Triexer 2

TRIEXER 2 Tablet by CIPLA LTD

Name

TRIEXER 2 Tablet (also available as TRIEXER 2 Tablet ER - Extended Release).

Composition

Each tablet contains a combination of three active ingredients:

• Glimepiride: 2 mg
• Metformin: 500 mg
• Pioglitazone: 15 mg

Uses

TRIEXER 2 Tablet is prescribed for the management of Type 2 Diabetes Mellitus in adults. It is typically used when diet, exercise, or single/dual anti-diabetic therapies alone are insufficient to control blood sugar levels. This medication works by improving insulin sensitivity, reducing glucose production in the liver, and stimulating insulin secretion from the pancreas. By effectively controlling blood sugar, it helps prevent serious long-term complications associated with diabetes, such as kidney damage, nerve problems, vision loss, limb amputations, and reduces the risk of heart attack and stroke.

Dosage and Administration

TRIEXER 2 Tablet should be taken orally, usually once daily, as directed by a healthcare professional. It is recommended to take the tablet with food, preferably after meals, to minimize stomach upset. The tablet should be swallowed whole and not crushed, cut, or chewed. The specific dose and duration of treatment will be determined by the doctor based on the patient's age, body weight, and disease condition. If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose, in which case the missed dose should be skipped to avoid doubling the dosage.

Side Effects

Common Side Effects:

• Diarrhea
• Nausea
• Abdominal discomfort or stomach pain
• Hypoglycemia (low blood sugar), with symptoms like shakiness, sweating, dizziness, irritability, or headache
• Headache
• Metallic taste
• Respiratory tract infections
• Oedema (swelling due to fluid retention)
• Dizziness
• Weight gain
• Bone fracture
• Sinus infection
• Constipation
• Sore throat
• Muscle pain

Serious Side Effects (seek immediate medical attention):

• Lactic acidosis (symptoms include cold hands or feet, dizziness, irregular heartbeat, unusual muscle pain, trouble breathing).
• Symptoms of heart failure (unusual shortness of breath, rapid weight increase, localized swelling, especially in ankles or legs).
• Severe hypoglycemia.
• Signs of liver issues (yellowing of the skin or eyes, abdominal pain, loss of appetite).
• Difficulty breathing.
• Blistering or peeling skin.

Precautions

• Contraindications: Not recommended for patients with Type 1 Diabetes Mellitus, bladder cancer, severe heart failure, or lactic acidosis. Patients with known allergy to any of its components should avoid its use. It is not recommended for children.
• Pregnancy & Breastfeeding: Caution is advised during pregnancy, and it may be unsafe. Breastfeeding should be avoided as the medicine may pass into human milk and affect the baby. Consult a doctor in both cases.
• Alcohol: Avoid alcohol consumption as it can increase the risk of lactic acidosis and hypoglycemia.
• Pre-existing Conditions: Inform your doctor if you have kidney disease, liver problems, or heart problems, as the medication should be used with caution and close monitoring in such cases.
• Drug Interactions: Inform your doctor about all prescription and non-prescription medicines, vitamins, and herbal supplements you are taking. It can interact with insulin, insulin secretagogues, cationic medicines (like amiloride and digoxin), and carbonic anhydrase inhibitors (like topiramate and zonisamide).
• Driving & Operating Machinery: Blood sugar fluctuations (both high and low) can affect the ability to drive or operate machinery; exercise caution.
• Monitoring: Regular monitoring of blood sugar levels is important. Always carry a sugary item (like candy or juice) to manage unexpected hypoglycemia.

Storage

Store TRIEXER 2 Tablet at room temperature, ideally below 30°C (or below 25°C), in a tightly closed container. It should be protected from light and moisture. Keep the medicine out of reach of children. Always use the medicine before its expiry date.

What is TRIEXER 2 used for?

TRIEXER 2 is an anti-diabetic medication primarily used to manage Type 2 Diabetes Mellitus, especially in adult patients whose blood sugar levels are not adequately controlled by diet and exercise alone, or with single or dual therapy. It helps to control high blood glucose levels, reducing the risk of long-term complications such as kidney damage, nerve problems, vision loss, and cardiovascular disease.

