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Introduction About PIONORM GM TABLET
PIONORM GM TABLET is a combination of Glibenclamide, Pioglitazone and Metformin which belongs to the group of medicines called Antidiabetics. It is used in the management of type 2 diabetes when single drug therapy, diet and exercise alone are not able to control diabetes.
Type 2 diabetes is a chronic medical condition in which the body does not make enough insulin or the produced insulin does not work well. Symptoms include excessive urination, excessive thirst, hunger, fatigue and blurred vision.
Avoid alcohol consumption while taking PIONORM GM TABLET as it may increase the risk of side effects. Do not take PIONORM GM TABLET if you have impairment in liver, kidney and heart function.
Before taking PIONORM GM TABLET, inform your doctor if you have hypoglycaemia (low blood sugar), haemolytic anemia and lactic acidosis. Your doctor may check your liver and kidney function test and blood sugar levels periodically while taking [GBNEYWORD].
PIONORM GM TABLET is not recommended for use in pregnant and breast-feeding woman. Also, it is not recommended for use in children and it should be used with caution in elderly patients. The common side effects of taking PIONORM GM TABLET are headache, nausea, vomiting, weight gain, diarrhoea and abdominal pain. Consult your doctor if any of the side effect worsens.
Uses Of PIONORM GM TABLET
- To manage type 2 diabetes (when single drug therapy, diet and exercise alone are not able to control diabetes)
How PIONORM GM TABLET Works
PIONORM GM TABLET lowers blood sugar level, where glibenclamide stimulates the secretion of insulin hormone that regulates blood sugar level. Pioglitazone makes liver and muscle cells more sensitive to insulin to make it easier for sugar in the blood to get into the cells and metformin decreases the glucose production in liver (gluconeogenesis) and increases the insulin sensitivity to absorb blood sugar. All these actions together are helpful in maintaining blood sugar level in type 2 diabetes.
How to use PIONORM GM TABLET
Always take PIONORM GM TABLET as advised by your physician. Swallow this medicine with a glass of water before meals. Your doctor will decide a suitable dose and duration for you depending upon your age and disease condition.
Side Effects Of PIONORM GM TABLET
Common
- disturbance in vision
- anemia (decreased red blood cell count)
- weight gain
- hypoglycaemia (decreased blood sugar levels)
- joint pain
- headache, dizziness
- blood in urine
- erectile dysfunction
- altered taste sensation
- nausea, vomiting
- diarrhoea
- abdominal pain
- loss of appetite, heartburn
- shortness of breath
Uncommon
- flatulence
- head spinning sensation (vertigo)
- sweating
- tiredness
Rare
- signs of decreased blood platelets (such as bleeding or bruising)
- signs of low white blood cells (which makes prone to infections)
Stop taking PIONORM GM TABLET and contact your doctor immediately if you experience any of the following side effects:
- signs of lactic acidosis (such as vomiting, stomach pain with muscle cramps, general feeling of being not well, severe tiredness and difficulty in breathing)
- abnormal liver function including yellowing of the skin and eyes (jaundice), problems with the bile flow (cholestasis), inflammation of the liver (hepatitis) or liver failure
- severe hypoglycaemia (signs include loss of consciousness, seizures or coma)
- signs of bladder cancer (blood in urine, pain when urinating or a sudden urge to urinate)
- broken bones
- blurred vision due to swelling (or fluid) at the back of the eye
- signs of allergic reaction (such as hives and swelling of the face, lips, tongue, or throat that may cause difficulty in breathing or swallowing)
How To Manage Side Effects

Diarrhea
Drink lot of fluids such as water or fruit juice to keep yourself hydrated. Avoid eating high-fat or spicy foods. Do not take any medicine on your own to manage diarrhoea without consulting your doctor.

Dizziness Or Drowsiness
Lie down until dizziness is gone, then get up slowly. Move slowly and carefully, do not hurry. Get adequate rest. Drink plenty of water and other fluids. Consult your doctor if the symptom gets worse.

