Xiga-Met XR (10/1000mg) 14 Tablets

Dapagliflozin, a sodium-glucose co-transporter 2 (SGLT-2) inhibitor, works by increasing the removal and decreasing the absorption of glucose in the bloodstream. Metformin hydrochloride, a biguanide, increases the body's sensitivity to insulin, and also decreases the amount of sugar made by the liver. Both of these medicines work simultaneously to help control blood sugar levels in those with type 2 diabetes, reducing the risk of complications related to the disease. While these drugs can assist with managing blood sugar levels, they should be taken only as prescribed by a medical professional.

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SGLT2 Inhibitor, Biguanides

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Tablet

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Unveiling its multifaceted uses and transformative applications as follows:

• Treatment of type 2 diabetes mellitus in adults.
• Lowering of blood glucose in adults with type 2 diabetes mellitus when oral glucose tolerance factor-based medicines or insulin alone do not provide adequate glucose control.
• Treatment in adults with type 2 diabetes mellitus and moderate to severe obesity.
• Reduction in the risk of deterioration of renal function, cardiovascular death, hospitalization for cardiovascular disease or stroke in adults with type 2 diabetes mellitus and cardiovascular disease or multiple cardiovascular risk factors despite optimal treatment with insulin and/or oral glucose-lowering medicinal products, with or without established cardiovascular disease.

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Tailoring Treatment for Optimal Health, Prescribed Medication Dosage is:

• Take as directed by your doctor.
• Do not take more or less than the prescribed dosage.
• Keep medication out of reach of children.
• Avoid alcohol and grapefruit juice while on this medication.

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An overdose of Dapagliflozin and Metformin Hydrochloride can be a serious matter and requires emergency medical attention. If you notice someone exhibiting signs of an overdose, it is vital to contact emergency services immediately. While you wait for professional help to arrive, there are a few things you can do to provide basic care. These include placing the individual in a recovery position, which prevents choking and protects the airway, and retrieving the medication packet or any remaining medication to aid in diagnosis and treatment by medical staff. If the victim is unconscious and unable to vomit, you may consider gently pumping their stomach. Furthermore, it is important to monitor their vital signs, including oxygen levels, blood pressure, and pulse. If metformin levels are considerably high, dialysis may be necessary. You can also give them calcium gluconate, which counteracts the effects of metformin. Provide supportive care, such as oxygen therapy, to alleviate symptoms until medical assistance arrives. Remember, these measures are not a substitute for professional medical advice and should only be used until emergency services arrive. Ultimately, seeking immediate medical attention is crucial for an individual who has overdosed. Treatment options vary depending on the severity of the situation and may include medication or dialysis to restore normal metformin levels. Until emergency services arrive, providing a calm and safe environment can help support the individual experiencing the overdose.

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If you miss a dose of dapagliflozin and metformin, it is important to take the missed dose as soon as you remember it. However, if it is almost time for your next dose, it is best to skip the missed dose and continue with your regular dosing schedule. Doubling the dose to catch up can result in an overdose of metformin, which can be harmful. If you have missed multiple doses recently, you may experience symptoms of hypoglycemia (low blood sugar). If you do experience any symptoms, it is necessary to consult with a doctor immediately. They may advise you to monitor your blood sugar levels regularly and may alter the dosage or duration of the medication depending on your specific situation. It is important to follow their guidance on the course of action.

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Dapagliflozin 10mg should be taken once daily with or without food; maintain a balanced diet and regular exercise to support a healthy lifestyle. Metformin Hydrochloride 1000mg should be taken in two separate doses three times a day with meals; tablets should be taken with food to minimize stomach upset, but the medication should be taken at the same time whether or not food is consumed. It is advised to strictly follow the dosage schedule as prescribed by your doctor. These medications should be taken at different times to ensure their full effectiveness. It is crucial to consult your doctor or pharmacist if you have questions or concerns about your specific dosage or how to take these medications. Let me know if you would like more information on either of these medications.

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Discerning instances where this medication may not be appropriate:

• If you are taking other medications for diabetes, as they can cause low blood sugar levels and combining them with Dapagliflozin can amplify this effect.
• In patients with moderate to severe renal impairment to avoid side effects caused by drug accumulation.
• Kidney damage or problems 
• Metformin can build up in the body and cause toxicity because it is excreted by the kidneys.
• Lactic acidosis is a known side effect of Metformin.

