Riomet Trio(2mg)

Tablet
MRP:Rs. 97 for 1 Strip(s) (10 Tablet each)
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1

SALT INFORMATION

Glimepiride(2mg)

TYPICAL USAGE

Glimepiride is used to lower the blood sugar levels in type 2 diabetes mellitus when diet, physical exercise and weight reduction alone are not adequate

SIDE EFFECTS

* Common: There is a risk of getting symptoms of low blood sugar level (hypoglycemia) like headache, dizziness, urge to vomit, sluggishness, hunger pangs, restlessness, problems with sleeping, as well as weight gain. * Rare: Decrease in the number of blood platelets (thrombocytopenia), white blood cells (leukopenia, agranulocytosis, granulocytopenia), and red blood cells (erythropenia), anemia due to rupture of red blood cells (hemolytic anemia).

DRUG INTERACTION

* Drugs that affect the action of glimepiride by altering blood sugar level include phenylbutazone, azapropazone, insulin, metformin, salicylates, steroids, chloramphenicol, coumarin, fenfluramine, disopyramide, hydrochlorothiazide, furosemide, prednisone, methylprednisolone, phenytoin, nicotinic acid, fluoxetine, cyclophosphamide, fluconazole, tritoqualine, glucagon, barbiturates, rifampicin, acetazolamide, glucocorticoids, and laxatives. * Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

MECHANISM OF ACTION

Glimepiride belongs to a blood sugar lowering group of medicines called sulfonylurea. Glimepiride increases the amount of insulin released by the pancreas, and thereby decreases the blood sugar level.

DOSAGE

* Always follow the instructions of doctor regarding the dosage and duration. * Treatment of adults with high blood sugar level: 1 mg once daily; Maximum recommended dose is 6 mg per day.

DOs and DON'Ts

* Take glimepiride just before or with the first main meal of the day. * Do not skip any meal while taking glimepiride. * Swallow the glimepiride tablet without crushing or chewing with at least half a glass of water. * Do not take glimepiride if you are allergic to  glimepiride, other sulfonylureas, sulfonamides * . * Glimepiride tablets should not be given to children and adolescents under 18 years of age.

CONTRA INDICATIONS

* Glimepiride tablets should not be given to children and adolescents under 18 years of age.  * Do not take glimepiride if you are/have: * Hypersensitive to glimepiride, other sulfonylureas, sulfonamides, or other ingredients of the drug. * Insulin dependent diabetes. * Diabetic coma. * High concentrations of ketone in blood (ketoacidosis). * Severe kidney and liver disease.

FAQ

Q. Is glimepiride safe?Glimepiride is safe if used at prescribed doses for the prescribed duration as advised by your doctor.Q. Is glimepiride a generic drug?Yes, glimepiride is a generic drug sold under several pharmaceutical brand names (Amaryl, Zoryl, etc.).Q. Can I take glimepiride with metformin or insulin?Glimepiride may be given in combination with metformin and/or insulin depending on your medical condition and as prescribed by the doctor.Q. Does glimepiride cause fluctuations in weight, diarrhea, hair loss, erectile dysfunction, swelling, constipation?Glimepiride is reported to cause low blood sugar level, weight gain, and swelling, but is not reported to cause diarrhea, constipation, hair loss, or erectile dysfunction.Q. Is glimepiride a fast acting sulfa drug?Glimepiride is a medium- to long-acting sulfonylurea drug against type 2 diabetes mellitus (action lasts for 24 hours). Its maximum effect is seen after 2-3 hours of drug intake.Q. Is glimepiride same as glipizide, glyburide, metformin, or insulin?They are not same. Glimepiride, glipizide and glyburide belong to the same class of drugs called sulfonylureas. Metformin belong to class called biguanides. Glimepiride causes release of insulin but it is not insulin.

FURTHER INFORMATION

* Patient information leaflet: https://www.medicines.org.uk/emc/PIL.25789.latest.pdf * Summary of product characteristics. https://www.medicines.org.uk/emc/medicine/25845

Metformin(500mg)

TYPICAL USAGE

* Metformin is used for the treatment of type 2 diabetes mellitus, particularly in overweight patients, as an adjunct to the diet and exercise.