Headache
Drink ample amount of water and avoid skipping meals. Get adequate rest. Try to be relaxed and stress free. Apply pain relieving balm on your forehead if necessary. Consult your doctor if the symptom does not improve.

Nausea And Vomiting
Stick to simple meals. Avoid eating oily, fried or spicy foods. Do not lie down or sleep immediately after eating. Consult your doctor if the symptom does not improve.

Stomach Pain
Try to rest and relax. Eat and drink slowly or try to have smaller meals more frequently. Keep a heat pad on your stomach. If the symptom does not improve, consult your doctor.
Warning & Precautions

Pregnancy
ContraindicatedPIONORM GM TABLET is not recommended for use in pregnant woman. Consult your doctor before taking it.

Breastfeeding
ContraindicatedPIONORM GM TABLET is not recommended for use in breastfeeding woman. Consult your doctor before taking it.

Driving and Using Machines
Use with CautionDo not drive or operate any machines if you feel dizzy, weak or increased sweating after taking PIONORM GM TABLET.

Alcohol
ContraindicatedDo not consume alcohol while taking PIONORM GM TABLET as it may increase the risk of side effects.

Kidney
ContraindicatedPIONORM GM TABLET is not recommended for use in patients with kidney failure or kidney dysfunction. Consult your doctor before taking PIONORM GM TABLET.

Liver
ContraindicatedPIONORM GM TABLET is not recommended for use in patients with liver impairment. Consult your doctor before taking PIONORM GM TABLET.

Allergy
ContraindicatedDo not take PIONORM GM TABLET if you are allergic to Glibenclamide, Pioglitazone or Metformin.

Lungs
ContraindicatedPIONORM GM TABLET is not recommended for use in patients with respiratory failure. Consult your doctor before taking PIONORM GM TABLET.

Heart Disease
ContraindicatedPIONORM GM TABLET is not recommended for use in patients with heart failure, recent myocardial infarction (heart attack) or shock. Consult your doctor before taking PIONORM GM TABLET.

Use In Pediatrics
ContraindicatedPIONORM GM TABLET is not recommended for use in children. Consult child’s doctor for advice.

