When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to glyburide or metformin, or if you have kidney disease or metabolic acidosis.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• It is best to take this medicine with food or milk.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with bosentan.
• Some foods and medicines can affect how glyburide/metformin works. Tell your doctor if you are using chloramphenicol, cimetidine, ciprofloxacin, cyclosporine, disopyramide, fluoxetine, isoniazid, miconazole, niacin, phenytoin, probenecid, an NSAID pain or arthritis medicine, medicine to treat an infection, a sulfa medicine, a phenothiazine medicine, an MAO inhibitor, certain blood pressure medicines, a diuretic (water pill), a steroid medicine, warfarin or another blood thinner, thyroid medicine, estrogens, or birth control pills.
• If you are also taking colesevelam, take it at least 4 hours after you take glyburide/metformin.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, heart or blood vessel problems, congestive heart failure, adrenal or pituitary gland problems, or G6PD deficiency. Tell your doctor it you drink alcohol.
• This medicine may cause the following problems:
  
  • Lactic acidosis (rare, but serious)
  • Higher risk of heart or blood vessel problems
  • Low blood sugar
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using it before you have surgery, an X-ray, a CT scan, or other medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision, changes in vision
• Confusion, fast heartbeat, increased hunger, shakiness, sweating
• Stomach pain, nausea, vomiting, muscle pain or cramping
• Trouble breathing, lightheadedness, dizziness
• Unusual tiredness or weakness

If you notice these less serious side effects, talk with your doctor:

• Mild nausea, diarrhea, or stomach upset

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088