⚡ Quick Answer — What is Glisen PM?
Glisen PM is een triple-drug fixed-dose combination van glimepiride, pioglitazone and metformin (Glimepiride 1 mg (or 2 mg) + Pioglitazone 15 mg + Metformin 500 mg) used for diabetes type 2 not controlled on dual therapy. It targets hyperglycaemia through three complementary mechanisms: glimepiride stimulates insulin release from the pancreas, pioglitazone reduces insulin resistance in muscle/fat/liver, and metformin reduces liver glucose output. Typical HbA1c reduction: 2.0–2.5 points. Usual dose: one tablet once daily with breakfast. Side-effect profile combines hypoglycaemia risk (from glimepiride), weight gain and oedema (from pioglitazone), and metformin GI upset. Avoid in heart failure, active bladder cancer, eGFR < 30, severe hepatic impairment, and sulfa allergy. This is typically a step before insulin initiation.
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What Is Glisen PM?
Glisen PM is an oral fixed-dose combination tablet containing three active antidiabetic ingredients: glimepiride, pioglitazone and metformin hydrochloride (Glimepiride 1 mg (or 2 mg) + Pioglitazone 15 mg + Metformin 500 mg). It is manufactured by WHO-GMP certified manufacturer and supplied in packs of 30, 60, 90 or 180 tablets.
Triple therapy in a single tablet is used when dual therapy (usually metformin + sulfonylurea or metformin + TZD) is not achieving glycaemic targets, and the clinician wants to intensify treatment without starting insulin yet.
How Does Glisen PM Work?
The three components attack hyperglycaemia from three different directions:
- Metformine — reduces hepatic glucose production; improves peripheral insulin sensitivity; no hypoglycaemia on its own.
- Pioglitazon — PPAR-γ agonist; improves insulin sensitivity in muscle, fat and liver; improves lipid profile and fatty liver; no hypoglycaemia on its own.
- Glimepiride — third-generation sulfonylurea; closes beta-cell KATP channels to stimulate insulin release. This is the component that adds hypoglycaemia risk.
Combined HbA1c reduction is typically 2.0–2.5 percentage points compared with dual therapy.
Dosering en toediening
één tablet tweemaal daags, bij het ontbijt en avondeten. De dosering wordt individueel bepaald op basis van eerdere therapie, HbA1c-streefniveau en nierfunctie. one tablet once daily, with or just before breakfast. Some prescribers use one tablet twice daily with larger meals if HbA1c is not controlled on once-daily dosing.
- — verbetert de verdraagzaamheid van metformine. — improves tolerability and times the sulfonylurea’s insulin release to the post-meal glucose rise.
- Do not skip meals — glimepiride can cause hypoglycaemia on an empty stomach.
- Carry fast-acting carbohydrate.
- Monitor blood glucose, HbA1c, weight, ankle oedema, ALT, and renal function.
- Vitamin B12 check annually (long-term metformin).
Bijwerkingen
Vaak voorkomend:
- Hypoglykemie — from the glimepiride component; shakiness, sweating, palpitations, hunger, confusion. Treat with 15 g fast-acting carbohydrate.
- Gewichtstoename — 2–4 kg on average (pioglitazone + glimepiride drive gain; metformin slightly offsets).
- Perifeer oedeem — from pioglitazone; most common reason for stopping.
- Metformin GI side effects in first 1–2 weeks (diarrhoea, nausea, metallic taste).
- Mild anaemia (haemodilution from pioglitazone).
Zeldzaam maar ernstig: severe hypoglycaemia (especially in older adults, renal impairment); heart failure decompensation; bladder cancer (long-term high-dose pioglitazone); macular oedema; bone fracture in women; lactic acidosis (very rare; acute kidney injury or hypoxia).
Geneesmiddelinteracties
- Many drugs raise hypoglycaemia risk: insulin, other antidiabetics, alcohol, trimethoprim/sulfamethoxazole, fluconazole, clarithromycin, ACE inhibitors, high-dose salicylates, non-selective beta-blockers (also mask symptoms).
- Corticosteroids, thiazides, thyroid hormones, phenytoin, rifampicin, atypical antipsychotics, oral contraceptives reduce glucose-lowering effect.
- Gemfibrozil — doubles pioglitazone levels; pioglitazone component limited to 15 mg/day.
- IV contrast — hold Glisen PM pre- and post-procedure if eGFR < 60.
- Kationische geneesmiddelen — raise metformin levels.
Who Should Not Take Glisen PM?
- Hartfalen (NYHA III–IV)
- Active bladder cancer or unexplained haematuria
- Ernstig nierfalen (eGFR < 30)
- Severe hepatic impairment; ALT > 2.5× ULN
- Diabetische ketoacidose; diabetes type 1
- Allergie voor sulfonamiden (sulfa)
- Acute ziekte met risico op weefselhypoxie
- Zwangerschap, borstvoeding
- Known hypersensitivity to any component
In older adults (> 65): triple therapy containing a sulfonylurea carries a high hypoglycaemia risk. Many clinicians prefer a DPP-4 inhibitor or SGLT-2 inhibitor instead of glimepiride in this group.
Opslag
Store Glisen PM below 30°C in a dry place. Keep out of reach of children.
Veelgestelde vragen
When is a triple-drug diabetes tablet like Glisen PM prescribed?
Usually when dual therapy (typically metformin + sulfonylurea, or metformin + TZD) is not achieving HbA1c targets, and the clinician wants to intensify oral therapy before starting insulin. It is also convenient for patients already taking these three medicines separately — one tablet instead of three improves adherence.
Is Glisen PM the same as taking the three drugs separately?
Clinically, yes — same molecules at the same doses. The fixed-dose combination improves adherence and typically costs less, but offers less flexibility if one component needs a dose change.
Will Glisen PM cause low blood sugar?
Yes — it contains glimepiride, a sulfonylurea. Skipping meals, unusual exercise, alcohol without food, and renal impairment all raise hypoglycaemia risk. Always take with food and carry glucose tablets.
How much weight will I gain on Glisen PM?
Typically 2–4 kg over the first year — driven by pioglitazone (fluid and fat redistribution) and glimepiride (anabolic effect of more insulin). Metformin partially offsets this. Diet and exercise are the best counterweights.
Should I switch to insulin instead?
That is a decision for you and your prescriber. Insulin gives more predictable glucose control and is essential once beta-cell reserve is exhausted, but it requires injections and has its own hypoglycaemia and weight-gain profile. Triple oral therapy is often tried first in motivated patients who want to avoid injections.
Where can I buy Glisen PM online?
You can order Glisen PM (Glimepiride 1 mg (or 2 mg) + Pioglitazone 15 mg + Metformin 500 mg) from MedsBase in packs of 30, 60, 90 or 180 tablets. We ship worldwide, with discreet packaging and genuine WHO-GMP certified manufacturer stock.
Gerelateerde diabetesmedicatie
- Pioglit MF Forte — Pioglitazone + Metformin dual combo
- Glycomet-GP — Metformin + Glimepiride
- Amaryl — Glimepiride monotherapy
- Glycomet SR — Metformine met vertraagde afgifte
- Januvia — Sitagliptin (DPP-4 inhibitor alternative)
- Jardiance — Empagliflozin (SGLT-2-alternatief)
- Bekijk alle diabetesmedicatie
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