You are correct...

QUESTION

You should cut the dose of Glucovance in half when switching patients who are already taking glyburide and metformin separately?

1. True
2. False

Absolutely not. DON'T do it.

It is true that the amount of glyburide absorbed in a Glucovance tablet isn't equivalent to regular glyburide tabs. Glucovance provides slightly greater absorption, about 7% to 18% more glyburide is absorbed.

But even an 18% increase in bioavailability DOESN'T warrant an automatic 50% dose decrease.

The approved product labeling for Glucovance says the starting dose of Glucovance should not exceed the daily dose of the glyburide and metformin already being taken.

When patients switch from regular glyburide to Glucovance, make sure they are getting their blood glucose levels monitored, and watch for signs and symptoms of hypoglycemia or hyperglycemia when switching to Glucovance.

Reference:
Bristol-Myers Squibb. Prescribing information for Glucovance. 7/31/00.

Garber AJ, Mooradian A, Schneider S, et al. Metformin/glyburide tablets as first-line therapy in type 2 diabetes achieve glycemic control at lower final doses versus metformin or glyburide [abstract]. 2000 Ninth Annual Meeting and Clinical Congress of the American Association of Clinical Endocrinologists. Atlanta, Georgia;3-7 May 2000:21.

Donovan DS, Mooradian A, Schneider S, et al. Treatment of type 2 diabetes with metformin/glyburide tablets: an open-label study, interim report [abstract]. 2000 Ninth Annual Meeting and Clinical Congress of the American Association of Clinical Endocrinologists. Atlanta, Georgia; May 3-7, 2000:14.

Blonde L, Riddle M, Cathcart K, et al. Glycemic response to metformin/glyburide tablets when treatment groups are stratified by pre-enrollment dose of sulfonylurea [abstract]. 2000 Ninth Annual Meeting and Clinical Congress of the American Association of Clinical Endocrinologists. Atlanta, Georgia; May 3-7, 2000:7.

Rosenstock J, Riddle M, Piper BA, et al. Efficacy of metformin/glyburide tablets as second-line therapy in patients with type 2 diabetes who have inadequate glycemic control with at least half-maximum sulfonylurea dosing [abstract]. 2000 Ninth Annual Meeting and Clinical Congress of the American Association of Clinical Endocrinologists. Atlanta, Georgia; May 3-7, 2000:45.

F-D-C Reports. BMS counting on initial combo use for Glucovance to supplant Glucophage. "The Pink Sheet" 2000;62:5-6.

Blonde L, Sandberg MI. Transitioning patients with Type 2 diabetes to a final combination glyburide / metformin tablet. Diabetes Technol Therap 2000;2:479.

If you have a unique Patient Question an Answer, please send to us at

publisher@diabetesincontrol.com

Question from Issue #133 

Question from Issue #134

Question from Issue #135

Question from Issue #136

Question from Issue #137

Question from Issue #138

Question from Issue #139

Question from Issue #140

Question from Issue #141

Question from Issue #142

Question from Issue #143

Question from Issue #144

Question from Issue #145

Question from Issue #146

Question from Issue #147

Question from Issue #148

Question from Issue #149

Question from Issue #150

Question from Issue #151

Question from Issue #152