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Metaglip Information - Interactions and Warnings
METAGLIP is contraindicated in patients with:
1. Renal disease or renal dysfunction which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia.
2. Congestive heart failure requiring pharmacologic treatment.
3. Known hypersensitivity to glipizde or metformin hydrochloride.
4. Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
Diabetic ketoacidosis should be treated with insulin.
METAGLIP should be temporarily discontinued in patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials, because use of such products may result in acute alteration of renal function.
METAGLIP 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. Patients, therefore, should be warned against excessive alcohol intake, acute or chronic, while receiving METAGLIP. Due to its effect on the gluconeogenic capacity of the liver, alcohol may also increase the risk of hypoglycemia.
Since impaired hepatic function has been associated with some cases of lactic acidosis, METAGLIP should generally be avoided in patients with clinical or laboratory evidence of hepatic disease.
In controlled clinical trials with metformin of 29 weeks duration, a decrease to subnormal levels of previously normal serum Vitamin B 12 , without clinical manifestations, was observed in approximately 7% of patients. Such decrease, possibly due to interference with B 12 absorption from the B 12 -intrinsic factor complex, is, however, very rarely associated with anemia and appears to be rapidly reversible with discontinuation of metformin or Vitamin B 12 supplementation.
Certain individuals (those with inadequate Vitamin B 12 or calcium intake or absorption) appear to be predisposed to developing subnormal Vitamin B 12 levels. In these patients, routine serum Vitamin B 12 measurements at two- to three-year intervals may be useful. Change in clinical status of patients with previously controlled type 2 diabetes A patient with type 2 diabetes previously well-controlled on metformin who develops laboratory abnormalities or clinical illness (especially vague and poorly defined illness) should be evaluated promptly for evidence of ketoacidosis or lactic acidosis. Evaluation should include serum elec-trolytes and ketones, blood glucose and, if indicated, blood pH, lactate, pyruvate, and metformin levels. If acidosis of either form occurs, METAGLIP (glipizide and metformin HCl) Tablets must be stopped immediately and other appropriate corrective measures initiated.
The risks of hypoglycemia, its symptoms and treatment, and conditions that predispose to its development should be explained to patients and responsible family members. Patients should be counseled against excessive alcohol intake, either acute or chronic, while receiving METAGLIP.
Tell your doctor if you plan to become pregnant or have become pregnant. As with other oral glucose-control medications, you should not take METAGLIP during pregnancy. Usually your doctor will prescribe insulin while you are pregnant. As with all medications, you and your doctor should discuss the use of METAGLIP if you are nursing a child.
This information is not intended to be a substitute for professional medical advice. You should not use this material to diagnose or treat a health condition or disease without consulting with your healthcare provider.
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