GLUCOVANCE

Drug Name: GLUCOVANCE

GLUCOVANCE DESCRIPTION:
GLYBURIDE/METFORMIN TABLETS - ORAL (GLEYE-byou-ride/met-FOR-min)

COMMON GLUCOVANCE BRAND NAME(S):
Glucovance

GLUCOVANCE SIDE EFFECTS:
Nausea, diarrhea, or stomach pain, may occur as your body adjusts to the effects of the medication. If these effects persist or worsen, notify your doctor. In some cases, GLUCOVANCE may cause low blood sugar (hypoglycemia). Symptoms of low blood sugar are: lightheadedness, dizziness, shakiness, sweating, chills, hunger. If the symptoms listed above occur, use your prescribed glucose liquid or tablets, or drink a glass of orange juice or non-diet soda in order to raise your blood sugar level quickly. Tell your doctor immediately if you have any of these serious side effects: severe nausea, vomiting, diarrhea, stomach pain. Stop taking GLUCOVANCE and tell your doctor immediately if you have any of these unlikely but serious side effects: rapid breathing, unusual drowsiness, muscle aches, unusually fast or slow heartbeat. If you notice other effects not listed above, contact your doctor or pharmacist.

HOW TO USE GLUCOVANCE:
GLUCOVANCE: Take GLUCOVANCE by mouth, usually twice daily with meals; or as directed by your doctor. Try to take GLUCOVANCE at the same time(s) each day. Do not skip meals, drink too much alcohol, or exercise without having recently eaten. These activities can cause your blood sugar to get too low and cause serious side effects.

GLUCOVANCE WARNING:
Metformin can cause a condition called lactic acidosis. Though occurring rarely, lactic acidosis can be fatal. Stop using GLUCOVANCE and seek immediate medical help if you develop any of the following symptoms of lactic acidosis: unusual tiredness (fatigue), weakness, or stomach discomfort; muscle pain, breathing trouble; feeling cold (low body temperature), dizzy or lightheaded; or a slow or irregular heartbeat. Lactic acidosis is more likely to occur in patients who: have heart failure, kidney or liver problems; are elderly; use alcohol excessively; are seriously dehydrated (lack body fluids); will undergo x-ray procedures that require an injectable contrast drug; will have surgery; develop a serious infection, heart attack or stroke; are over 80 years of age and have not had kidney and liver tests.

GLUCOVANCE USES:
This combination medication is used, along with diet and exercise programs, to control high blood sugar in diabetic patients (type 2 diabetes). One ingredient works by helping the body make more natural insulin and the other ingredient works by making the body use the natural insulin more effectively. Controlling blood sugar helps diabetics prevent heart disease, strokes, kidney disease, blindness, and circulation problems.

GLUCOVANCE PRECAUTIONS:
Tell your doctor your medical history, including any allergies, kidney disease, liver disease; heart problems (e.g., congestive heart failure, myocardial infarction); serious infections, stroke, dehydration, metabolic conditions (e.g., acidosis); certain hormonal conditions (adrenal/pituitary insufficiency); and recent or planned surgeries Limit alcohol consumption while using GLUCOVANCE. Caution is advised when using GLUCOVANCE in the elderly because they may be more sensitive to the effects of the drug. Tell your doctor if you are pregnant before using this medication. If you become pregnant while taking GLUCOVANCE, insulin may be recommended to treat your diabetes. Based on information of related drugs, GLUCOVANCE may pass into breast milk. Therefore, consult your doctor before breast- feeding.

GLUCOVANCE DRUG INTERACTIONS:
Tell your doctor of all prescription and nonprescription medication you may use, especially "blood thinners" (e.g., warfarin); MAO inhibitors (e.g., furazolidone, phenelzine, selegiline, tranylcypromine); beta-blockers (e.g., metoprolol, propranolol); aspirin-like drugs (salicylates, or NSAIDs such as ibuprofen, naproxen); probenecid; sulfa drugs; quinolone antibiotics (e.g., ciprofloxacin); "water pills" (e.g., thiazide diuretics); corticosteroids (e.g., prednisone); thyroid drugs; estrogens including oral birth control medication; phenytoin; isoniazid; niacin; decongestants or diet pills, certain psychiatric medication (phenothiazines); calcium channel blockers (e.g., verapamil, diltiazem); cimetidine, or other drugs removed by the kidney (using cationic renal secretion), including ranitidine or digoxin. If you are scheduled to have any diagnostic procedures using iodine contrast material (x-ray), tell your doctor that you are taking this product. GLUCOVANCE generally is stopped before your procedure, and withheld for 2 days after the procedure. Consult your doctor for more details. Do not start or stop any medicine without doctor or pharmacist approval.

GLUCOVANCE OVERDOSE:
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include muscle aches, trouble breathing, increased sleepiness, low body temperature, slow heartbeat, dizziness, and lightheadedness, headache, sweating, shakiness, increased hunger, changes in vision, nervousness, tiredness, seizures, and loss of consciousness.

GLUCOVANCE NOTES:
GLUCOVANCE is not a substitute for proper diet and exercise. It is recommended to attend a diabetes educations program to understand diabetes and all aspects of its treatment; including diet, exercise, personal hygiene, medications and the importance of having regular eye exams. Do not share GLUCOVANCE with others. Laboratory and/or medical tests (e.g., kidney function and blood counts) will be performed in order to monitor your progress and response to GLUCOVANCE.

MISSED GLUCOVANCE DOSE:
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

GLUCOVANCE STORAGE:
Store at room temperature between 36 and 86 degrees F (2 to 30 degrees C) away from light and moisture. Your condition can cause complications in a medical emergency. For information on enrollment call Medic Alert (TM) at 1-800-854-1166. In Canada call 1-800-668-1507.