Glipizide-Metformin 2.5mg/250mg Tab
WARNING: Rarely, metformin may cause too much lactic acid in the blood (lactic acidosis). The risk is higher in people who have kidney problems, liver problems, heart failure, use alcohol, or take certain other drugs, including topiramate. The risk is also higher in people who are 65 or older and in people who are having surgery, an exam or test with contrast, or other procedures. If lactic acidosis happens, it can lead to other health problems and can be deadly. Kidney tests may be done while taking this drug.Do not take this drug if you have a very bad infection, low oxygen, or a lot of fluid loss (dehydration).Call your doctor right away if you have signs of too much lactic acid in the blood (lactic acidosis) like confusion; fast breathing; fast or slow heartbeat; a heartbeat that does not feel normal; very bad stomach pain, upset stomach, or throwing up; feeling very sleepy; shortness of breath; feeling very tired or weak; very bad dizziness; feeling cold; or muscle pain or cramps. @ COMMON USES: It is used to lower blood sugar in patients with high blood sugar (diabetes).
Drug Class
Antidiabetic agent
Pharmacologic Class
Sulfonylurea; Biguanide
Pregnancy Category
Category C
FDA Approved
Sep 2002
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medication is a combination of two drugs, glipizide and metformin, used to help control high blood sugar in people with type 2 diabetes. Glipizide helps your body release more insulin, and metformin helps your body use insulin better and reduces the amount of sugar your liver makes.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. It's recommended to take this medication with meals. Additionally, be sure to follow the diet and exercise plan that your doctor has advised, as this will help you get the best results from your treatment. Even if you start to feel well, continue taking your medication as prescribed by your doctor or other healthcare provider.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication, store it at room temperature in a dry location, avoiding the bathroom. Keep all medications in a secure place, out of the reach of children and pets. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so. Instead, consult with your pharmacist for guidance on the proper disposal method. You may also want to inquire about drug take-back programs in your area, which can provide a safe and environmentally responsible way to dispose of unwanted medications.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember, with a meal. However, if it's nearly time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. It's essential to avoid taking two doses at the same time or taking extra doses, as this can increase the risk of adverse effects.
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. It's recommended to take this medication with meals. Additionally, be sure to follow the diet and exercise plan that your doctor has advised, as this will help you get the best results from your treatment. Even if you start to feel well, continue taking your medication as prescribed by your doctor or other healthcare provider.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication, store it at room temperature in a dry location, avoiding the bathroom. Keep all medications in a secure place, out of the reach of children and pets. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so. Instead, consult with your pharmacist for guidance on the proper disposal method. You may also want to inquire about drug take-back programs in your area, which can provide a safe and environmentally responsible way to dispose of unwanted medications.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember, with a meal. However, if it's nearly time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. It's essential to avoid taking two doses at the same time or taking extra doses, as this can increase the risk of adverse effects.
Lifestyle & Tips
- Take this medication with meals to reduce stomach upset and help prevent low blood sugar.
- Follow a healthy diet plan recommended by your doctor or dietitian.
- Engage in regular physical activity as advised by your healthcare provider.
- Monitor your blood sugar levels regularly as instructed.
- Limit alcohol intake, as it can increase the risk of low blood sugar and a serious side effect called lactic acidosis.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Initial: 2.5 mg glipizide / 250 mg metformin once daily with a meal. Titrate gradually based on glycemic control. Max: 20 mg glipizide / 2000 mg metformin daily.
Dose Range:
2.5 - 20 mg
Condition-Specific Dosing:
Type 2 Diabetes Mellitus:
Initial: 2.5 mg glipizide / 250 mg metformin once daily with a meal. May increase by 2.5 mg glipizide / 250 mg metformin per day every 1-2 weeks, up to 10 mg glipizide / 1000 mg metformin daily, given in divided doses with meals. Max daily dose: 20 mg glipizide / 2000 mg metformin.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
eGFR 60-89 mL/min/1.73m2: No dose adjustment for glipizide. Metformin: Monitor renal function at least annually. Continue current dose.
