Q: I have been diagnosed with diabetes: I take metformin and Dipazide. I test myself two to three times a day and watch my diet. However, sometimes my pharmacy is out of Dipazide, what can I do in those instances when Dipazide is not available?
A: Your question regards what to do when your pharmacy is out of your Dipazide XL (Glucotrol XL). //www.everydayhealth.com/drugs/Dipazide Please talk to your pharmacist at the clinic to see if they have a recommendation. There is another Dipazide available that is not the extended release. You would need to take this more often than once a day, but it could possibly be an option for you. There are also other medications available that treat diabetes. Your physician would need to write you a new prescription for any of these changes. Another option is to go to a different pharmacy. If cost is an issue for you, call around to the different pharmacies for pricing information. Many pharmacies offer coupons for incentives for patients to come to the pharmacy. For example, pharmacies in my area are often offering twenty $20 coupons for their stores and groceries if you bring in a new prescription. There are many corporations such as Walmart, Kroger, Target, Giant Eagle, et cetera that offer some generic medications at $4 for a month's supply. Keep in mind that your diabetes medication is very important and this shortage needs to be addressed by your health care providers. Please talk to your health care providers about your medication issues. Jen Marsico, RPh
Drugs that contain salicylate
These drugs can cause low blood sugar when taken with Dipazide. Examples of these drugs include:
A single-dose, metformin-furosemide drug interaction study in healthy subjects demonstrated that pharmacokinetic parameters of both compounds were affected by coadministration. Furosemide increased the metformin plasma and blood Cmax by 22% and blood AUC by 15%, without any significant change in metformin renal clearance. When administered with metformin, the Cmax and AUC of furosemide were 31% and 12% smaller, respectively, than when administered alone, and the terminal half-life was decreased by 32%, without any significant change in furosemide renal clearance. No information is available about the interaction of metformin and furosemide when coadministered chronically.
A single-dose, metformin-nifedipine drug interaction study in normal healthy volunteers demonstrated that coadministration of nifedipine increased plasma metformin Cmax and AUC by 20% and 9%, respectively, and increased the amount excreted in the urine. Tmax and half-life were unaffected. Nifedipine appears to enhance the absorption of metformin. Metformin had minimal effects on nifedipine.
Cationic drugs (eg, amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin) that are eliminated by renal tubular secretion theoretically have the potential for interaction with metformin by competing for common renal tubular transport systems. Such interaction between metformin and oral cimetidine has been observed in normal healthy volunteers in both single- and multiple-dose, metformin-cimetidine drug interaction studies, with a 60% increase in peak metformin plasma and whole blood concentrations and a 40% increase in plasma and whole blood metformin AUC. There was no change in elimination half-life in the single-dose study. Metformin had no effect on cimetidine pharmacokinetics. Although such interactions remain theoretical (except for cimetidine), careful patient monitoring and dose adjustment of METAGLIP (Dipazide and metformin) and/or the interfering drug is recommended in patients who are taking cationic medications that are excreted via the proximal renal tubular secretory system.
In healthy volunteers, the pharmacokinetics of metformin and propranolol and metformin and ibuprofen were not affected when coadministered in single-dose interaction studies.
What Are the Downsides of Taking Dipazide?
- In some patients taking Dipazide, the medication has lost its effectiveness over time.
- When compared to some other diabetes medications, Dipazide does have a higher risk for causing low blood sugar levels.
- Dipazide may also cause slight weight gain, averaging 2-3 pounds per week.
- It has been stated that for Dipazide to be effective, it needs to be taken about 30 minutes before mealtime.
- One study has shown that, when compared to insulin treatment, Dipazide may increase the risk of heart-related conditions.
- Dipazide is used for Type 2 diabetes treatment and is not used in the treatment of Type 1 diabetes.
- Dipazide may interact with other medications you may be taking including anti-nausea medications, anti-psychotic medications, beta blockers, calcium channel blockers, corticosteroids, decongestants, diuretics, estrogens, eye infection medications, gout medications, monoamine oxidase inhibitors, niacin, nonsteroidal anti-inflammatory drugs, oral contraceptives, thyroid medications and tuberculosis-treatment medications.
How should this medicine be used?
Dipazide comes as tablets and extended-release (long-acting) tablets to take by mouth. The regular tablet is usually taken one or more times a day, 30 minutes before breakfast or meals. The extended-release tablet is usually taken once a day with breakfast. To help you remember to take Dipazide, take it around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Dipazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor will probably start you on a low dose of Dipazide and gradually increase your dose if needed. After you have taken Dipazide for some time, Dipazide may not control your blood sugar as well as it did at the beginning of your treatment. Your doctor may adjust the dose of your medication as needed so that the medication will work best for you. Be sure to tell your doctor how you are feeling and if your blood sugar test results have been higher or lower than normal at any time during your treatment.
Swallow the extended-release tablets whole. Do not chew, divide, or crush the tablets.
Dipazide helps control blood sugar but does not cure diabetes. Continue to take Dipazide even if you feel well. Do not stop taking Dipazide without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Certain types of hormones may increase your blood sugar levels when taken with Dipazide. Be sure to test your blood sugar as directed by your doctor if you’re taking these medications together. Examples of these drugs include:
- somatropin (growth hormone)
- oral birth control pills