SIDE EFFECTS

* Nausea, vomiting, diarrhea, abdominal pain and loss of appetite, taste disturbance, Lactic acidosis (symptoms are vomiting, abdominal pain with muscle cramps, not feeling well with severe tiredness, and difficulty in breathing), malabsorption of vitamin B12,  skin reactions

DRUG INTERACTION

* Taking metformin with other anti-diabetic drugs may lead to excessive lowering of blood sugar levels, hence, the metformin dosage should be adjusted accordingly. * Metformin accumulation due to failure of kidney after intravascular administration of ionized media may lead to increased risk of lactic acidosis. Avoid metformin usage before and at least 48 hours afterwards X-ray or scan. * Diuretics, especially loop diuretics (furosemide) may increase the risk of lactic acidosis due to their ability to decrease kidney functions. * Metformin with diuretics (furosemide), anti-asthmatic drugs (salbutamol or terbutaline), or corticosteroids (prednisone) may affect the glucose control. * Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

MECHANISM OF ACTION

* Metformin belongs to class of medications called antidiabetics. The exact mechanism of action of metformin is not clear but it appears to act by decreasing glucose absorption from the intestine, decreasing production of glucose from proteins and fats in liver, and enhancing insulin sensitivity in muscle by increasing glucose uptake and utilization.

DOSAGE

* Adults: 500 mg or 850 mg 2 or 3 times daily given during or after meals to maximum of 3 g daily, taken as 3 divided doses. * Children (from 10 years of age and adolescents): 500 mg or 850 mg once daily, given during or after meals to maximum of 2 g daily, taken as 2 or 3 divided doses.

DOs and DON'Ts

* Take the medicine with food to avoid upset stomach * Check your blood sugar regularly * Do not take metformin in severe diarrhoea or vomiting, or when starting antihypertensive or diuretic therapy or therapy with a non-steroidal anti-inflammatory drug (NSAID). * This medication may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as:muscle pain or weakness;numb or cold feeling in your arms and legs;trouble breathing;feeling dizzy, light-headed, tired, or very weak;stomach pain, nausea with vomiting; orslow or uneven heart rate. * Do not take metformin if you need to have any type of x-ray or CT scan using a dye * You need to get cetain kidney function tests done before starting treatment  with metformin and regularly thereafter. * . * Caution should be taken when used in combination with insulin or other oral antidiabetics, which may lead to low blood glucose level (hypoglycemia).

CONTRA INDICATIONS

* Patients with serious complication of diabetes where high levels of blood acids called ketones are produced in the body (diabetic ketoacidosis); diabetic pre-coma; patients with kidney problem , liver problem, or heart failure; alcoholism.

FAQ

Q. Is Metformin a birth control pill/ insulin / statin/ banned drug?Metformin (also available as glyciphage, glycomet, glycomet SR) is an antidiabetic drug used in treatment of type 2 diabetes mellitus, particularly in overweight patients, as an adjunct to the diet and exercise.Q. Is metformin safe?Metformin is generally safe if used at prescribed doses for the prescribed duration as advised by your doctor.Q. Can I take metformin forever?Metformin should be taken at prescribed doses for the prescribed duration as advised by your doctor.Q. Is metformin good for weight loss / weight loss in non-diabetics?Metformin is used for the treatment of type 2 diabetes mellitus, particularly in overweight patients.Q. How long can I take metformin for PCOS / PCOS while pregnancy?Metformin sometimes used to treat women with polycystic ovary syndrome (PCOS). Continuing metformin during pregnancy decreases the chances of developing gestational diabetes. It also reduces the risk of early pregnancy loss, preterm labor and prevention of fetal growth restriction. Depending on your medical history, your doctor might encourage you to continue metformin during pregnancy, or advice you to stop taking it. Always consult your doctor regarding its use.Q. Can you take metformin for gestational diabetes / is metformin safe for pregnancy?Metformin is usually prescribed for treating gestational diabetes. Metformin use during pregnancy is usually safe at prescribed dose for the prescribed duration. Always consult your doctor regarding its use.Q. Does metformin help conceiving / help ovulation / help getting pregnant?Women with PCOS who are treated with metformin have a better chance of getting pregnant. Always consult your doctor regarding its use.

FURTHER INFORMATION

* Summary of product characteristics. https://www.medicines.org.uk/emc/medicine/21610 * Patient Information Leaflet. https://www.medicines.org.uk/emc/PIL.26346.latest.pdf

Pioglitazone Hydrochloride(15mg)

TYPICAL USAGE

It is used in combination with diet and exercise to lower blood glucose in adults with type 2 diabetes mellitus.

