Is it safe to take Nesina with Glimepiride, Pioglitazone, and Metformin? ## As long as your doctor has prescribed them all to be taken together. It is sometimes necessary for someone to take multiple oral diabetes medications to get their blood sugar under control. The FDA lists the typical side effects of Nesina as possibly including anxiety, nausea, dizziness, blurred vision, hypoglycemia and headache. It may also increase the effects of the Glimepiride, so please watch for low blood sugar levels.