Drug Comparisons

Many people with Type 2 diabetes require multiple "anti-diabetic" medications to control their blood sugars. Doctors often prescribe both a sulfonylurea (such as glyburide or glipizide) and metformin together in the treatment of Type 2 diabetes due to the drugs' additive effects on reducing blood sugar levels and HbA1C ("hemoglobin A1C" --a blood test that measures diabetes control). Sulfonylureas work to decrease blood sugar mainly by stimulating the pancreas to secrete more insulin. Metformin works to decrease blood sugar by increasing the body's sensitivity or response to insulin. Two products are now available that combine both a sulfonylurea (either glyburide or glipizide) with metformin into one tablet.

Drugs in this Class
Glipizide and Metformin Tablets ( Glipizide and Metformin Hydrochloride Tablets, Metaglip Tablets )
Glyburide, Metformin Tablets ( Glucovance Tablets )

Summarizing the Evidence

• For patients who need both a sulfonylurea and metformin, combining both medications into one tablet (as either Metaglip or Glucovance) may help increase compliance, especially for patients who have difficulty remembering to take more than one medication.

• One disadvantage for Metaglip and Glucovance is that they contain a combination of drug ingredients in fixed amounts. Your healthcare provider can not adjust the dose of one drug ingredient without subsequently adjusting the other drug ingredient. For instance, if you are taking Glucovance and needed more metformin but not glyburide, your doctor could not increase the dose of metformin without also increasing the dose of glyburide. Taking the medications as individual drug products--glyburide plus metformin--makes it easier to customize the doses of each drug ingredient to your needs.

• No head-to-head trials have been performed to compare the effectiveness of Metaglip to Glucovance. When comparing the individual drug ingredients contained in Metaglip and Glucovance, the two sulfonylureas contained--glipizide and glyburide--are both equally effective in lowering blood sugar levels. Both Metaglip and Glucovance contain the same drug ingredient of metformin.

• The choice of which combination product to use will most likely depend upon what medications you were taking before (for example, if you were previously taking glyburide and metformin separately, then most likely the combined product your doctor would prescribe is Glucovance; if you were previously taking glipizide and metformin separately, then most likely your doctor would prescribe Metaglip). The choice may also depend upon your doctor's preference and your prescription benefits formulary.

Dosing and Administration

• Both Metaglip and Glucovance are generally taken once or twice daily with meals.

Generic Availability

• Both Metaglip (glipizide and metformin) and Glucovance (glyburide and metformin) are available generically.

Drug Interactions

Some interactions between medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how the drugs interact and the severity of the interaction, please use our Drug Interactions Checker.

Side Effects

To view specific side effect information, please use our Side Effect Checker.

Additional Information

References

1. Metaglip [package insert]. Princeton, NJ. Bristol-Myers Squibb Company. October 2002.

2. Glucovance [package insert]. Princeton, NJ. Bristol-Myers Squibb Company. October 2002.

3. Drugdex Database. In: Gelman CJ, Rumack BH, editors. Denver: Micromedex Inc. 2007.

4. Prendergast BD: Glyburide and glipizide, second-generation oral sulfonylurea hypoglycemic agents. Clin Pharm 1984; 3:473-485.

5. Birkeland KI, Furuseth K, Melander A, Mowinckel P, Vaaler S: Long-term randomized placebo-controlled double-blind therapeutic comparison of glipizide and glyburide. Glycemic control and insulin secretion during 15 months. Diabetes Care. 1994 Jan;17(1):45-9.

6. McEvoy GE, ed. American Hospital Formulary Service drug information 2007. Bethesda, MD: American Society of Health-System Pharmacists; 2007.

7. Drug Facts and Comparisons. Updated Monthly. St. Louis, MO: Facts and Comparisons, A Wolters Kluwer Company. 2007.

Last Updated: April 2008
This content was created by members of the DrugDigest team of experts and is solely under DrugDigest's editorial control.

Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It should not be construed to indicate that the use of the product is safe, appropriate, or effective for you. Consult your healthcare professional before taking any medication.