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Show (Glyburide and Metformin HC! Tablets) sated lactic seidoels. Property iunotioning, Kinays. ae in 0 event lactic acidosis. M kidney problemsMghould not take GLUCOVANCE.(See 3.) Qt. Why do I need to take GLUCOVANCE? Your doctor has prescribed GLUCOVANCEto treat yourtype2 diabetes. This is also known as non-insulin-dependent di mellitus. Q2, What is type 2 diabetes? People with diabetes are not able to make enoughinsulin and/or respond normally to the insulin their body does make. When this happens, sugar (glucose) builds up in the blood. This can lead to serious medical problemsincluding kidney damage. amputations, and blindness. Diabetes is also closely linked to heart disease. The main goai of treating diabetes is to lower your blood sugarto a normal level Q3. Why is it important to control type 2 diabetes? The main goalof treating diabetesis to lower your blood sugar to anormal level. Studies have shown that good control of blood sugar may prevent or delay complications such as heart disease, kidney disease,or blindness. Q4, How is type 2 diabetes usually controlled? High blood sugar can be lowered by diet and exercise, umber of oral medications, and by, ineuln Injections, Before taking GLUCOVANCE you should first try to control your diabetes by exercise and weight loss. Even if you are taking GLUCOVANCE, you should still exercise and follow the diet recommended for your diabetes 5. Does GLUCOVANCEwork diferenty from other glucose control medications: Yes it does. GLUGOVANCE combines two glucose lowering rugs, glyburide and metformin. These two drugs together to improve the different metabolic defects found in type 2 diabetes. Glyburide lowers blood sugar primarily by causing more of the body's owninsulin to be released, and metformin lowers blood sugar,in part, by helping your b jour own insulin more effectively. Together, they are efficient in halping you achieve better glucose control. Q6, What happens if my blood sugaris still too high? When blood sugar cannotbe lowered enough by GLUCOVANCE your doctor may prescribe injectable insulin ortake other meastures to control your diabetes. Q7. Can GLUCOVANCEcause side effects? GLUCOVANCE,like all blood sugar-lowering medications, can cause side effects in some patients. Most of these side effects are minor. However, there are also serious,but rare, side effects related to GLUCOVANCE(see Q9 - Q13) Q8, What are the most common side effects of GLUCOVANCE? The most common side effects of GLUCOVANCEare normally minor ones such as diarrhea, nausea, and upset stomach. If these side effects occur, they usually occur during the first few weeks of therapy Taking your GLUCOVANCE wih meets can help reducethese si Less frequently ioe of hypoglycemia (low blood sugar), such aslightheadedness, dizziness, shakiness. or hunger may occur. The kidneys or i Your risk of developing lactic acidosis from taking GLUCOVANCE (Ghyuride end Metformin HC! Tablets) is very 'as long as your kidneys and liver are healthy. However, some factors can incroase your risk because they can affect Kicney ‘andliver function. You should discuss yourrisk with your physi- WARNING: A smail number of people who have taken metiformin hydrochloride have developed a serious son stion Nos. There is no evidencethat GLUCOVANCE causes harm to the 11. Are there other risk factors for lactic acidosis? risk of hypoglycemic symptoms increases when meals skipped, too much alcoholis consumed, ry occurs without enough food. Following the advice of your doctor can help you to avoid these symptoms. Q9. Are there any serious side effects that GLUCOVANCEcan cause? GLUCOVANCErarely causes serious side effects. The most serious side effect that GLUCOVANCE can cause is called lactic acidosis. cian. You should not take GLUCOVANCEif: * You have chronic kidney or liver problems You have congestive heart failure which is treated with medications, e.g., digoxin (Lanoxin) or furosemide (Lasix”) drinking) * You are seriously dehydrated (havelost a large amount of body fluids) © You are going to have certain x-ray procedures with injectable contrast agents *# You are going to have surgery '* You develop a serious condition such as a heart attack, severe infection, ora stroke * You are 280 years of age and have NOThad yourkidney function tested Q12. What are the of lactic acidosis? Some of the symptoms include: feeling very weak, tired or uncomfortable; unusual muscle pain, trouble breathing, unusual ‘or unexpected stomach discomfort, feeling cold, feeling dizzy or h suddenly developing a slow or iregular heartbeat If you notice these symptoms,or if your medical condition has suddenly changed, stop taking GLUCOVANCEtablets and call your doctor right