Siformin (50/500mg) 10 Tablets

It contains; sitagliptin and metformin. Sitagliptin, an orally-active inhibitor of the dipeptidyl peptidase-4 (DPP-4) enzyme, used as an oral hypoglycemic agent in Type II diabetes mellitus. Dipeptidyl peptidase-4 (DPP-4) is an enzyme that acts to inactivate glucagon like peptide-1(GLP-1). When sitagliptin inhibits DPP-4 then levels of GLP-1 will increase that results in increased insulin release from body after taking meals and in this way glucose tolerance by body will increase. For adult patients with type 2 diabetes mellitus, sitagliptin is indicated to improve glycemic control as an adjunct to diet and exercise. Used in patients that shows inadequate glycemic control by diet and exercise alone and for whom metformin is inappropriate due to contraindications or intolerance. Metformin (N, N-dimethylbiguanide) belongs to the biguanide class of antidiabetic drugs (containing two linked guanidine rings). This drug has a major clinical advantage that it does not induce hypoglycemia or weight gain with remarkable cardiovascular safety. Metformin is also used for the treatment of polycystic ovary disease, diabetic nephropathy, and gestational diabetes. Metformin acts via both AMP-activated protein kinase (AMPK)-dependent and AMPK-independent mechanisms; by inhibiting mitochondrial respiration and inhibiting mitochondrial glycerophosphate dehydrogenase, and a mechanism involving the lysosome. Metformin acts directly or indirectly on the liver in order to reduce glucose production, and acts on the gut to increase glucose utilization. At the molecular level, metformin acts to inhibit the mitochondrial respiratory chain in the liver, which results in activation of AMPK, enhances insulin sensitivity (via effects on fat metabolism) and lowers cAMP, and reduces the expression of gluconeogenic enzymes. Metformin shows AMPK-independent effects on the liver that results in inhibition of fructose-1,6-bisphosphatase by AMP.

Metformin, Sitagliptin

Tablet

Diabetes Type 2

Dose must be taken according to the doctor’s advice only; doses given below are suggested as supportive literature for better understanding in some areas of requirements. Adult dose: If a patient was previously taking metformin alone then he may start with 50mg of sitagliptin along with previously taken dose of metformin two times a day. If a patient was previously taking 850mg of metformin (alone) two times a day, then he may start with 50mg of sitagliptin and 1000mg of metformin two times a day. If the patient was previously taking sitagliptin(alone) then the doctor may start his dose with 50mg of sitagliptin and 500mg of metformin two times a day. Dose must be not more than 50mg of sitagliptin and 1000mg metformin two times a day.

In case of overdose with this drug consult your doctor first, he may take the usual supportive measures, e.g., he may remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring and take supportive therapy as dictated by the patient's clinical status. Sitagliptin is modestly dialyzable. It is not known if Sitagliptin can be dialyzable by peritoneal dialysis or not. Metformin overdose can cause hypotension.

In case you missed any dose, take the next dose as soon as you remember, but don't double your next dose to compensate for the missed one.

Take it orally as advised by the physician.

Do not use it in case of hypersensitivity to Sitagliptin. Not suitable for use in type I diabetes mellitus or for the treatment of diabetic ketoacidosis. Metformin should not be used in case of hypersensitivity to the drug, metabolic acidosis, chronic heart, failure, myocardial infarction, diabetic ketoacidosis, severe renal disease, abnormal creatinine clearance resulting from shock, septicemia and lactation.

Hypersensitivity reactions Hypoglycemia Headachedizziness Constipationvomiting Acute Pancreatitis Pruritus Angioedema rash Urticariacutaneous vasculitis Exfoliative skin conditions Myalgia Back pain Arthropathy.

After initiation of Sitagliptin, patients should be observed carefully for signs and symptoms of pancreatitis (inflammation of pancreas). If pancreatitis is suspected, Sitagliptin should promptly be discontinued and appropriate management should be initiated. Assess renal function prior to initiation of this drug. If metformin-associated lactic acidosis is suspected, general supportive measures should be taken in a hospital setting, along with immediate discontinuation of this medicine.

Do not use grapefruit with sitagliptin or metformin. Taking grapefruit along with this medicine could increase the accumulation of metformin in the liver and in result increases the risk of lactic acidosis. Taking metformin with a meal can reduce the chances of developing an upset stomach or gastric discomfort.

If you are diabetic, go for the following tests: Glucose Tolerance Test, Blood sugar test, Blood Glucose Fasting Test