 65 years of age, report any side effects promptly to your doctor. ALTHOUGH RARE, IF LACTIC ACIDOSIS DOES OCCUR, IT CAN BE FATAL. Tell your doctor if you notice anything that is making you feel unwell.
Glucovance side effects
Torsemide: Hyperglycemia has been detected during torsemide therapy, but the incidence is low. Because of this, a potential pharmacodynamic interaction exists between torsemide and all antidiabetic agents, including metformin.
Hyperglycemia has been detected during torsemide therapy, but the incidence is low. Because of this, a potential pharmacodynamic interaction exists between torsemide and all antidiabetic agents. Trandolapril: ACE inhibitors may enhance the hypoglycemic effects of insulin or other antidiabetic agents by improving insulin sensitivity.
Tranylcypromine: Animal data indicate that monoamine oxidase inhibitors MAO inhibitors may stimulate insulin secretion.
Common Glucovance ide effects may include:
Top Glucovance Mechanism: How does Gabitril work.
However, when hypogonadal men with or without diabetes are administered exogenous androgens, glycemic control typically improves as indicated by significant reductions in fasting plasma glucose concentrations and HbA1c.
The hypoglycemic action of sulfonylureas may be potentiated by certain drugs, including nonsteroidal anti-inflammatory agents and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, and beta-adrenergic blocking agents.
You can do this by doing one of the following:Make sure that you have a full breakfast immediately after your first dose.
In particular, treatment of the elderly should be accompanied by careful monitoring of renal function. The onset of lactic acidosis often is subtle, and accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, increasing somnolence, and nonspecific abdominal distress. There may be associated hypothermia, hypotension, and resistant bradyarrhythmias with more marked acidosis. The patient and the patient's physician must be aware of the possible importance of such symptoms and the patient should be instructed to notify the physician immediately if they occur.
Where can I get more information?
During clinical trials of bortezomib, hypoglycemia and hyperglycemia were reported in diabetic patients receiving antidiabetic agents, including metformin.
Be sure your family and close friends know how to help you in an emergency.