التداخل بين غليبنكلاميد وميتفورمين وسيتاغليبتين

Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues: Increased risk of hypoglycemia when used in combination with insulin and/or an insulin secretagogue.

Lower dose of insulin or insulin secretagogue may be required.

…ESRD requiring hemodialysis or peritoneal dialysis. [See Dosage and Administration (2.2) ; Use in Specific Populations (8.6) .] 5.4 Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues When JANUVIA was used in combination with insulin or insulin secretagogues (e.g., sulfonylurea), medications known to cause hypoglycemia, the incidence of hypoglycemia…

Insulin Secretagogues or Insulin Coadministration of JANUVIA with an insulin secretagogue (e.g., sulfonylurea) or insulin may require lower doses of the insulin secretagogue or insulin to reduce the risk of hypoglycemia. [See Warnings and Precautions (5.4) .]

This warning is based on the study conducted by the University Group Diabetes Program (UGDP), a long-term prospective clinical study designed to evaluate the effectiveness of glucose-lowering drugs in preventing or delaying vascular complications in patients with type 2 diabetes mellitus.