What is this medicine?

This medicine is used to control Type 2 Diabetes.
It contains two medicines:

1. Glimepiride (3 mg) – helps your pancreas release more insulin.
2. Metformin (850 mg) – reduces sugar made by the liver and helps the body use insulin better.

This dose is considered strong, especially because Glimepiride is at 3 mg, which is a higher strength.

How does it work?

1. Glimepiride (3 mg)

• Increases insulin release from the pancreas.
• Helps lower blood sugar after meals.
• Works quickly.

2. Metformin (850 mg)

• Lowers sugar production in the liver.
• Makes the body use insulin more effectively.
• Slows sugar absorption from food.
• Does not cause weight gain.

Together, they help control fasting sugar + post-meal sugar throughout the day.

Why do doctors prescribe this dose?

Doctors prescribe this stronger combination when:

• Blood sugar remains high with lower doses.
• Metformin + lower glimepiride (1 mg or 2 mg) is not enough.
• You need more power to control high blood sugar.
• You have both high fasting and post-meal sugar.
• To prevent long-term diabetes complications:
  • Heart issues
  • Kidney damage
  • Nerve damage
  • Eye problems

Glimepiride 3 mg is a higher dose, so it gives stronger sugar-lowering action.

How to take it

• Usually taken once or twice daily.
• Must be taken with food (very important).
• Most common timing:
  • Once daily with breakfast, OR
  • Breakfast + dinner
• Swallow whole with water.

Important:
Do NOT skip meals.
Glimepiride 3 mg can cause low blood sugar if you take it without eating.

Common side effects

From Glimepiride (3 mg — higher dose)

• Low blood sugar (hypoglycemia)
  Symptoms:
  • Sweating
  • Shaking
  • Hunger
  • Weakness
  • Dizziness
  • Fast heartbeat
• Mild weight gain

From Metformin (850 mg)

• Stomach upset:
  • Gas
  • Loose stools
  • Nausea
  • Stomach pain
• Metallic taste

These usually improve in a few days.

Serious but rare side effects

• Severe low blood sugar
  (More common at 3 mg if food is skipped)
• Lactic acidosis (very rare but serious; due to Metformin)
  Symptoms:
  • Extreme weakness
  • Very fast breathing
  • Severe tiredness
  • Muscle pain
    → Call doctor immediately
• Allergic reactions (rash, swelling, breathing difficulty)

Who should avoid or use with caution

• People with kidney problems
• Severe liver disease
• Heavy alcohol drinkers
• Pregnant or breastfeeding women (only if doctor approves)
• People with frequent vomiting or dehydration
• Before a CT scan with contrast dye (may need to stop temporarily)

What to monitor

• Daily blood sugar
• HbA1c every 3 months
• Kidney tests once or twice a year
• Signs of low blood sugar
• Weight changes

Important precautions

• Eat meals on time; never skip food.
• Avoid excessive alcohol.
• Stay hydrated.
• Inform doctor before surgery or contrast CT scan.
• Do not stop the medicine suddenly.