Each film coated tablet of Gloryl-M®  500/ 4  contains :  

• Metformin Hydrochloride    500  mg
• Glimepiride                4   mg

Each film coated tablet of Gloryl-M® 500/ 2 contains :       

• Metformin Hydrochloride    500  mg
• Glimepiride                2   mg

• Gloryl-M®: is used as oral antidiabetic medicine, it is recommended as an adjunct to diet and physical exercise for the treatment of non-insulin dependent diabetes mellitus (Type 2).

• Gloryl-M®: is used when  the monotherapy with glimepiride or metformin dose not  result in adequate glycemic control.

• Gloryl-M®: is used in the replacement of the free combination therapy of glimepiride and metformin.

Gloryl-M® is contraindicated in the following cases:

• Insulin dependent diabetes (Type 1- diabetes requiring lnsulin therapy).
• Diabetic ketoacidosis. 
• Hypersensitivity to Gloryl-M®, or any of its ingredients,and other Sulfonylureas and biguanides. 
• Lactic acidosis. 
• Renal diseases or renal dysfunction.
• Heart failure.
• Recently heart attack, severe circulatory  problems or breathing difficulty.
• Liver diseases.
• Severe infections or any dehydration.
• X-ray with iodinated contrast materials administered IV stop tacking Gloryl-M® at the time of and for a few days after the procedure.
• If you are not eating sufficiently, if you are debilitated or suffering from pituitary or adrenal insufficiency.

• Gloryl-M® hypoglycemic effects may potentiated when administered with the following drugs: ( insulin and other oral antidiabetics, ACE inhibitors , allopurinol, anabolic steroids and male sex hormones, chloramphenicol, coumarin derivatiues, cyclophosphamide, disopyramide, fenfluramine, fenyramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, miconazole, para- aminosalicylic acid, pentoxifylline, phenylbutazone, azapropazone, oxyphenbutazone, probenecide, quinolines, salicylates, sulfinpurazone, sulfonamides, tetracyclines, tritoqualine, and trofosfamide) . 
• Weaking of blood sugar lowring effect and thus raised blood sugar levels may occur when the following medicines is taken, for example: (Acetazolamide, barbiturates, corticosteroides, diazoxide, diuretics, epinephrine, and other sympathomimetic agents, glocagon, laxatives, nicotinic acid, estrogens and progestogens, phenothiazines, phenytoin, rifampicin and  thyroid hormones).
• H2 receptor antagonists, clonidine and reserpine may` potentiate or decrease the Gloryl-M® effects.
• Beta- blockers decrease glucose tolerance. In patients with diabetes melitus this may lead to  deterioration of metabolic control, in addition, beta blockers may be potentiate or weaken the blood sugar lowering action of Gloryl-M® unpredictably.
• coumarin derivatives may increase or decrease the activity of Gloryl-M®.
• Lactic acidosis may occur by concomitant. with Gloryl-M® administration of the following drugs : Iodinated contrast materials and antibiotics having strong renal toxicity (for example gentamycin).

• Gloryl-M® should not be used during pregnancy, if there is planning for pregnancy or Breast feeding. 

• Hypoglycemia.
• Lactic acidosis practically those who have renal dysfunction.
• Temporary visual impairment may occur due to change  in blood Sugar levels.
• Occasionally, gastrointestinal symptoms may occur, most frequently during initiation of therapy and resolve spontaneously in most cases: ( Nausea, vomiting, sensation of pressure or fullness in the epigastria, flatulence, abdominal pain, and diarrhea. In rare cases, liver enzyme levels may increase. In isolated cases, impairment of liver function  (e.g with cholestasis and jaundice) and hepatitis may develop, possibly  leading  to liver failure) .
• Severe  changes in blood picture may occur, rarely, thrombopenia and in   isolated cases, leucopenia, hemolytic anemia, erythrocytopenia   and agranulocytosis, and pancytopenia may develop.
• A decrease in vit B12 levels can be observed, therefore, serum B12 levels should be appropriately monitored.
• Allergic or pseudo allergic reactions may occur e.g.:(in the form of itching, urticaria or rashes), such reactions may be mild, but  may become  more serious and may be complained by dyspnoea,  and fall  in blood pressure, sometimes  progressing to shock. In isolated cases, a decrease in serum sodium , inflammation of blood vessels  and hypersensitivity of the skin to light may occur.

Over dosage:

• If an excessive dose is taken ,this  may lead  to severe and sometimes life-threatening hypoglycemia and may require hospitalization even as precautionary  measure. 

• Gloryl-M® should be administered once or twice daily ,immediately before or with  meals.
• The tablet should  be swallowed  whole with about half a glass of water.
   

• Please follow closely the instructions for dosage monitoring (blood and urine tests), diet and physical activity ( physical work and exercise) as discussed with your doctor. 
• Inform your doctor  in event of the following : surgery, fever, infection, difficulty  in eating.
• In the first weeks of treatment, the risk of developing hypoglycaemia may be increased, and you may need to be closely monitored.
• Vision, alertness and reactions during driving or machine operation may be impaired when treatment for diabetes is not properly balanced or in the case of hypoglycemia.

•  Blister contains 10  tablets, pack contains three  blister.

• Store in a dry place, away  from light and temperature below 30 °C.