Wilda-M (50/850mg) 14 Tablets

It contains; Vildagliptin and Metformin. Vildagliptin; Inhibits dipeptidyl peptidase-4 (DPP-4) this mechanism results in the prevention of degradation of glucagon-like peptide-1 (GLP-1) and reduction of glycaemia in patients with type 2 diabetes mellitus, with low risk for hypoglycemia and no weight gain. This drug covalently binds to the catalytic site of DPP-4, resulting in prolonged enzyme inhibition. This increases intact GLP-1 levels, both in the fasting state and after taking a meal. Vildagliptin stimulates insulin secretion and inhibits glucagon secretion in a glucose-dependent manner. At hypoglycemic levels, the counter regulatory glucagon response is enhanced relative to baseline by vildagliptin. Vildagliptin also inhibits glucose production in the liver, by changes in islet hormone secretion, and improves insulin sensitivity. These effects result in improved glycaemia with low risk for hypoglycemia. Vildagliptin also suppresses the levels of postprandial triglyceride (Triglyceride)-rich lipoprotein after ingestion of a fat-rich meal and reduces fasting lipolysis (lipid breakdown), resulting in inhibition of fat absorption and decreased Triglyceride stores in non-fat tissues. 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, Vildagliptin

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: The usual dose of vildagliptin is 50mg twice daily when used as monotherapy, with metformin, or with a thiazolidinedione and 50mg once daily (in the morning) when used with a sulfonylurea drug. The dose of metformin is 500mg twice a day with the morning and evening meals, or 850mg once daily with the morning meal. The doctor may adjust the dose if needed until the patient's blood sugar is controlled. Doctors may recommend 500 or 850mg two to three times a day with meals according to the patient's condition. Dose must be adjusted by the doctor in case of combinative therapy.

Vildagliptin; its overdose can cause trouble while breathing, irregular heartbeat, severe dizziness and fainting. Metformin overdose can cause hypotension. Consult your doctor in case of overdose.

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.

All patients are advised to continue their recommended diet with an adequate distribution of carbohydrate intake during the day.

Vildagliptin should not be used in patients with type 1 diabetes, diabetic ketoacidosis, severe liver impairment, during pregnancy and breastfeeding (in extreme need, administration during pregnancy will be decided by the doctor). 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.

Nausea Constipation Headache Tiredness Swelling of face, lips and eyelids Excessive sweating Stomach ache Loss of appetite Weight loss Hypoglycemia

Caution is required with the use of vildagliptin in kidney patients. 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.

Balanced diet is necessary along with the use of this medicine, and management of carbohydrate levels in food is required. 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.

Store at 25°C. Protect from heat and moisture.