Moderate:
eGFR 45-59 mL/min/1.73m2: Metformin: Not recommended to initiate. If already on metformin, max dose 1000 mg/day. Glipizide: Use with caution, start at lower end of dosing range, titrate slowly. Monitor closely. eGFR 30-44 mL/min/1.73m2: Metformin: Not recommended to initiate. If already on metformin, max dose 850 mg/day. Glipizide: Use with caution, start at lower end of dosing range, titrate slowly. Monitor closely.
Severe:
eGFR < 30 mL/min/1.73m2: Contraindicated due to metformin component (increased risk of lactic acidosis).
Dialysis:
Contraindicated due to metformin component.
Hepatic Impairment:
Mild:
Use with caution. Increased risk of hypoglycemia (glipizide) and lactic acidosis (metformin). Monitor liver function and glucose closely.
Moderate:
Use with caution. Increased risk of hypoglycemia (glipizide) and lactic acidosis (metformin). Monitor liver function and glucose closely. Consider lower doses.
Severe:
Generally not recommended due to increased risk of lactic acidosis with metformin and severe hypoglycemia with glipizide.
Pharmacology
Mechanism of Action
Glipizide stimulates insulin secretion from pancreatic beta cells by binding to sulfonylurea receptors, leading to closure of ATP-sensitive potassium channels, depolarization, and calcium influx. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Absorption:
Bioavailability:
Glipizide: ~100%; Metformin: 50-60%
Tmax:
Glipizide: 1-2 hours; Metformin: 2-3 hours (IR)
FoodEffect:
Glipizide: Food delays absorption but does not affect extent. Metformin: Food decreases and slightly delays absorption.
Distribution:
Vd:
Glipizide: ~10 L; Metformin: 654 L
ProteinBinding:
Glipizide: >98%; Metformin: Negligible
CnssPenetration:
Limited for both
Elimination:
HalfLife:
Glipizide: 2-4 hours; Metformin: 6.2 hours (plasma), 17.6 hours (blood)
Clearance:
Not available (varies)
ExcretionRoute:
Glipizide: Urine (80%), Feces (10%); Metformin: Renal (unchanged)
Unchanged:
Glipizide: <1%; Metformin: ~100%
Pharmacodynamics
OnsetOfAction:
Glipizide: ~30 minutes; Metformin: Days to weeks for full effect
PeakEffect:
Glipizide: 1-2 hours; Metformin: 2-3 weeks for full effect
DurationOfAction:
Glipizide: 10-24 hours; Metformin: 12-24 hours (IR)
Safety & Warnings
BLACK BOX WARNING
Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. The onset of metformin-associated lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal distress. Metformin-associated lactic acidosis was characterized by elevated blood lactate levels (>5 mmol/L), anion gap acidosis (without evidence of ketonuria or ketonemia), and an increased lactate/pyruvate ratio; metformin plasma levels were generally >5 mcg/mL. If acidosis is suspected, discontinue Glipizide-Metformin and institute general supportive measures in a hospital setting. Prompt hemodialysis is recommended. Risk factors include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors), age 65 years or greater, radiological studies with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic impairment.
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Feeling extremely tired or weak
Low blood sugar (hypoglycemia), which may be more likely when this medication is used with other diabetes medications. Symptoms of low blood sugar may include:
+ Dizziness
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
If you experience any of these symptoms, contact your doctor right away and follow their instructions for managing low blood sugar, which may include taking glucose tablets, liquid glucose, or some fruit juices.
Stomach Problems
It's common to experience stomach problems like upset stomach, vomiting, or diarrhea when starting this medication. However, if you develop stomach problems later during treatment, contact your doctor right away, as this could be a sign of a serious condition called lactic acidosis.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only have mild ones, it's essential to contact your doctor or seek medical help if you're bothered by any of the following:
Dizziness or headache
Diarrhea, upset stomach, or vomiting
Stomach pain
Muscle pain
Signs of a common cold
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Feeling extremely tired or weak
Low blood sugar (hypoglycemia), which may be more likely when this medication is used with other diabetes medications. Symptoms of low blood sugar may include:
+ Dizziness
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
If you experience any of these symptoms, contact your doctor right away and follow their instructions for managing low blood sugar, which may include taking glucose tablets, liquid glucose, or some fruit juices.
