سعر اموفاج اكسترا 5/500 مجم 30 قرص 2022

Glibenclamide (glyburide) 5 mg + metformin hydrochloride 500 mg tablets, pack of 30 (3 strips); oral antidiabetic combination for type 2 diabetes.

• Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitusPopulation: AdultsDailyMed (U.S. National Library of Medicine)

• Most common adverse reactions (>5%): diarrhea (17%), headache (9%), nausea/vomiting (8%), abdominal pain (7%) and dizziness (6%); hypoglycemia can occur.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Severe renal impairment (eGFR below 30 mL/min/1.73 m2).International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Hypersensitivity to metformin or glyburide; acute or chronic metabolic acidosis including diabetic ketoacidosis; concomitant bosentan.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Boxed warning - lactic acidosis: postmarketing cases of metformin-associated lactic acidosis, some fatal; risk factors include renal impairment, iodinated contrast, surgery, hypoxic states, excessive alcohol, hepatic impairment and age 65 or older. Discontinue if lactic acidosis is suspected.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Hypoglycemia (glyburide component), particularly in elderly, debilitated or malnourished patients and those with renal, hepatic, adrenal or pituitary insufficiency.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Possible increased risk of cardiovascular mortality with sulfonylureas (UGDP study); hemolytic anemia in patients with G6PD deficiency; vitamin B12 deficiency with metformin (measure B12 at 2-3-year intervals); no conclusive evidence of macrovascular risk reduction.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Carbonic anhydrase inhibitors (topiramate, zonisamide, acetazolamide, dichlorphenamide)May increase the risk of lactic acidosis; consider more frequent monitoring.DailyMed (U.S. National Library of Medicine)
• Drugs that reduce metformin clearance (OCT2/MATE inhibitors such as ranolazine, vandetanib, dolutegravir, cimetidine)May increase metformin exposure and the risk of lactic acidosis; consider the benefits and risks of concomitant use.DailyMed (U.S. National Library of Medicine)
• AlcoholAlcohol potentiates the effect of metformin on lactate metabolism; warn patients against excessive alcohol intake.DailyMed (U.S. National Library of Medicine)

• Available data with glyburide and metformin in pregnancy have not identified a drug-associated risk of major birth defects or miscarriage; poorly controlled diabetes in pregnancy carries maternal and fetal risks.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Metformin is present in human milk; glyburide data are limited. Monitor breastfed infants for signs of hypoglycemia (jitteriness, cyanosis, apnea, hypothermia, excessive sleepiness, poor feeding, seizures).International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Glibenclamide (glyburide): Stimulates insulin release from functioning pancreatic beta cells by binding the sulfonylurea receptor and closing ATP-sensitive potassium channels (US label).
• Metformin: Decreases hepatic glucose production, decreases intestinal glucose absorption and improves insulin sensitivity by increasing peripheral glucose uptake and utilization; insulin secretion remains unchanged (US label).