Carbophage G2

CARBOPHAGE G2 by MERCK LTD is an oral anti-diabetic medication prescribed for the management of type 2 diabetes mellitus in adults. It is particularly indicated when diet and exercise alone do not achieve adequate glycemic control.

Name

• Brand Name: CARBOPHAGE G2
• Manufacturer: Merck Ltd.

Composition

CARBOPHAGE G2 contains a combination of two active ingredients:

• Glimepiride (2 mg)
• Metformin (500 mg)

Glimepiride works by stimulating pancreatic beta cells to produce and release more insulin, which helps lower blood sugar levels. Metformin reduces glucose production by the liver, delays glucose absorption from the intestines, and enhances the body's sensitivity to insulin.

Uses

CARBOPHAGE G2 is used to:

• Treat type 2 diabetes mellitus in adults.
• Improve glycemic control in patients whose blood sugar levels are not managed by diet and exercise alone.
• Help prevent diabetes-related complications such as kidney damage, eye problems, and nerve issues.
• Improve insulin resistance, and has been mentioned for use in polycystic ovary syndrome (PCOS).

Dosage and Administration

CARBOPHAGE G2 tablets are for oral administration. It is typically taken once daily with meals to minimize gastrointestinal side effects. The tablet should be swallowed whole with a glass of water and not chewed, crushed, or broken. The exact dosage and duration of treatment should be determined by a physician based on individual blood glucose levels and response to therapy.

Side Effects

Common Side Effects:

• Hypoglycemia (low blood sugar)
• Stomach pain, nausea, vomiting, diarrhea
• Headache, dizziness
• Metallic or altered taste

Serious (Rare) Side Effects:

• Lactic acidosis (buildup of lactic acid in the blood), particularly in patients with kidney disease, elderly individuals, or those consuming excessive alcohol.
• Inflammation of the liver (hepatitis), potentially leading to jaundice (yellowing of skin or eyes).
• Severe allergic reactions (e.g., skin rash, hives, increased sensitivity to sun).
• Vitamin B12 deficiency with long-term use.

Precautions

• Contraindications: Do not take CARBOPHAGE G2 if you have type 1 diabetes mellitus, diabetic ketoacidosis, severe kidney or liver disease, acute heart problems, metabolic acidosis, or an allergy to glimepiride, metformin, or any other components of the medicine.
• Pregnancy and Breastfeeding: CARBOPHAGE G2 is not recommended during pregnancy or breastfeeding; consult a doctor if pregnant, planning pregnancy, or breastfeeding.
• Alcohol Consumption: Avoid alcohol as it may increase the risk of lactic acidosis and can affect blood sugar levels.
• Drug Interactions: Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements, as certain medicines (e.g., CYP2C9 inhibitors, other glucose-lowering agents, thiazide diuretics, corticosteroids) can interact with CARBOPHAGE G2.
• Medical Conditions: Inform your doctor about any pre-existing medical conditions, especially liver or kidney problems, low blood sugar, or circulation problems.
• Driving and Operating Machinery: This medicine may decrease alertness; drive or operate machinery only if you are alert.
• Dietary Considerations: High-fibre foods can potentially slow the absorption of metformin.

Storage

Store CARBOPHAGE G2 in a cool, dry place, protected from sunlight, ideally between 10ºC to 25ºC or below 30ºC. Keep the medicine out of reach and sight of children and ensure it is used before its expiry date.

What is Carbophage G2 used for?

Carbophage G2 is an antidiabetic medication used to manage type 2 diabetes mellitus in adults. It is prescribed when diet, exercise, and treatment with a single antidiabetic agent (either glimepiride or metformin alone) are not enough to control blood sugar levels. This medicine helps regulate blood sugar and reduce the risk of diabetes-related complications such as nerve damage, kidney issues, or heart disease.

How does Carbophage G2 work?

Carbophage G2 contains two active ingredients: Glimepiride and Metformin. Glimepiride works by stimulating the pancreas to release more insulin, which helps lower blood glucose. Metformin works by reducing the amount of glucose produced by the liver, delaying the absorption of glucose from the intestines, and increasing the body's sensitivity to insulin. Together, these actions effectively control blood sugar levels.

What is the usual dosage for Carbophage G2?

The dosage of Carbophage G2 is determined by your doctor based on your individual medical condition, blood sugar levels, and response to treatment. It is typically taken once or twice daily with meals, often with the first main meal of the day. The tablet should be swallowed whole with water and not crushed, chewed, or split. It's crucial to follow your doctor's exact instructions regarding dosage and timing.

What are the possible side effects of Carbophage G2?

Common side effects include low blood sugar (hypoglycemia), nausea, vomiting, diarrhea, stomach pain, headache, and taste disturbances (like a metallic taste). More serious, but rare, side effects can include lactic acidosis (a build-up of lactic acid in the blood) and severe allergic reactions. Long-term use may also lead to a deficiency in Vitamin B12. Consult your doctor if any side effects worsen or if you experience severe symptoms.

Is Carbophage G2 safe during pregnancy or breastfeeding?

No, Carbophage G2 is generally not recommended during pregnancy as it may cause harm to the unborn baby. It is also contraindicated during breastfeeding because its components can pass into breast milk and potentially cause adverse effects in the infant. Always inform your doctor if you are pregnant, planning pregnancy, or breastfeeding, as they may suggest alternative treatments.

Can Carbophage G2 be taken with other medications?

Carbophage G2 can interact with other medicines. It's important to inform your doctor about all medications you are currently taking, including over-the-counter drugs, supplements, and herbal remedies. Some medications that may interact include other antidiabetic agents (like insulin), anticoagulants (e.g., Warfarin), NSAIDs, certain antibiotics, and medicines for high blood pressure or heart conditions. These interactions can affect the effectiveness of Carbophage G2 or increase the risk of side effects like hypoglycemia.

What precautions should be taken while on Carbophage G2?

Several precautions should be observed when taking Carbophage G2:

• Alcohol Consumption: Avoid consuming alcohol, as it can increase the risk of low blood sugar and a serious condition called lactic acidosis.
• Medical Conditions: This medicine is not suitable for individuals with type 1 diabetes, diabetic ketoacidosis, severe kidney or liver disease, or certain heart problems.
• Blood Sugar Monitoring: Regularly monitor your blood sugar levels as advised by your doctor.
• Hypoglycemia: Be aware of the symptoms of low blood sugar (e.g., sweating, dizziness, shakiness) and carry a quick source of sugar (like glucose tablets or fruit juice) to treat it immediately.
• Driving: Exercise caution when driving or operating machinery, as low blood sugar can impair alertness.
• Children: It is not recommended for use in children and adolescents under 18 years of age.

What happens if a dose of Carbophage G2 is missed?

If you miss a dose of Carbophage G2, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to compensate for the missed one, as this can lead to low blood sugar. Missing doses can result in high blood sugar levels.

How should Carbophage G2 be stored?

Carbophage G2 should be stored in a cool, dry place, typically below 25°C or 30°C, and away from direct sunlight and moisture. Always keep the medicine in its original container and ensure it is out of the reach and sight of children. Check the expiry date before use.