Clinical medicine profile
Metformin / Glibenclamide
Biguanide antidiabetic
- Route
- ORAL
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
A traceable source link is not attached to this profile. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Severe renal impairment (thresholds per label, often eGFR <30).
- Acute conditions predisposing to hypoxia/acidosis (shock, severe HF, severe infection).
- Acute alcohol intoxication.
- Hypersensitivity.
Precautions
- Hold around iodinated contrast if eGFR low (local protocol).
- B12 deficiency with long-term use — monitor if anaemic/neuropathy.
- GI titration improves tolerability.
- XR formulations reduce GI effects.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Initial dose: One tablet (5mg /500mg) OD (Max. daily dose: 20mg/2000mg)
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Dose by eGFR; stop if severe impairment or acute kidney injury.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Avoid in significant hepatic impairment (lactic acidosis risk).
Use, effects & interactions
Indications
- Uncomplicated and non-ketonic diabetes mellitus (maturity onset type II diabetes).
- Clinical selection for Metformin / Glibenclamide should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Biguanide antidiabetic.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- [Metformin] Diarrhoea, nausea, abdominal discomfort, metallic taste.
- Serious: lactic acidosis (rare, high mortality if occurs). [Glibenclamide] GI disturbances
- blood dyscrasia
- hypoglycaemia
- jaundice
- skin rashes
- hypersensitivity reactions
- headache
- dizziness
- hyponatraemia
- paraesthesia
- photosensitivity.
Drug interactions
Open multi-drug checker ↗- Fixed-dose/multi-ingredient product.
- Clinical details partially inherited from component monographs: Metformin, Glibenclamide.
- Confirm combination SmPC for exact dosing.
Mechanism & disposition
See under glibenclamide and metformin respectively Metformin decreases hepatic gluconeogenesis, improves peripheral insulin sensitivity, and reduces intestinal glucose absorption.
Read complete mechanism
See under glibenclamide and metformin respectively Metformin decreases hepatic gluconeogenesis, improves peripheral insulin sensitivity, and reduces intestinal glucose absorption. Does not stimulate insulin secretion — low intrinsic hypoglycaemia risk alone.
Days for glycaemic effect
Taken daily chronically
ORAL
saturable. Not metabolised; renally excreted unchanged. Accumulation in renal impairment drives lactic acidosis risk. [Glibenclamide] Absorption,
are product-specific. Consider food effects, protein binding, hepatic CYP/UGT
when adjusting for organ impairment, age and drug interactions. Verify parameters in the current SmPC.
Pregnancy, lactation & diet
[Metformin] Increasingly used in GDM/PCOS pathways per specialist protocols; insulin remains standard in many settings. [Glibenclamide] Use only if potential benefit justifies potential risk; prefer agents with better reproductive data when alternatives exist.
Generally considered compatible.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.