Stomach Problems
It's common to experience stomach problems like upset stomach, vomiting, or diarrhea when starting this medication. However, if you develop stomach problems later during treatment, contact your doctor right away, as this could be a sign of a serious condition called lactic acidosis.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only have mild ones, it's essential to contact your doctor or seek medical help if you're bothered by any of the following:
Dizziness or headache
Diarrhea, upset stomach, or vomiting
Stomach pain
Muscle pain
Signs of a common cold
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Symptoms of low blood sugar (hypoglycemia): sweating, shaking, fast heartbeat, dizziness, hunger, confusion, irritability. Carry a source of sugar (e.g., glucose tablets, juice) to treat low blood sugar.
- Symptoms of lactic acidosis (a rare but serious side effect): unusual muscle pain, trouble breathing, stomach discomfort, unusual tiredness, dizziness, feeling cold, slow or irregular heartbeat. Seek immediate medical attention if these occur.
- Symptoms of vitamin B12 deficiency: unusual tiredness, weakness, numbness or tingling in hands or feet, sore tongue, memory problems.
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
Certain health conditions, including:
+ Acidic blood problems
+ Kidney disease
+ Liver disease
+ Type 1 diabetes
Recent medical events, such as a heart attack or stroke
Any difficulties with eating or drinking, including situations where you may be required to fast before a procedure or surgery
Upcoming or recent exams or tests that involve contrast agents (within the past 48 hours)
Additionally, if you:
Are pregnant or think you might be pregnant (do not take this medication if you are pregnant)
Are breast-feeding or plan to breast-feed
This medication can interact with other drugs and health conditions. Therefore, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products, vitamins, or supplements you are using
Your complete medical history
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to ensure your safety.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
Certain health conditions, including:
+ Acidic blood problems
+ Kidney disease
+ Liver disease
+ Type 1 diabetes
Recent medical events, such as a heart attack or stroke
Any difficulties with eating or drinking, including situations where you may be required to fast before a procedure or surgery
Upcoming or recent exams or tests that involve contrast agents (within the past 48 hours)
Additionally, if you:
Are pregnant or think you might be pregnant (do not take this medication if you are pregnant)
Are breast-feeding or plan to breast-feed
This medication can interact with other drugs and health conditions. Therefore, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products, vitamins, or supplements you are using
Your complete medical history
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to ensure your safety.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before consuming alcohol, discuss the potential risks with your doctor.
To ensure your safety, avoid driving and other activities that require alertness until you understand how this medication affects you. Additionally, do not drive if you have experienced low blood sugar, as this increases the risk of accidents.
If you have a deficiency of the enzyme G6PD, use caution when taking this medication, as it may lead to anemia. This deficiency is more common in individuals of African, South Asian, Middle Eastern, and Mediterranean descent.
Follow your doctor's instructions for monitoring your blood sugar levels and undergo blood tests as recommended by your doctor. It is also crucial to discuss your test results with your doctor.
Long-term treatment with metformin may cause a decrease in vitamin B-12 levels. If you have a history of low vitamin B-12 levels, consult your doctor before taking this medication.
If you are also taking colesevelam, take it at least 4 hours after taking this medication. Be aware that this medication may increase the risk of death from heart disease, and discuss this with your doctor.
During periods of stress, such as fever, infection, injury, or surgery, it may be more challenging to control your blood sugar levels. Changes in physical activity, exercise, or diet can also affect your blood sugar levels.
If you experience diarrhea or vomiting, contact your doctor promptly, as you may need to drink more fluids to prevent excessive fluid loss. In hot weather or during physical activity, drink plenty of fluids to avoid dehydration.