away. Lactic acidosis is a medicalemergency that mustbe treated in a hospital es What dea sy desir aca Ger te cecrenee yk lactic acidosis? Tell your doctorif you have anillness that results in severe vom- iting, diarrhea, and/or fever, or if your intake of fluidsis significantly reduced, These situations canlead to severe dehydration, and it may be necessary to stop taking GLUCOVANCE temporarily. You should let your doctor know if you are going to have any surgery or specialized x-ray procedures that require injection of contrast agents. GLUCOVANCEtherapy will need to be stopped temporarily in such instances. Q14, Can| take GL with other Remind your doctor that you are taking GLUCOVANCE when any newdrug is prescribed or a change is made in how you take C a t already prescribed. GLUCOVANCEmayinterfere with the some drugs work and some drugs may interfere with the actionofGLUCOVANGE 15, Whatif | become pregnant while taking GLUCOVANCE? ‘ou shouldfile your return even if you can’t afford to paythe taxes you owe. A Form 9465 | “Installment Agreement Request”is | almost always granted when you owe less than $10,000. Hiding only makes the IRS madder. PLAN FOR N t's nevertoo early. Ifyou havelosses in shares you couldn't bear to sell last year, considerselling them nowto establish your tax loss—up to $3000 of which can serve to lower your 2003 taxable income. If you have gains in shares you've held at least a year and a day,consid- | er using them toestablish a charitable | gift fund accountat Vanguard,Fidelity | or Schwab. Giving appreciated secu-| ities is a cheaper wayto be charitable than giving cash. If you have children, considerset- | ting up a Coverdell Education Savings Account and/or a Section 529 college tuition plan. (See savingforcollege.com to help researchthealternatives, Utah offers one of the best plans.) ib AndrewTobias, PARADE's PersonalFi nanceEditor, is the authorof “The Only Investment Guide You'll Ever Need.” Tell your doctorif you plan to become pregnant or have become pregnant. with other oral glucose-contro! medications, you should not take GLUCOVANCEduring pregnancy. Usually your doctor will prescribe ingulin while you are pregnant. As with all medications, you and your doctor should discuss the use of GLUCOVANCEif you are nursing a child Q16, How do | take GLUCOVANCE? Your doctor will tell you how many GLUCOVANCEtablets to ae a3en how often. This should also be printed on the label of rescription. You will probably be started on a low dose of ELUGOVANCE and your dosage wil be increased gradually unti your blood sugaris controlled, Q17. Where can | get more information about GLUCOVANCE? This leaflet is a summary of the most important information about GLUCOVANCE. If you have any questionsor problems, you shouldtalk to your doctor or other healthcare provider about type 2 diabetes as well as GLUCOVANCEandits side effects. There is also a leaflet (package insert) vaten for heath profes sionals that your pharmacist canlet you rea GLUCOVANCE*isa registered trademark of Merck Santé S.A.S.. an associate of Merck KGaA of Darmstadt, Germany. Licensed to Bristol-Myers Squibb Company. Micronase* is @ registered trademark of Pharmacia & Upjohn Company. Distributed by Bristol-Myers Squibb Company Princeton, NJ 08543 USA cases Is algo important for yourIver to be workingnormally when you boodGLUCOVANCE Your liver helps remove lactic acid from your Visit www.irs.gov(the IRS Web site) for any forms or publications you need,along with “frequently asked questions,” “hints” and—new this y' “Where's My Refund?" If an Internet connectionis not handy, call the new refund hotline listed below...although,if youall call at oncethis Sunday morning,| make no promises. Here are some othe helpful numbers: 1-800-829-1040—Tax helpline 1-800-829-3676—Forms/publications 1-800-829-1954—Refund hotline 1-888-796-1074—Fore-filing Feat beyond April 1-800-829-4059—TDDline for ee, hearing-impai & Bristol-Myers Squibb Company rare,if lactic acidosis does occur,it can be fatalin up to half the Siaoe will monitor your diabetes and may perform blood tests on you from time to time to make sure your kidneys and your liver are functioning normally DON'T HIDE * You drink alcoho! excessively (all the time or short-term “binge” Q10. What is lactic acidosis and can it happen to me? Lactic acidosis isa bya buildup bolactic sold fithe Deas: ated with met . mally, acto acidosis has been patients taking metformin over the cous fa TAX TIPS/continued Sees =ae rs 1-888-912-1 artic suggest boenpeanerts to IRS procedures 1-877-777-4778— Advocate hotline (if all else fails) F7-B001B-10-02 607211DIM-06 Revised: October 2002 PAGE 10 : FEBRUARY 16, 2003 « PARADE MAGAZINE w~eem Rx only PATIENT INFORMATION ABOUT GLUCOVANCE® |
