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Tell your doctor right away if you have any serious side effectsincludingnew/worsening vision problemse.gcolor or night vision problemsbone fracturereddish-colored urineurgent need to urinatepain while urinatingloss of appetiteyellowing eyes/skindark urinemental/mood changese.ghallucinationsconfusionseizureseasy bruising/bleedingsigns of infectione.gfeverpersistent sore throat

Skip the missed dose and use your next dose at the regular timeDo not use two doses at one time.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pioglitazone and glimepiride combination in the elderlyHoweverelderly patients are more likely to have hypoglycemia and age-related kidney problemswhich may require caution and an adjustment in the dose for patients receiving pioglitazone and glimepiride combination.

Symptomatic HFnot recommendedMonitor for signs/symptoms of CHFdiscontinue or reduce dose if occursEdemaGlimepiridepotential increased risk of cardiovascular mortalityHepatic diseaseMonitor liver function before initiating therapyif abnormalities detectedinterrupt and assess probable causedo not restart if ALT3XULN with total bilirubin2XULNRoutine monitoring LFTs during therapy without liver diseasenot recommendedActive bladder cancernot recommendedPrior history of bladder cancerconsider glycemic control benefits vs risk of cancer recurrenceRisk of fracturesespfemalesStressElderlydebilitateduncompensated strenuous excercisemalnourished or deficient caloric intakeadrenal or pituitary insufficiencyor alcohol intoxicationincreased risk of hypoglycemiaG6PD deficiencyconsider non-sulfonylurea alternativeRenal impairmentPerform regular eye examsResumption of premenopausal ovulation in anovulatory women may occurmay result in unintended pregnancyPregnancyNursing mothers.

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