If you have been taking this medication for an extended period or at high doses, it may become less effective, and you may require higher doses to achieve the same effect. This is known as tolerance. If you notice that the medication is no longer working effectively, contact your doctor. Do not take more than the prescribed dose.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.
To ensure your safety, avoid driving and other activities that require alertness until you understand how this medication affects you. Additionally, do not drive if you have experienced low blood sugar, as this increases the risk of accidents.
If you have a deficiency of the enzyme G6PD, use caution when taking this medication, as it may lead to anemia. This deficiency is more common in individuals of African, South Asian, Middle Eastern, and Mediterranean descent.
Follow your doctor's instructions for monitoring your blood sugar levels and undergo blood tests as recommended by your doctor. It is also crucial to discuss your test results with your doctor.
Long-term treatment with metformin may cause a decrease in vitamin B-12 levels. If you have a history of low vitamin B-12 levels, consult your doctor before taking this medication.
If you are also taking colesevelam, take it at least 4 hours after taking this medication. Be aware that this medication may increase the risk of death from heart disease, and discuss this with your doctor.
During periods of stress, such as fever, infection, injury, or surgery, it may be more challenging to control your blood sugar levels. Changes in physical activity, exercise, or diet can also affect your blood sugar levels.
If you experience diarrhea or vomiting, contact your doctor promptly, as you may need to drink more fluids to prevent excessive fluid loss. In hot weather or during physical activity, drink plenty of fluids to avoid dehydration.
If you have been taking this medication for an extended period or at high doses, it may become less effective, and you may require higher doses to achieve the same effect. This is known as tolerance. If you notice that the medication is no longer working effectively, contact your doctor. Do not take more than the prescribed dose.
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects.
Overdose Information
Overdose Symptoms:
- Severe hypoglycemia (extremely low blood sugar)
- Lactic acidosis (severe muscle pain, difficulty breathing, abdominal pain, extreme fatigue, hypothermia, hypotension)
- Gastrointestinal upset (nausea, vomiting, diarrhea)
What to Do:
Seek immediate medical attention. Call 911 or Poison Control at 1-800-222-1222. Treatment involves supportive care, correction of hypoglycemia (e.g., oral glucose, IV dextrose), and potentially hemodialysis for severe lactic acidosis.
Drug Interactions
Contraindicated Interactions
- Iodinated contrast agents (for metformin - hold before/after procedure)
- Miconazole (oral, for glipizide - severe hypoglycemia)
Major Interactions
- Alcohol (increased risk of lactic acidosis with metformin)
- Carbonic anhydrase inhibitors (e.g., topiramate, zonisamide - increased risk of lactic acidosis)
- Cimetidine (increases metformin plasma concentration)
- Diuretics (e.g., thiazides, loop diuretics - can cause hyperglycemia, may increase risk of lactic acidosis with metformin)
- Corticosteroids (can cause hyperglycemia)
- Beta-blockers (can mask symptoms of hypoglycemia)
- NSAIDs (can impair renal function, increasing metformin accumulation and risk of lactic acidosis; can enhance hypoglycemic effect of glipizide)
- Sulfonamides, Chloramphenicol, Probenecid, Salicylates (can enhance hypoglycemic effect of glipizide)
Moderate Interactions
- Digoxin (glipizide may increase digoxin levels)
- Furosemide (increases metformin plasma concentration)
- Nifedipine (increases glipizide plasma concentration)
- Phenytoin (can reduce hypoglycemic effect of glipizide)
- Rifampin (can reduce hypoglycemic effect of glipizide)
- Other antidiabetic agents (additive hypoglycemic effect)
Minor Interactions
- Not typically listed for this level of detail
Monitoring
Baseline Monitoring
Renal function (eGFR)
Rationale: Metformin is primarily renally eliminated; risk of lactic acidosis increases with impaired renal function. Glipizide also requires caution in renal impairment.
Timing: Prior to initiation
HbA1c
Rationale: To establish baseline glycemic control and guide therapy.
Timing: Prior to initiation
Liver function tests (LFTs)
Rationale: Both drugs are metabolized/cleared by the liver to some extent; hepatic impairment increases risk of adverse effects.
