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Instruct patients to inform their doctor that they are taking Glucovance prior to any surgical or radiological procedureas temporary discontinuation of Glucovance may be required until renal function has been confirmed to be normalsee PRECAUTIONS

You may experience blurred visiondizzinessor drowsiness due to extremely low or high blood sugarDo not driveuse machineryor do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.

Sulfonylurea drugs are extensively bound to serum proteinsDisplacement from protein binding sites by other drugs may lead to enhanced hypoglycemic actionIn vitrothe protein binding exhibited by glyburide is predominantly non-ionicwhereas that of other sulfonylureaschlorpropamidetolbutamidetolazamideis predominantly ionicAcidic drugssuch as phenylbutazonewarfarinand salicylatesdisplace the ionic-binding sulfonylureas from serum proteins to a far greater extent than the non-ionic binding glyburideIt has not been shown that this difference in protein binding results in fewer drug-drug interactions with glyburide tablets in clinical use.

Metformin can cause a rare but serious condition known as lactic acidosisa build-up of acid in the bloodLactic acidosis can cause death and requires immediate treatmentSymptoms of lactic acidosis include.

Alcohol is known to potentiate the effects of metformin on lactate metabolismWarn patients against excessive alcohol intake while receiving Glucovance.

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