Manufacturer: Glenmark Pharmaceuticals Ltd
Salt Composition : Glimepiride(2mg), Metformin(500mg), Pioglitazone(15mg)
Strip of 15 Tablet Sr
(Inclusive of all taxes)
Trigulin 2 Tablet SR should be taken in the dose and duration as advised by your doctor. It must be taken with food to avoid stomach upset. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose. Overdose may lead to low blood sugar (hypoglycemia).
Some people may develop hypoglycemia (low blood sugar level) when this medicine is taken along with other antidiabetic medicines, alcohol or upon skipping a meal. Monitor your blood sugar levels regularly while taking it. Other common side effects of this medicine include nausea, taste changes, diarrhea, stomach pain, headache, edema (swelling), blurred vision, bone fracture, and respiratory tract infection.
Before taking this medicine, inform your doctor if you have any kidney, liver or heart problems. Pregnant or breastfeeding women should also consult their doctor before taking it. Your doctor will check your kidney function tests before starting treatment with it. Avoid excessive alcohol intake while taking it as this may increase the risk of developing some side effects.
Glimepiride lowers the blood sugar level increasing release of insulin hormone from the pancreas. Insulin moves sugar (glucose) from the blood into the cells.
Metformin decreases the absorption in the intestine and production of sugar by the liver.
Pioglitazone acts by improving the sensitivity of liver (hepatic) and peripheral (muscle) tissue to insulin
All of these components are known to increase the insulin sensitivity of the body (allows the cells of the body to use blood glucose more effectively, reducing blood sugar).
Glimepiride is completely metabolized by oxidative biotransformation after either an IV or oral dose. The major metabolites are the cyclohexyl hydroxy methyl derivative (M1) and the carboxyl derivative (M2). Cytochrome P450 2C9 has been shown to be involved in the biotransformation of glimepiride to M1.Metformin is rapidly distributed following absorption and does not bind to plasma proteins. No metabolites or conjugates of metformin have been identified. The absence of liver metabolism clearly differentiates the pharmacokinetics of metformin from that of other biguanides, such as phenformin.Pioglitazone is a thiazolidinedione that increases insulin sensitivity in target tissues. It is well-absorbed, with a mean absolute bioavailability of 83% and reaching maximum concentrations in around 1.5 hours. It is metabolised by the hepatic cytochrome P450 enzyme system.
Hypoglycemia (low blood glucose level)
Dizziness
Headache
Nausea
Vomiting
Diarrhea
Flatulence
Bronchitis (inflammation of the airways)
Anemia (low number of red blood cells)
Edema (swelling)
GLIMEPIRIDE+METFORMIN+PIOGLITAZONE should be avoided in patients with heart diseases (congestive heart failure and myocardial infarction), vitamin B12 deficiency, and alcoholism, type I diabetes, bladder cancer, edema (fluid retention), liver disease, premenopausal anovulation, obesity
Trigulin 2 Tablet SR may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.
It is unsafe to consume alcohol with Trigulin 2 Tablet SR.
Trigulin 2 Tablet SR is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.
GLIMEPIRIDE+METFORMIN+PIOGLITAZONE belongs to the group of medications called 'antidiabetic agents' used in the treatment of Type 2 diabetes mellitus. Type 2 diabetes mellitus is a chronic or life-long condition in which blood sugar or glucose levels rise more than normal.
GLIMEPIRIDE+METFORMIN+PIOGLITAZONE may have an interaction with medicines used to treat bacterial infections (rifampicin, tetracycline, and clarithromycin), a medicine used to treat fungal infections (fluconazole), other oral antidiabetics, and medicines used to treat gout (probenecid).
Do not chew, crush or break it. Trigulin 2 Tablet SR is to be taken with food.
Store below 30°C
If you miss a dose of Trigulin 2 Tablet SR, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Consult a doctor before taking any medicines.
Take it with food to lower your chance of having an upset stomach.
It may cause hypoglycemia (low blood sugar level) when used with other antidiabetic medicines, alcohol or if you delay or miss a meal.
Always carry some sugary food or fruit juice with you in case you experience hypoglycemic symptoms such as cold sweats, cool pale skin, tremor, and anxiety.
Your doctor may check your liver function regularly. Inform your doctor if you develop symptoms such as abdominal pain, loss of appetite, or yellowing of the eyes or skin (jaundice).
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Trigulin 2 Tablet SR is to be taken with food.
Q. Can I drink alcohol while taking Trigulin 2 Tablet SR?
No, it is not safe to drink alcohol while using Trigulin 2 Tablet SR. Drinking alcohol may lower your blood sugar levels (hypoglycemia). Also, it can increase the chances of lactic acidosis.
Q. What should I inform the doctor before taking Trigulin 2 Tablet SR?
Before taking Trigulin 2 Tablet SR inform your doctor if you have congestive heart failure, kidney problems, liver problems, swelling of the back of the eye. Inform the doctor if you are pregnant, breastfeeding or a premenopausal woman. Let the doctor know if you are taking any prescription and non-prescription medicines, vitamins, and herbal supplements.
Q. Can the use of Trigulin 2 Tablet SR lead to Vitamin B12 deficiency?
Yes, the use of Trigulin 2 Tablet SR can cause vitamin B12 deficiency as it contains metformin in it. On long-term use, it interferes with absorption of vitamin B12 in the stomach.
Q. Can the use of Trigulin 2 Tablet SR cause hypoglycemia?
Yes, the use of Trigulin 2 Tablet SR can cause hypoglycemia (low blood sugar level). Symptoms of hypoglycemia include nausea, headache, irritability, hunger, sweating, dizziness, fast heart rate and feeling anxious or shaky. It happens more often if you miss or delay your meal, drink alcohol, over-exercise or take other antidiabetic medicine along with it. So, regular monitoring of blood sugar level is important. Always carry some sugary item like a candy or chocolate with you.
Q. What are the instructions for the storage and disposal of Trigulin 2 Tablet SR?
Keep this medicine in the container it came in, tightly closed. Store it according to the instructions mentioned on the pack or label. Dispose of the unused medicine. Make sure it is not consumed by pets, children and other people.