SIDE EFFECTS

* Common: Infection of nose, sinuses, pharynx or larynx (upper respiratory tract infection), decreased sensitivity to stimulation (hypoesthesia), visual disturbance, bone fracture, weight gain. * Uncommon: sinusitis, bladder cancer, inability to sleep (insomnia). * Rare: Elevated liver enzyme, impaired liver cell function.

DRUG INTERACTION

* Pioglitazone interacts with strong CYP2C8 inhibitors (e.g., gemfibrozil): it causes an increase in pioglitazone concentrations. It also interacts with CYP2C8 inducers (e.g., rifampin) that result in decrease of pioglitazone concentrations.  * Pioglitazone when used in combination with other antidiabetic drug metformin has the risk low hemoglobin or red blood cell count (anemia), headache, joint pain (arthralgia), blood in urine (hematuria), problem with erection in males (erectile dysfunction) * Pioglitazone when used in combination with other anti-diabetic drugs like sulphonylurea (e.g. glimepiride, glibenclamide, glipizide, gliclazide etc) has the risk of dizziness or gas (flatulence) * Pioglitazone when used in combination with metformin and sulphonylurea has the risk of excessive fall in blood sugar (hypoglycemia), joint pain (arthralgia), increase in levels of certain enzymes in blood (e.g. creatine phosphokinase) * Pioglitazone when used in combination with insulin has the risk of inflammation of air passage between nose and lungs (bronchitis), decreased blood sugar (hypoglycemia), heart failure, breathlessness (dyspnea), joint pain (arthralgia), back pain, swelling (edema) * Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

MECHANISM OF ACTION

Pioglitazone belongs to class of thiazolidinedione. Pioglitazone decreases insulin resistance in the periphery and in the liver that helps the body make better use of insulin it produces and also decreases the glucose output from the liver.

DOSAGE

Always follow the instructions of doctor regarding the dosage and duration  * Treatment of type 2 diabetes: 15 mg once daily, up to a maximum of 45 mg once daily.

DOs and DON'Ts

* Consult your doctor if you have any mental confusion, persistant abdominal pain, dark uine, yellowing of skin/eyes or easy bruising * Check your blood sugar regularly * Consult your doctor:                     -If you are allergic to pioglitazone or any of the other ingredients of this medicine.                     -If you have heart failure or have had heart failure in the past.                    -If you have liver disease.                    -If you have had a complication of diabetes causing rapid weight loss, nausea or                           vomiting (diabetic ketoacidosis) or a special type of diabetic eye disease with                             swelling of the back of the eye(macular edema).                    -If you have ever had bladder cancer and blood in urine.                    -If you have cysts on your ovaries (polycystic ovary syndrome).

CONTRA INDICATIONS

* Diabetes patient with a history of severe heart failure. * Patients of type 1 diabetes or diabetic ketoacidosis.

FAQ

Q.Does pioglitazone cause hair loss?No, pioglitazone does not cause hair loss. However, if you experience such side effects, consult your doctor.Q.Does pioglitazone cause bladder cancer or any other cancer?In clinical studies, more people who took pioglitazone for more than one year developed bladder cancer as compared to those who did not take pioglitazone. It is recommended to consult your doctor about the risk of taking this medication if you have had bladder cancer in the past or have a history of passing blood in urine. No other cancer type has been linked with use of pioglitazone.Q.Does pioglitazone cause heart failure?Pioglitazone can cause fluid retention, which may worsen or precipitate heart failure.Q.Is pioglitazone safe?Pioglitazone is safe if used at prescribed doses for the prescribed duration as advised by your doctor.

FURTHER INFORMATION

1.Prescribing information. http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021073s043s044lbl.pdf2.Summary of product characteristics. https://www.medicines.org.uk/emc/medicine/42363.Patient information leaflet. http://www.medicines.org.uk/emc/PIL.11530.latest.pdf4.Medline plus drug informationhttp://www.nlm.nih.gov/medlineplus/druginfo/meds/a699016.html

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INTERACTIONS

Can I take Riomet Trio(2mg) during pregnancy?

Studies in animals have shown risk to fetus, however there are no sufficient studies in humans. This drug may be used in pregnant women if benefit outweighs the risk. Patients should follow the advice of the doctor regarding its use.

Can I take Riomet Trio(2mg) while breastfeeding/lactation?

Contraindicated: The drug should not be used by breastfeeding women, as evidences from studies have shown that there is a high risk of causing significant damage to infants.

Can I take Riomet Trio(2mg) with alcohol?

Since there is some doubt about the results of concurrent use in this interaction, it is advised to give some guidance to the patient about its possible adverse effects and/or consider close monitoring.