Use In Geriatrics
Use with CautionPIONORM GM TABLET should be used with caution in elderly patients. Consult your doctor before taking PIONORM GM TABLET.
Others
PIONORM GM TABLET is not recommended for use if you have:
- diabetic ketoacidosis (serious diabetes complication where the body produces excess blood acids (ketones) or diabetic pre-coma (life-threatening disorder that causes unconsciousness due to high or low blood sugar levels)
- dehydration
- severe infection
Before taking PIONORM GM TABLET, inform your doctor if you have:
- hypoglycaemia (low blood sugar)
- haemolytic anemia (rare blood disorder in which red blood cells are rapidly destroyed)
- lactic acidosis (build-up of lactic in the bloodstream)
Interactions
A. Drug-Drug interactions:
Before taking PIONORM GM TABLET, inform your doctor if you are taking any of the following medicines:
- midazolam (used to reduce anxiety)
- gemfibrozil (used to manage high cholesterol)
- isoniazid, rifampicin (used to manage tuberculosis)
- furosemide (used to reduce swelling or oedema)
- medicines used to manage heart problems (Ex. amiloride, digoxin, procainamide, quinidine, propranolol, epinephrine)
- medicines used to suppress inflammation (Ex. prednisolone, dexamethasone)
- medicines used to manage mental health problems (Ex. moclobemide, amitriptyline)
- thyroid products like thyroxine (used to manage hypothyroidism)
- oral contraceptives such as ethinyl estradiol, desogestrel (used to manage pregnancy)
- phenytoin (used to manage fits)
- medicines used to provide relief from pain (Ex. aspirin, ibuprofen and celecoxib)
- chloramphenicol, sulfadiazine, cotrimoxazole and vancomycin (used to manage bacterial infections)
- warfarin (used to manage or manage blood clots)
- probenecid (used to manage gout)
Overdosage:
If you or anyone else accidentally takes too much of PIONORM GM TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are weakness, rapid heartbeat, increased sweating, dizziness and difficulty in concentration.
Synopsis
| Drug | : | Glibenclamide, Pioglitazone, Metformin | 
| Pharmacological Category | : | Sulfonylureas, Thiazolidinediones, Biguanides | 
| Therapeutic Indication | : | Type 2 diabetes mellitus | 
| Dosage Forms | : | Tablet | 
More Information
- Keep PIONORM GM TABLET out of reach of children
- Store at room temperature
FAQs About PIONORM GM TABLET
Q: What if I forget to take PIONORM GM TABLET?
A: If you forgot to take a dose of PIONORM GM TABLET, take it as soon as you remember. However, if it is time for the next dose of PIONORM GM TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of PIONORM GM TABLET to compensate for the missed ones.
Q: What are the side effects of taking PIONORM GM TABLET?
A: The most common side effects of taking PIONORM GM TABLET are abnormal vision, respiratory infection, weight gain, numbness, decreased blood sugar (hypoglycemia), headache, dizziness, joint pain, impotence, back pain, shortness of breath, flatulence, nausea, vomiting, diarrhea, abdominal pain, loss of appetite, and change in taste. Consult your doctor if any of the side effects worsen.
Q: Is PIONORM GM TABLET safe in pregnancy?
A: PIONORM GM TABLET is not recommended for use during pregnancy. Consult your doctor before taking it.
Q: Who should not take PIONORM GM TABLET?
A: PIONORM GM TABLET is not recommended for use if you have severe kidney disease, liver disease, heart failure, a history of heart failure, have recently had a heart attack, have severe problems with your circulation (such as shock), have breathing difficulties, type 1 diabetes mellitus, diabetic ketoacidosis or diabetic coma, bladder cancer, have blood in your urine that your doctor has not checked, or have dehydration due to severe diarrhea or vomiting, or have severe infections. Consult your doctor before taking it.
Q: Will taking a higher dose of PIONORM GM TABLET be more effective?
A: No, taking a higher dose of PIONORM GM TABLET will not be effective; rather, it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.
References
1. KD. Tripathi. Oral Antidiabetic drugs. Essentials of medical pharmacology. Eighth edition. 2019. Page – 294.
2. Yi-Wei Wang, Si-Jia He, Xiao Feng, Jin Cheng, Yun-Tao Luo, Ling Tian, and Qian Huang. Metformin: a review of its potential indications. NIH National Library of Medicine, National centre for biotechnology information. PubMed Central. August 2011. [Accessed on 13th July 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574599/
3. Sarayu A. Pai and Nilima A. Kshirsagar. Pioglitazone utilization, efficacy and safety in Indian type 2 diabetic patients: A systematic review and comparison with European Medicines Agency Assessment Report. NIH National Library of Medicine, National centre for biotechnology information. PubMed Central. November 2016. [Accessed on 13th July 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5393077/
4. Torrent Pharmaceuticals Ltd. Dibeta Trio (Glibenclamide, Pioglitazone and Metformin Hydrochloride (SR) Tablets). [Revised in February 2014]. [Accessed on 13th July 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/1850.pdf
5. Chanelle Medical, Loughrea, Co Galway. Health Products Regulatory Authority (HPRA). [Revised in May 2016]. [Accessed on 13th July 2022] https://www.hpra.ie/img/uploaded/swedocuments/2179143.PA0688_040_002.752e1eeb-1045-476a-97ac-9f7549199666.000001Product%20Leaflet%20Approved%205mg.160725.pdf
6. Gerard Laboratories. Electronic Medicines Compendium (EMC). [Revised in August 2020] [Accessed on 13th July 2022] https://www.medicines.org.uk/emc/files/pil.8836.pdf
7. Milpharm Limited. Electronic Medicines Compendium (EMC). [Revised in June 2020]. [Accessed on 13th July 2022] https://www.medicines.org.uk/emc/files/pil.594.pdf
Useful Diagnostic Tests
- Glucose tolerance test
- Random blood sugar
- Fasting blood sugar
- Liver function tests
Author Details
The contents of this website are for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay in seeking it because of something you have read on this website.
 
  
  
  
  
  
 