Gemer 2 Tablet

Gemer 2 tablet is an oral anti-diabetic medicine. It contains a combination of glimepiride and metformin as its active ingredient. It is used for the treatment of type 2 diabetes mellitus, a condition where blood sugar level rises above the normal range and cannot be controlled by diet and exercise alone.

This medicine lowers the raised blood glucose levels. You must follow a healthy diet and exercise along with the medicine. Gemer must be taken as directed by the doctor and in doses and duration as prescribed.

It must be taken with meals, with the first meal of the day. Take this tablet at the same time daily to gain optimal therapeutic benefit. Zoryl M 2 tablet , Glimestar M2 tablet , Amaryl M2 tablet , Glycomet GP 2 tablet and Gluconorm G 2 tablet are some more medications that combine metformin and glimepiride.

Before using the Gemer, inform the doctor if you are pregnant, planning a pregnancy or are breastfeeding and about the detailed medical history. An individual with uncontrolled diabetes is at increased risk of various health complications such as eye, kidney and nerve problems, heart diseases and stroke.

Dosage

Overdose

• An overdose of Gemer Tablet may lead to hypoglycemia (low blood sugar) and lactic acidosis (Excessive lactic acid build-up).
• This results in headache, nausea, vomiting, sleep disturbances, restlessness, impaired alertness and reactions, depression, confusion, dizziness, etc.
• If you experience these symptoms, take glucose or juice or sugar-containing products (sugar candy) and contact the doctor or visit the nearest hospital as you may require close monitoring for the next few hours.

Missed a Dose

• A missed dose may lead to high blood sugar levels, which includes symptoms like feeling thirsty, excessive urination, loss of appetite, dry mouth, the fruity smell from breath, etc.
• If you have missed taking a dose of the Gemer Tablet, take it as soon as you remember.
• If it's time for the next dose, skip the missed dose and continue with the regular dose schedule.
• Avoid taking a double dose to compensate for the missed one.

Mode of Action

How Does It Work?

• Gemer Tablet controls blood sugar to a greater extent than metformin or glimepiride alone.
• Glimepiride lowers the blood sugar level and increases the release of insulin from the pancreas.
• Insulin passes sugar (glucose) from the blood into the cells.
• Metformin decreases the absorption in the intestine and the production of sugar in the liver.
• Both of these components increases the insulin sensitivity of the body (which allows the cells of the body to use blood glucose more effectively, reducing blood sugar).

Directions for Use

Take as directed by the doctor. Swallow as a whole with a glass of water, with meals. Do not cut, break or chew the medicine. Take at a fixed time every day for optimal results. Avoid consuming more than prescribed by the doctor.

Precautions and Warnings

Pregnancy

Can I take Gemer Tablet during pregnancy?

Avoid during pregnancy as it may cause harm to the unborn baby. Inform the doctor if you are planning a pregnancy, he might suggest other alternatives.

Breast Feeding

Can I take a Gemer Tablet while breastfeeding?

There is little safety information available, avoid while breastfeeding. The doctor may prefer an alternate medicine while nursing a newborn /premature infant.

Driving

Can I drive after consuming the Gemer Tablet?

• Gemer Tablet causes low blood sugar levels which leads to drowsiness, unconsciousness or confusion. It is dangerous while driving.
• Consult the doctor whether you can drive a car if you have frequent episodes of hypoglycemia.
• Keep a juice or chocolate in the car while driving, in case you start feeling the symptoms of hypoglycemia, have the juice or chocolate.
• Avoid artificial sweeteners.

Alcohol

Can I consume alcohol while taking Gemer Tablet?

• Avoid alcohol during treatment with Gemer Tablet.
• Alcohol alters the way medicine works. Avoid consuming consume alcohol on an empty stomach. Alcohol increases the risk of low blood sugar.
• Excessive consumption of alcohol while taking the medicine cause an increased risk of lactic acidosis.

Other General Warnings

Talk to your doctor if

• You suffer from hunger, headache, nausea, vomiting, sleepiness, restlessness, aggression, reduced alertness, confusion, shakiness or dizziness. These could be signs of low blood sugar. If you have any of these, have sugar or sweet juice. Inform the doctor as you may need a change in the medicine's dose.
• You suffer from pins-and-needles sensation, numbness and weakness.
• You are undergoing a diagnostic imaging test that involves the injection of iodine.
• You suffer from dehydration due to diarrhoea, vomiting or limited fluid intake.
• You have suffered through trauma.
• You are undergoing surgery shortly.
• You have or had thyroid, kidney and liver disease.
• You skip meals or have irregular mealtimes.
• You suffer from weight gain (specific diet restriction may be suggested).

