Glucovance is a prescription medication combining two established antidiabetic agents—metformin hydrochloride and glyburide—into a single tablet, designed to improve glycemic control in adults with type 2 diabetes mellitus. This fixed-dose combination leverages complementary mechanisms to address both insulin resistance and insufficient insulin secretion, key pathophysiological defects in type 2 diabetes. By integrating these actions, Glucovance offers a streamlined therapeutic approach that may enhance adherence and optimize metabolic outcomes when diet and exercise alone prove insufficient. It is indicated as an adjunct to lifestyle modifications and should be used under appropriate medical supervision.

Features

• Contains metformin hydrochloride and glyburide in a single oral tablet
• Available in multiple strength combinations (e.g., 1.25 mg/250 mg, 2.5 mg/500 mg, 5 mg/500 mg glyburide/metformin)
• Dual mechanism targeting hepatic glucose production and pancreatic insulin secretion
• Film-coated for ease of swallowing
• Requires prescription and regular blood glucose monitoring

Benefits

• Provides synergistic glycemic control through complementary pharmacological actions
• May reduce hemoglobin A1c (HbA1c) more effectively than monotherapy components alone
• Convenient once- or twice-daily dosing supports treatment adherence
• Potentially lowers the number of tablets required compared to separate agents
• Addresses both insulin resistance and beta-cell dysfunction comprehensively
• Can be used as part of a structured diabetes management plan under medical guidance

Common use

Glucovance is commonly prescribed for the management of type 2 diabetes mellitus in adults, particularly when glycemic control has not been achieved adequately with metformin or a sulfonylurea alone, or with diet and exercise. It may also be initiated in patients already being treated with both components separately. Therapy is individualised based on glycemic response, renal function, and tolerance.

Dosage and direction

Dosage must be individualized based on effectiveness and tolerance, while considering renal function. The usual starting dose is Glucovance 1.25 mg/250 mg once or twice daily with meals. Dosage may be increased in increments no more frequently than every two weeks, up to the maximum recommended daily dose of 20 mg glyburide/2000 mg metformin (e.g., Glucovance 5 mg/500 mg tablet four times daily). Administration with meals helps reduce gastrointestinal side effects. Regular monitoring of blood glucose and HbA1c is essential.

Precautions

• Assess renal function before initiation and periodically thereafter; contraindicated in renal impairment.
• Risk of hypoglycemia, especially with irregular meal schedules, excessive alcohol intake, or concomitant glucose-lowering drugs.
• Monitor for signs of vitamin B12 deficiency with long-term use.
• Lactic acidosis is a rare but serious metabolic complication; discontinue use in conditions predisposing to hypoxemia or dehydration.
• Use caution in elderly, debilitated, or malnourished patients and those with adrenal or pituitary insufficiency.
• Temporary discontinuation may be required for procedures using intravascular iodinated contrast media.

Contraindications

• Renal disease or renal dysfunction (e.g., serum creatinine levels ≥1.5 mg/dL in males, ≥1.4 mg/dL in females)
• Known hypersensitivity to metformin, glyburide, or other sulfonylureas
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis
• Congestive heart failure requiring pharmacologic treatment
• Severe hepatic impairment
• During or in anticipation of radiographic procedures involving iodinated contrast materials

Possible side effects

• Hypoglycemia
• Gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal discomfort)
• Headache
• Dizziness
• Rash
• Lactic acidosis (rare but serious)
• Hematologic changes (e.g., megaloblastic anemia due to vitamin B12 malabsorption)
• Hyponatremia associated with SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)

Drug interaction

• Alcohol: increases risk of hypoglycemia and lactic acidosis.
• Drugs that may enhance hypoglycemic effect: insulin, other oral antidiabetics, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAO inhibitors, propoxyphene, salicylates, sulfonamide antibiotics.
• Drugs that may reduce hypoglycemic effect: corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, isoniazid.
• Drugs that may affect metformin elimination: cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, vancomycin) compete for renal tubular transport.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for a missed one. Consistent timing helps maintain stable blood glucose levels.

Overdose

Overdose of Glucovance may result in hypoglycemia (with glyburide component) or lactic acidosis (with metformin component). Hypoglycemic symptoms include sweating, tremor, blurred vision, and confusion; severe cases may lead to seizure, coma, or neurologic impairment. Lactic acidosis presents with nausea, vomiting, abdominal pain, and hyperventilation. Treatment is supportive and symptomatic; hypoglycemia should be managed with oral or intravenous glucose. Hemodialysis may remove both metformin and glyburide.

Storage

Store at room temperature (20°C to 25°C/68°F to 77°F), in a dry place, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, changing, or stopping any medication. Individual patient needs and responses may vary.

Reviews

Clinical studies and patient reports indicate that Glucovance can be effective in achieving glycemic targets when used appropriately. Many users appreciate the convenience of a combination tablet, though some report gastrointestinal side effects during the initial adjustment period. Adherence to dosing and monitoring recommendations is critical for optimal outcomes and safety. Always discuss your experience and any side effects with your healthcare provider.