How does TRIEXER 2 work?

TRIEXER 2 is a combination of three active ingredients: Glimepiride, Metformin, and Pioglitazone.

• Glimepiride is a sulfonylurea that stimulates the pancreas to release more insulin, which helps move sugar from the blood into cells.
• Metformin is a biguanide that reduces glucose production in the liver, delays sugar absorption from the intestines, and increases the body's sensitivity to insulin.
• Pioglitazone is a thiazolidinedione that further enhances insulin sensitivity in muscle and adipose tissue, enabling cells to utilize glucose more effectively.

These three components work together to provide comprehensive blood sugar control through different mechanisms.

What is the usual dosage of TRIEXER 2?

TRIEXER 2 should be taken orally as prescribed by your doctor. The tablet should be swallowed whole, not crushed, cut, or chewed. It is typically taken once daily with food to avoid stomach upset. The dosage should not exceed three tablets per day of TRIEXER 2. It is important to follow your doctor's instructions on the dosage and timing to ensure safety and effectiveness.

What are the possible side effects of TRIEXER 2?

Common side effects of TRIEXER 2 may include hypoglycemia (low blood sugar), diarrhea, nausea, abdominal discomfort, headache, and respiratory tract infections. Other possible side effects include dizziness, vomiting, metallic taste, edema (swelling due to fluid retention), and bone fractures. Most side effects are temporary and generally resolve over time, but if they persist or worsen, you should consult your doctor.

Is TRIEXER 2 safe during pregnancy or breastfeeding?

TRIEXER 2 is generally not recommended for use during pregnancy or while breastfeeding. There are no adequate human data to determine its safety during pregnancy, and it is not known if it passes into human milk or can harm the baby. If you are pregnant, planning a pregnancy, or breastfeeding, it is crucial to consult your doctor for advice on the best way to manage your blood glucose levels. Pioglitazone, one of the ingredients, may also result in resumed ovulation in patients with polycystic ovarian syndrome, increasing the risk of pregnancy.

Can TRIEXER 2 be taken with other medications?

TRIEXER 2 can interact with several other medications. Inform your doctor about all medicines, supplements, and herbal products you are taking.

• Combining with insulin or other insulin secretagogues (e.g., glipizide) can increase the risk of hypoglycemia.
• Certain cationic medicines (e.g., amiloride, digoxin) may interfere with metformin elimination.
• Carbonic anhydrase inhibitors (e.g., topiramate, zonisamide) can enhance the risk of lactic acidosis.
• Concomitant use of pioglitazone with NSAIDs or insulin may increase the risk of edema and heart failure.
• Caution is advised with inhibitors or inducers of cytochrome P450 2C9 (e.g., fluconazole, rifampin) as they can affect glimepiride levels.
• Avoid excessive alcohol intake, as it can increase the risk of lactic acidosis and hypoglycemia.

What precautions should be taken while taking TRIEXER 2?

Before taking TRIEXER 2, inform your doctor about any pre-existing medical conditions, especially kidney disease, liver problems, or heart failure. Regular monitoring of kidney function is advisable. Patients with active bladder cancer or a history of bladder cancer should not receive pioglitazone. If you have symptoms like abdominal pain, loss of appetite, or yellowing of the eyes or skin (jaundice), inform your doctor immediately as these could indicate liver issues. Your ability to drive or operate heavy machinery may be affected if your blood sugar is too low or too high.

What happens if a dose of TRIEXER 2 is missed?

If you miss a dose of TRIEXER 2, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to compensate for a missed one, as this can lead to low blood sugar (hypoglycemia).

How should TRIEXER 2 be stored?

TRIEXER 2 should be stored at room temperature, below 30°C. Keep the medicine in a tightly closed container, protected from light and moisture. Ensure it is kept out of the reach and sight of children. Always use the medicine before its expiry date.