Contraindications

• If you are allergic to metformin, glimepiride or other ingredients of the Gemer Tablet.
• If you are pregnant or are breastfeeding.
• If you have kidney or liver failure.
• If you have metabolic acidosis (too much acid in the body fluids) like lactic acidosis, diabetic ketoacidosis or diabetic pre-coma.
• If you suffer from dehydration, severe infections, shock and injections containing iodine.
• If you have or had heart or lung failure, the incidence of heart attack and shock.
• If you are an alcoholic.

Side effects

• Headache
• Nausea
• Vomiting
• Nausea
• Sleepiness
• Low blood sugar level

Interactions

Interactions with other medicines

• Some medicines affect the way the Gemer Tablet works, or the medicine itself reduces the effectiveness of other medicines taken at the same time.
• Inform the physician regarding the medicines, supplements or herbals you take or might take to avoid possible interaction.
• You may suffer from symptoms of low blood sugar if you are taking other medicines for diabetes like Insulin, Pioglitazone, medicines for high blood pressure (ACE inhibitors like Captopril), Steroids, Chloramphenicol, Fenfluramine, medicine to lower blood cholesterol (fibrates), medicine to treat depression (Fluoxetine), medicine to treat blood clotting like Coumarins, Cyclophosphamide, Miconazole, Probenecid, antibiotics like Clarithromycin, Doxycycline, Ofloxacin, etc.
• You may have symptoms of high blood sugar if you are taking oral contraceptives, Acetazolamide, water pill, Phenytoin, Rifampicin, medicines for constipation, Phenytoin, Rifampicin and medicines for thyroid disorders.
• Medicines like anti-allergic (ranitidine), clonidine, reserpine and medicines used to treat high blood pressure like atenolol alter the way the medicine works and may block the body's response to low blood sugar. This leads to dangerously low levels of blood sugar.
• Medicines like Diclofenac, Ibuprofen, Water pill, Enalapril may affect kidney functions if taken along with the medicine.
• Medicines used to treat thyroid affect the way the medicine works.

Storage and disposal

• Store at room temperature in a dry place.
• Protect it from direct sunlight and moisture.
• Keep it away from children and pets.

Frequently Asked Questions (FAQs)

What diet should I follow?

• Your diet must be high in fibre and low in fat, with adequate protein, carbohydrates, vitamins and minerals.
• Maintain the meal timings and try to have soups and salads.
• Include boiled, steamed or baked food.
• Ensure moderate use of edible oils (groundnut oil, olive oil) and little use of ghee and butter.
• Drink 8-10 glasses of water daily.
• Keep fruit or low-calorie and high fibre biscuits while travelling.

What should I avoid being a diabetic patient?

• Avoid shopping when you are hungry. You end up buying oily and fried food.
• Avoid overeating.
• Avoid using maida, white bread, potato, noodles, cornflakes, poori, biryani, naan, fried rice, etc.
• Stop having daals with ghee and deep-fried pulses.
• Avoid using cream soups, carrot juice, deep-fried vegetables and vegetable curries with excess oil.

My blood sugar falls too often; what is the reason?

• Your blood sugar may fall if you skip meals, have irregular meal patterns, fast, increase alcohol intake, especially on an empty stomach or take a double dose of the medicine. If you are taking medicines mentioned in the drug interaction section, inform the doctor.
• Take juice or sugar candy with you. In case of hypoglycemia, like headache, irritability, drowsiness, reduced alertness or nausea, immediately have the juice or glucose.
• Avoid artificial sweeteners in this situation.
• If such episodes happen too often, inform the doctor, as you may need a decrease in the dose of the medicine.

For how long do I need to take Gemer?

You have to take this medicine for as long as a doctor has prescribed you. Do not stop the treatment mid-way even if you feel better, without consulting a doctor.

What is the use of Gemer?

Gemer Tablet is used to treat high blood sugar levels, mainly Type 2 diabetes mellitus, when it cannot be controlled by Glimepiride or Metformin alone, along with controlled diet and exercise.