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Composition

Metformin(500MG),Sitagliptin(50MG)

SALT INFORMATION

Metformin(500MG)

TYPICAL USAGE

* Metformin is used for the treatment of type 2 diabetes mellitus, particularly in overweight patients, as an adjunct to the diet and exercise.

SIDE EFFECTS

* Nausea, vomiting, diarrhea, abdominal pain and loss of appetite, taste disturbance, Lactic acidosis (symptoms are vomiting, abdominal pain with muscle cramps, not feeling well with severe tiredness, and difficulty in breathing), malabsorption of vitamin B12,  skin reactions

DRUG INTERACTION

* Taking metformin with other anti-diabetic drugs may lead to excessive lowering of blood sugar levels, hence, the metformin dosage should be adjusted accordingly. * Metformin accumulation due to failure of kidney after intravascular administration of ionized media may lead to increased risk of lactic acidosis. Avoid metformin usage before and at least 48 hours afterwards X-ray or scan. * Diuretics, especially loop diuretics (furosemide) may increase the risk of lactic acidosis due to their ability to decrease kidney functions. * Metformin with diuretics (furosemide), anti-asthmatic drugs (salbutamol or terbutaline), or corticosteroids (prednisone) may affect the glucose control. * Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

MECHANISM OF ACTION

* Metformin belongs to class of medications called antidiabetics. The exact mechanism of action of metformin is not clear but it appears to act by decreasing glucose absorption from the intestine, decreasing production of glucose from proteins and fats in liver, and enhancing insulin sensitivity in muscle by increasing glucose uptake and utilization.

DOSAGE

* Adults: 500 mg or 850 mg 2 or 3 times daily given during or after meals to maximum of 3 g daily, taken as 3 divided doses. * Children (from 10 years of age and adolescents): 500 mg or 850 mg once daily, given during or after meals to maximum of 2 g daily, taken as 2 or 3 divided doses.

DOs and DON'Ts

* Take the medicine with food to avoid upset stomach * Check your blood sugar regularly * Do not take metformin in severe diarrhoea or vomiting, or when starting antihypertensive or diuretic therapy or therapy with a non-steroidal anti-inflammatory drug (NSAID). * This medication may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as:muscle pain or weakness;numb or cold feeling in your arms and legs;trouble breathing;feeling dizzy, light-headed, tired, or very weak;stomach pain, nausea with vomiting; orslow or uneven heart rate. * Do not take metformin if you need to have any type of x-ray or CT scan using a dye * You need to get cetain kidney function tests done before starting treatment  with metformin and regularly thereafter. * . * Caution should be taken when used in combination with insulin or other oral antidiabetics, which may lead to low blood glucose level (hypoglycemia).

CONTRA INDICATIONS

* Patients with serious complication of diabetes where high levels of blood acids called ketones are produced in the body (diabetic ketoacidosis); diabetic pre-coma; patients with kidney problem , liver problem, or heart failure; alcoholism.

FAQ

Q. Is Metformin a birth control pill/ insulin / statin/ banned drug?Metformin (also available as glyciphage, glycomet, glycomet SR) is an antidiabetic drug used in treatment of type 2 diabetes mellitus, particularly in overweight patients, as an adjunct to the diet and exercise.Q. Is metformin safe?Metformin is generally safe if used at prescribed doses for the prescribed duration as advised by your doctor.Q. Can I take metformin forever?Metformin should be taken at prescribed doses for the prescribed duration as advised by your doctor.Q. Is metformin good for weight loss / weight loss in non-diabetics?Metformin is used for the treatment of type 2 diabetes mellitus, particularly in overweight patients.Q. How long can I take metformin for PCOS / PCOS while pregnancy?Metformin sometimes used to treat women with polycystic ovary syndrome (PCOS). Continuing metformin during pregnancy decreases the chances of developing gestational diabetes. It also reduces the risk of early pregnancy loss, preterm labor and prevention of fetal growth restriction. Depending on your medical history, your doctor might encourage you to continue metformin during pregnancy, or advice you to stop taking it. Always consult your doctor regarding its use.Q. Can you take metformin for gestational diabetes / is metformin safe for pregnancy?Metformin is usually prescribed for treating gestational diabetes. Metformin use during pregnancy is usually safe at prescribed dose for the prescribed duration. Always consult your doctor regarding its use.Q. Does metformin help conceiving / help ovulation / help getting pregnant?Women with PCOS who are treated with metformin have a better chance of getting pregnant. Always consult your doctor regarding its use.

FURTHER INFORMATION

* Summary of product characteristics. https://www.medicines.org.uk/emc/medicine/21610 * Patient Information Leaflet. https://www.medicines.org.uk/emc/PIL.26346.latest.pdf

Sitagliptin(50MG)

TYPICAL USAGE

Sitagliptin is used to control blood sugar levels in patients with type 2 diabetes mellitus.

SIDE EFFECTS

* Common: low blood sugar (hypoglycemia), headache, upper respiratory infection, inflammation of nose, throat or chest (nasopharyngitis), stuffy or runny nose and sore throat, inflammation of bones (osteoarthritis), pain in the arm or leg. * Uncommon: dizziness, constipation * Frequency not known: kidney problems such as impaired function of kidney and acute kidney failure (sometimes requiring dialysis), vomiting, joint pain (arthralgia), muscle pain (myalgia), back pain, interstitial lung disease, acute inflammation of pancreas (pancreatitis), swelling of eyes and lips (angioedema), rashes due to allergy (urticaria), inflammation of small- and medium-sized blood vessels that supply the skin and fat (cutaneous vasculitis), widespread scaling and peeling of the skin associated with itching, skin and hair loss (exfoliative skin conditions) including Stevens-Johnson syndrome (serious, widespread, allergic reaction with a rash involving the skin and internal lining of the organs).

