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Glucovance is capable of producing hypoglycemia or hypoglycemic symptomsthereforeproper patient selectiondosingand instructions are important to avoid potential hypoglycemic episodesThe risk of hypoglycemia is increased when caloric intake is deficientwhen strenuous exercise is not compensated by caloric supplementationor during concomitant use with other glucose-lowering agents or ethanolRenal or hepatic insufficiency may cause elevated drug levels of both glyburide and metformin hydrochlorideand the hepatic insufficiency may also diminish gluconeogenic capacityboth of which increase the risk of hypoglycemic reactionsElderlydebilitatedor malnourished patients and those with adrenal or pituitary insufficiency or alcohol intoxication are particularly susceptible to hypoglycemic effectsHypoglycemia may be difficult to recognize in the elderly and people who are taking beta-adrenergic blocking drugs.

Patients receiving Glucovance in combination with a thiazolidinedione may be at risk for hypoglycemia.

No animal studies have been conducted with the combined products in GlucovanceThe following data are based on findings in studies performed with the individual products.

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