Timing: Prior to initiation
Vitamin B12 levels
Rationale: Metformin can decrease vitamin B12 absorption.
Timing: Prior to initiation, especially in patients with risk factors for B12 deficiency
Routine Monitoring
HbA1c
Frequency: Every 3-6 months
Target: Individualized, typically <7%
Action Threshold: Above target range, consider dose adjustment or additional therapy
Fasting Plasma Glucose (FPG) / Self-Monitoring Blood Glucose (SMBG)
Frequency: Daily to weekly (SMBG), as needed
Target: FPG: 80-130 mg/dL; Post-prandial: <180 mg/dL
Action Threshold: Persistent readings outside target range, consider dose adjustment
Renal function (eGFR)
Frequency: At least annually; more frequently (e.g., every 3-6 months) in elderly, those with impaired renal function, or when initiating interacting drugs.
Target: >60 mL/min/1.73m2 (ideally)
Action Threshold: eGFR < 45 mL/min/1.73m2: Re-evaluate dose; eGFR < 30 mL/min/1.73m2: Discontinue
Vitamin B12 levels
Frequency: Every 2-3 years, or if symptoms of deficiency (e.g., anemia, neuropathy) develop.
Target: Normal range
Action Threshold: Low levels: Supplement B12
Symptom Monitoring
- Symptoms of hypoglycemia (e.g., sweating, tremor, dizziness, confusion, hunger, irritability)
- Symptoms of lactic acidosis (e.g., malaise, myalgia, respiratory distress, somnolence, abdominal distress, unusual fatigue)
- Gastrointestinal side effects (e.g., nausea, vomiting, diarrhea, abdominal discomfort)
- Symptoms of vitamin B12 deficiency (e.g., fatigue, weakness, numbness, tingling, memory problems)
Special Patient Groups
Pregnancy
Generally not recommended during pregnancy. Insulin is typically the preferred treatment for glycemic control in pregnant women with diabetes. Poorly controlled diabetes during pregnancy increases the risk of maternal and fetal complications.
Trimester-Specific Risks:
First Trimester:
Potential for congenital malformations (though data for glipizide/metformin are limited and conflicting).
Second Trimester:
Risk of fetal macrosomia and other complications if glycemic control is poor.
Third Trimester:
Risk of neonatal hypoglycemia and other complications if glycemic control is poor. Metformin crosses the placenta.
Lactation
Metformin is generally considered compatible with breastfeeding, with low levels excreted into breast milk and minimal infant exposure. Glipizide is excreted into breast milk and has a higher risk of infant hypoglycemia. Use with caution; monitor breastfed infant for signs of hypoglycemia.
Infant Risk:
Low for metformin; moderate for glipizide (risk of hypoglycemia).
Pediatric Use
Safety and effectiveness have not been established in pediatric patients. Not recommended for use in children.
Geriatric Use
Use with caution due to increased risk of hypoglycemia (especially with glipizide) and age-related decline in renal function (increasing risk of lactic acidosis with metformin). Start with lower doses and titrate slowly. Monitor renal function more frequently.
Clinical Information
Clinical Pearls
- Always take Glipizide-Metformin with meals to minimize gastrointestinal side effects and reduce the risk of hypoglycemia.
- Educate patients thoroughly on the symptoms and management of hypoglycemia and the rare but serious symptoms of lactic acidosis.
- Ensure patients are well-hydrated, especially during illness or before procedures involving iodinated contrast, to reduce the risk of lactic acidosis.
- Regularly monitor renal function (eGFR) as metformin accumulation is a significant risk factor for lactic acidosis.
- Consider periodic monitoring of vitamin B12 levels, especially in patients on long-term metformin therapy or those with risk factors for deficiency.
Alternative Therapies
- Insulin
- Other oral antidiabetic agents (e.g., DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, TZDs, alpha-glucosidase inhibitors, meglitinides)
- Lifestyle modifications (diet, exercise)
Cost & Coverage
Average Cost:
Varies widely, typically $10-$50 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.