DRUG INTERACTION

* Sitagliptin when taken along with medicines used to treat diabetes like insulin and sulfonylureas, decrease in blood sugar level (hypoglycemia) may occur. * Other medicines used to treat irregular heart beat such as digoxin and medicines used to decrease the activity of immune system (immunosuppressants) like cyclosporine may alter the effects of sitagliptin. * Always consult your doctor for the change of dose regimen or an alternative drug of choice that may strictly be required.

MECHANISM OF ACTION

Sitagliptin belongs to class of medications called dipeptidyl peptidase-4 (DPP-4) inhibitors.This medicine helps to improve the levels of insulin after a meal and decreases the amount of sugar made by the body. It works by increasing the amounts of certain natural substances that lower blood sugar when it is high.

DOSAGE

Always follow the instructions of doctor regarding the dosage and duration.  * Treatment of type 2 diabetes in adults: 100 mg once daily.

DOs and DON'Ts

Do not start or continue the sitagliptin tablets if you are allergic (hypersensitive) to sitagliptin or any of the other ingredients of sitagliptin.Consult your doctor if you experience any of these side effects: stomach pain, nausea, vomiting, or loss of appetite, serious allergic reactions like skin rash, fever, swelling and difficulty in breathing.Doctor’s advice should be considered before taking sitagliptin tablets in case of any following conditions such as: * Type 1 diabetes. * Diabetic ketoacidosis or diabetic coma. * Kidney problems or liver problems. * Severe infection or are dehydrated. * Heart attack or have severe circulatory problems, such as shock or breathing difficulties. * High triglycerides level. * Stones in gall bladder. * Inflammation of pancreas (pancreatitis).

CONTRA INDICATIONS

* Children and adolescents of age below 18 years. * Patients who are allergic to sitagliptin or any of the other ingredients of this medicine.

FAQ

Q. Is sitagliptin/ Januvia safe?Sitagliptin/ Januvia is safe at the prescribed dose by the doctor. Patients should follow the advice of the doctor regarding its use.Q. Is sitagliptin/ Januvia generic?Sitagliptin is generic drug; Januvia is a brand name of sitagliptin.Q. Is sitagliptin/ Januvia banned in India?No. Sitagliptin is available in India.Q. Is sitagliptin better than vildagliptin?Sitagliptin and vildagliptin belong to same class of drugs and are equally effective and safe in treatment of type 2 diabetes mellitus. Always consult your doctor for an alternative drug of choice that may strictly be required.Q. Is sitagliptin FDA approved?Yes. Sitagliptin is FDA approved.Q. Is sitagliptin a statin/ insulin/ metformin?No. Sitagliptin belongs to class of medications called dipeptidyl peptidase-4 (DPP-4) inhibitors and is a different drug than statin/insulin/metformin.Q. Is sitagliptin/Januvia a blood thinner?Sitagliptin/Januvia is specifically used for treatment of type 2 diabetes mellitus and not a blood thinner. Patients should follow the advice of the doctor regarding its use.Q. Can I take Januvia with metformin/ insulin/ glipizide/ Victoza/ Lantus/ glyburide/ glimepiride/ Actos / Byetta/ Bydureon?Sitagliptin can be taken in combination with other antidiabetic drugs, when prescribed by doctor. Always follow doctor’s advice regarding its use.Q. Does sitagliptin cause weight loss/ constipation/ joint pain/ itching/ hypoglycemia/ pancreatitis/ cancer/ dry mouth?Sitagliptin may cause weight loss, constipation, itching, hypoglycemia, joint pain and pancreatitis. It does not cause cancer or dry mouth. However, consult your doctor if you experience any of these side effects.Q. Does Januvia make you sleepy?No. Januvia does not make you sleepy. Patients should follow the advice of the doctor regarding its use.

FURTHER INFORMATION

* Prescribing information. http://www.medicines.org.uk/emc/medicine/23112 * Summary of product characteristics. http://www.medicines.org.uk/emc/medicine/19609/SPC/ * http://www.drugs.com/ppa/sitagliptin-phosphate.html

SUBSTITUTES

3 Substitutes
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  • Zita Met(50/500)
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  • Janumet (50/500mg)
    (30 Tablet in Strip)
    Merck Ltd
    Rs. 23.20/Tablet
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    Rs. 696
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  • Janumet (50/500mg)
    (30 Tablet in Strip)
    Merck Ltd
    Rs. 23.20/Tablet
    Tablet
    Rs. 696
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INTERACTIONS

Can I take Istamet (50/50mg) during pregnancy?

Studies in animals have shown no risk to the fetus, however there are no sufficient studies in humans. Patients should follow the advice of the doctor regarding its use. Patients should follow the advice of the doctor regarding its use.

Can I take Istamet (50/50mg) while breastfeeding/lactation?

Contraindicated: The drug should not be used by breastfeeding women, as evidences from studies have shown that there is a high risk of causing significant damage to infants.

Can I take Istamet (50/50mg) with alcohol?

Since there is some doubt about the results of concurrent use in this interaction, it is advised to give some guidance to the patient about its possible adverse effects and/or consider close monitoring.