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Unraveling the side effects lurking behind this medications are as follows:

• Increased risk of acute kidney injury (AKI)
• Bone fractures with concurrent use of proton pump inhibitors
• Vomiting
• Diarrhea
• Constipation
• Abdominal discomfort
• Loss of appetite
• Weight loss
• Hypoglycemia (low blood sugar)
• Upper respiratory tract infection
• Muscular pain

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Patients should be aware of the following precautions and warnings when considering treatment:

• Do not use in patients with type 1 diabetes mellitus or for diabetic ketoacidosis.
• Risk of lactic acidosis, especially in diabetic patients with significant renal failure or other risk factors such as poorly controlled diabetes, ketosis, prolonged fasting, excessive alcohol intake, hepatic insufficiency, dehydration, and acute conditions associated with hypoxia or impaired renal function.
• Caution with concomitant use of drugs that can impair renal function, such as antihypertensives, diuretics, and NSAIDs.
• Discontinue if metabolic acidosis is suspected or if dehydration, severe infection, or hypoperfusion occurs.
• Promptly discontinue in cases of cardiovascular collapse (e.g., shock, acute heart failure, acute myocardial infarction) or other conditions characterized by hypoxemia.
• Temporarily discontinue therapy before or during intravascular contrast studies with iodinated materials and withhold for 48 hours, reinstituting only after renal function has been re-evaluated.
• Suspend therapy for any surgical procedure, except minor ones not associated with restricted intake of food and fluids.
• Caution with excessive alcohol intake.
• Be aware of predisposing factors to ketoacidosis, such as low β-cell function reserve due to pancreatic disorders, insulin dose reduction, reduced caloric intake, or 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.
• Temporary interruption may be necessary for patients who develop volume depletion.
• Caution with concomitant use of insulin and insulin secretagogues like sulfonylureas, as hypoglycemia is especially risky in elderly, debilitated, malnourished patients, or those with adrenal or pituitary insufficiency or alcohol intoxication.
• Discontinue if Fournier's gangrene is suspected.
• Avoid in patients with persistently low eGFR (<45 mL/min/1.73 m²), severe renal impairment (eGFR <30 mL/min/1.73 m²), or end-stage renal disease (ESRD). Assess renal function before starting therapy.
• Avoid in patients with clinical or laboratory evidence of hepatic disease.
• Not to be used during pregnancy (second and third trimesters) or lactation.
• Use cautiously in children and elderly patients.

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Drug interactions with dapagliflozin + metformin include:

• Diuretics (e.g., furosemide) (may increase the risk of dehydration and hypotension)
• Insulin (e.g., glargine) (may increase the risk of hypoglycemia- monitor blood glucose levels closely)
• Other oral hypoglycemic agents (e.g., sulfonylureas) (may have additive effects on blood glucose control)
• Renin-angiotensin-aldosterone system inhibitors (e.g., lisinopril) (may increase the risk of hypotension and renal impairment)
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen) (may impact renal function and increase the risk of dehydration)
• CYP3A4 inhibitors (e.g., ketoconazole) (no significant interaction with dapagliflozin, but monitor for potential changes in efficacy)
• CYP3A4 inducers (e.g., rifampin) (may affect the metabolism and efficacy of dapagliflozin)
• Contrast agents (e.g., iodinated contrast media) (may increase the risk of acute kidney injury- ensure adequate hydration)
• Metformin-related interactions (e.g., alcohol) (may increase the risk of lactic acidosis)

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Dapagliflozin and metformin hydrochloride are two distinct medications that are typically prescribed together to patients with type 2 diabetes mellitus. While both medications are designed to help manage and treat the symptoms of diabetes, it is crucial to understand that each medication has its own unique composition, and as a result, storage instructions need to be followed carefully to ensure efficacy. Dapagliflozin is one of the two medications. It belongs to a class of drugs called SGLT2 inhibitors, and its presence in the diabetic medication combination is to help lower blood sugar levels by inhibiting the reabsorption of glucose in the kidneys. It is important this medication is stored correctly to ensure it stays effective and safe. Dapagliflozin should be stored at room temperature between 59°F and 86°F (15°C and 30°C). It should be protected from heat, light, and moisture. Furthermore, it should be stored in a location that is not easily accessible to children. Lastly, similar to most medications, it should not be used once it has passed its expiration date. The other medication, metformin hydrochloride, is a drug that belongs to the biguanide class of medications, and its use helps manage type 2 diabetes by reducing the amount of glucose produced by the liver and making the body's cells more responsive to insulin. It is vital to store this medication according to its requirements to ensure it remains effective and safe. Metformin hydrochloride should be stored at room temperature between 68°F and 77°F (20°C and 25°C). Much like dapagliflozin, it should be kept in a cool, dry place, away from heat, light, and moisture. This medication should also be kept out of reach and sight of children. Likewise, use after the expiration date on the label, carton, or bottle should be avoided. Following these storage instructions for each

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