Glucovance Contraindications

Metformin + glibenclamide (Glucovance) must never be used in case of: Hypersensitivity to metformin hydrochloride, glibenclamide or other sulfonylureas and sulfonamides or to any of the excipients; Any type of metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis); Diabetic pre-coma; Severe renal failure (CrCl below 30 mL/min or eGFR below 30 mL/min/1.73m²); Acute conditions with the potential to alter renal function such as dehydration, severe infection, cardiovascular collapse (shock); Disease (especially acute disease, or worsening of chronic diseases) which may cause tissue hypoxia such as unstable congestive heart failure, respiratory failure, recent myocardial infarction, cardiovascular collapse or shock; Hepatic insufficiency, acute alcohol intoxication, alcoholism; Porphyria (a rare hereditary disease due to an enzyme deficiency causing the body to produce and excrete too much porphyrin, a component used to make the part of blood pigment that carries oxygen); Lactation; In association with miconazole even for local use (see Interactions).
Intravascular administration of iodinated contrast materials may lead to renal failure. This may induce metformin accumulation and may expose to lactic acidosis. Depending on the renal function, metformin + glibenclamide (Glucovance) must be discontinued 48 hours before or from the time of intravascular administration of iodinated contrast media and not reinstituted until 48 hours afterwards, and only after renal function has been re-evaluated and found to be normal.
Metformin + glibenclamide (Glucovance) must be discontinued 48 hours before an elective major surgery and may not be reinstituted until 48 hours afterwards, and only after kidney function has been re-evaluated and found to be normal.