Tengreat M

Yes, you can take Tengreat M with a beta-blocker. People with diabetes tend to develop heart disease or stroke at an earlier age than the general population. One reason for this is that high glucose levels increase your risk of high blood pressure (hypertension). No harmful interactions are seen between them. However, a recent study suggests that beta-blockers can decrease the plasma level of Tengreat M and long-term use can increase lactic acid and uric acid in the blood.

Lactic acidosis associated with Tengreat M  treatment is a rare but fatal adverse effect. Lactic acidosis appears to result from biguanide interference causing an increase in production and decrease in clearance of lactate leading to higher cellular lactate levels. A decrease in pyruvate carboxylase activity, the rate-limiting enzyme in the formation of glucose from lactate, can also decrease hepatic metabolism of lactate. leading to increasing lactic acidosis. Signs and symptoms of Tengreat M induced lactic acidosis are nonspecific and include anorexia, nausea, vomiting, altered level of consciousness, hyperpnoea, abdominal pain, and thirst. 

Tengreat M can be taken forever, diabetes is a progressive disease it's possible that more medication and/or insulin may eventually need to be added to the regime. 

Tengreat M contain metformin, is an oral antidiabetic drug which belongs to the class of biguanide. It is the first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight. It is also used in the treatment of polycystic ovary syndrome. Moreover, it also reduces the risk of cardiovascular complications of diabetes.

Yes, you can take Tengreat M with gliclazide, no harmful interactions have been reported between them. However, it is not necessary that no interaction can happen between these two. But before taking such kind of combination you must consult your doctor.