Glucovance Warnings and Precautions (Cont.)

Some Glucovance Warnings and Precautions

Some Glucovance warnings and precautions to be aware of include:
 
  • Oral diabetes drugs, including Glucovance, may increase the risk of death due to heart or blood vessel problems, compared to diabetes treatment with diet or insulin. This warning is based on one research study that looked at a diabetes medication similar to Glucovance. It is unclear at this time how important this risk may be for people taking Glucovance.
     
  • Very rarely, metformin (one of the active ingredients of Glucovance) may cause a life-threatening condition called lactic acidosis. Your risk of lactic acidosis increases with other medical conditions, including congestive heart failure (CHF), kidney failure, and liver problems (see Metformin and Lactic Acidosis for more information, including possible symptoms of lactic acidosis).
     
  • Drinking alcohol can increase your risk of lactic acidosis. Drinking large amounts of alcohol on a regular basis or drinking a large amount of alcohol at once (binge drinking) should be avoided while taking metformin (see Metformin and Alcohol).
     
  • Since liver disease (including liver failure and cirrhosis) can increase your risk of lactic acidosis, you should not take Glucovance if your liver is not functioning normally. Also, your kidney function needs to be monitored while you are taking Glucovance. This means that you should have blood tests that check your kidneys before you start Glucovance and the tests should be repeated at least once every year. If your kidney function is very poor, you should not take Glucovance, due to an increased risk of lactic acidosis.
     
  • Taking metformin (one of the active ingredients in Glucovance) and contrast dye at the same time can increase your risk of kidney damage. Contrast dye is used for certain radiology procedures, including some x-rays, CT scans, and heart catheterizations (see Metformin and Contrast Medium for more information). Also, Glucovance should be temporarily stopped for most major surgeries and should be restarted when you are eating normally again.
     
  • Glucovance can cause low blood sugar (hypoglycemia) in some people. This is more common in elderly people and in people with adrenal, pituitary, liver, or kidney problems -- as well as during fasting before surgery and after prolonged exercise. Your risk of hypoglycemia also increases if you drink alcohol or do not eat as much as you usually do. Low blood sugar symptoms may include irritability, trembling, cold sweats, or blurry vision, among other things (see Glucovance and Hypoglycemia for more information).
Because low blood sugar can be very dangerous, you should talk with your healthcare provider about what to do if you have low blood sugar. You should also contact your healthcare provider immediately if you have very low blood sugar.
  • If you are allergic to sulfonamides ("sulfa" medications), you may also be allergic to Glucovance. Most people with sulfa allergies can take Glucovance without problems. Let your healthcare provider know if you have a sulfa allergy.
     
  • Fever, infections, injury, or surgery can temporarily increase blood sugar, even in people with well-controlled diabetes. Glucovance may not be enough to treat your diabetes at these times, and the use of insulin may be required. Contact your healthcare provider if you have a fever, infection, or injury -- or if you will be having surgery. Also, make sure you know the symptoms of high blood sugar and how to check your blood sugar levels (see Glucovance and Hypoglycemia for more information).
     
  • Let your healthcare provider know if you drink a much lower amount of liquid than normal, or if you have an illness that causes severe vomiting, diarrhea, or fever. These conditions can lead to severe dehydration (loss of water in your body). You may need to stop taking Glucovance for a short time if you have any of these conditions.
     
  • Glucovance can decrease your levels of vitamin B12. Your healthcare provider should monitor your vitamin B12 levels during treatment with Glucovance, especially if you have a vitamin B12 deficiency (including pernicious anemia).
      
  • Glucovance can interact with certain other medications (see Glucovance Drug Interactions).
     
  • Glucovance is considered a pregnancy Category B medication. This means that while Glucovance is probably safe for use in pregnant women, the full risks of Glucovance in pregnancy are not known. Talk with your healthcare provider before taking Glucovance during pregnancy (see Glucovance and Pregnancy).
     
  • It is not known if Glucovance passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about this.
     
  • Sulfonylurea medicines, such as the glyburide component of Glucovance, have been reported to increase sensitivity to the sun. Therefore, when going outdoors, try wearing long sleeves, pants, and a hat. Any exposed skin should be covered with sunscreen that is at least SPF 15.
     
(Glucovance Warnings and Precautions Continued: Page 3)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;