Dapa-Met XR (5/500mg) 14 Tablets

Metformin is a medication used to help manage blood sugar levels in people with diabetes. It works in several ways to lower blood sugar. First, it reduces the amount of glucose the liver produces. Second, it slightly slows down how quickly glucose is absorbed from the intestines after eating. Finally, it helps the body use insulin more effectively, allowing cells to take in and use glucose better. By affecting these processes, metformin helps keep blood sugar levels in check both before and after meals. Dapagliflozin blocks a protein called SGLT2 (sodium-glucose co-transporter 2) in the kidneys. This protein is responsible for reabsorbing glucose back into the blood from the urine. By inhibiting SGLT2, dapagliflozin prevents glucose from being reabsorbed. This causes excess glucose to be excreted in the urine. With more glucose leaving the body through urine, the amount of glucose in the blood decreases, which helps lower blood sugar levels.

Biguanide, SGLT2 Inhibitor

This medication is used to manage:

• Type 2 Diabetes
• Blood Sugar Levels
• Glycemic Control
• Insulin Sensitivity

Dapagliflozin + Metformin HCl dosage recommendations are:

• Type 2 diabetes - Take orally, once daily with the evening meal. The recommended dose of dapagliflozin is 10 mg once daily. The recommended starting dose of metformin is 500 mg once daily, which can be increased to 2000 mg once daily, with gradual dose escalation to reduce gastrointestinal side effects. Adjust the dose of Dapagliflozin/Metformin HCl (XIGDUO XR) to match the dose of metformin already being taken or the nearest therapeutically appropriate dose.

Seek immediate medical attention. Overdose may cause severe hypoglycemia. Symptoms may include dizziness, sweating, confusion, and loss of consciousness. Treatment may involve glucose administration and supportive care.

Take the missed dose as soon as you remember. If it is close to the time of the next dose, skip the missed dose. Do not take double doses.

Take tablet daily with food to reduce the risk of gastrointestinal side effects.

Metformin + Dapagliflozin combintion should not be taken in the following situations:

• Moderate to severe renal impairment, including end-stage renal disease or patients on dialysis
• History of a serious hypersensitivity reaction to dapagliflozin or hypersensitivity to metformin hydrochloride
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma

Unraveling the side effects lurking behind this product are the following:

• Hypoglycemia
• Nausea
• Diarrhea
• Stomach upset
• Weight gain

Here are the essential warnings and precautions for this medication:

• Do not use in patients with type 1 diabetes mellitus or for diabetic ketoacidosis.
• Be aware of the risk of lactic acidosis, particularly in diabetic patients with significant renal failure. Risk factors include poorly controlled diabetes, ketosis, prolonged fasting, excessive alcohol intake, hepatic insufficiency, dehydration, and acute conditions affecting renal function or causing hypoxia.
• Concomitant use with drugs that can acutely impair renal function, such as antihypertensives, diuretics, and NSAIDs, should be avoided.
• Discontinue the medication if metabolic acidosis is suspected.
• Cease treatment during dehydration, severe infection, or hypoperfusion. Promptly discontinue if cardiovascular collapse occurs, such as shock, acute congestive heart failure, acute myocardial infarction, or other hypoxemic conditions.
• Temporarily stop therapy before or during intravascular contrast studies with iodinated materials and withhold for 48 hours. Reinstatement should only occur after re-evaluation of renal function.
• Temporarily suspend the medication for any surgical procedure, except minor procedures not associated with restricted intake of food and fluids.
• Avoid excessive alcohol intake, as it can increase the risk of adverse effects.
• Be cautious in patients with predisposing factors for ketoacidosis, such as low β-cell function reserve due to pancreatic disorders (e.g., type 1 diabetes, history of pancreatitis or pancreatic surgery), insulin dose reduction, reduced caloric intake, increased insulin requirements due to infections, illness, surgery, or alcohol abuse.
• Evaluate serum electrolytes, ketones, blood glucose, blood pH, lactate, pyruvate, and metformin levels in patients with type 2 diabetes mellitus.
• Temporarily interrupt therapy in patients who develop volume depletion.
• Monitor closely for hypoglycemia, especially in elderly, debilitated, or malnourished patients, and those with adrenal or pituitary insufficiency or alcohol intoxication.
• Discontinue if Fournier's gangrene is suspected.
• Avoid use in patients with an eGFR persistently less than 45 mL/min/1.73 m² or severe renal impairment with an eGFR less than 30 mL/min/1.73 m² (by MDRD) or end-stage renal disease (ESRD).
• Assess renal function before initiating therapy and avoid use in patients with clinical or laboratory evidence of hepatic disease.

Drug interactions with metformin and dapagliflozin include:

• Insulin and other antidiabetic agents (e.g., sulfonylureas) (may increase risk of hypoglycemia)
• Renal impairment (may require dose adjustments)
• Diuretics (e.g., furosemide) (may increase risk of dehydration and hypotension)
• CYP3A4 inhibitors (e.g., ketoconazole) (may increase dapagliflozin levels)
• CYP3A4 inducers (e.g., rifampin) (may decrease dapagliflozin levels)
• NSAIDs (e.g., ibuprofen) (may increase risk of renal impairment)
• Alcohol (may enhance effects on blood glucose levels and increase risk of dehydration)
• Metformin and dapagliflozin generally have minimal interaction with other medications, but individual patient scenarios should always be reviewed for potential interactions.

Store at room temperature in a tightly closed container. Dispose of unused or expired medication by returning it to a pharmacy for safe disposal.