Metformin Hydrochloride + Sitagliptin

Welcome to Dwaey, specifically on Metformin Hydrochloride + Sitagliptin page.
This medicine contains important and useful components, as it consists of
Metformin Hydrochloride + Sitagliptin is available in the market in concentration.

Generic Name of Metformin Hydrochloride + Sitagliptin - Learn More

Metformin Hydrochloride + Sitagliptin

Metformin Hydrochloride + Sitagliptin Precaution - What You Need to Know

Before initiating treatment with Metformin Hydrochloride and Sitagliptin, patients should consult their healthcare provider to ensure the combination is suitable for their specific medical conditions. Special attention should be given to individuals with renal impairment, as both drugs can be affected by kidney function. For metformin, dose adjustments may be necessary in patients with renal dysfunction to avoid the risk of lactic acidosis. Sitagliptin, primarily excreted through the kidneys, may require dosage reduction in patients with renal impairment (creatinine clearance < 50 mL/min). Additionally, sitagliptin has been associated with a slight increase in the risk of pancreatitis, so patients should be closely monitored for any signs or symptoms such as severe abdominal pain, nausea, or vomiting. Both drugs should be used with caution in patients with liver disease, as metformin and sitagliptin can both alter liver function. Metformin should be discontinued if liver dysfunction is suspected. Hypoglycemia is less common with sitagliptin but may occur when used in combination with other antidiabetic agents. Patients should monitor their blood glucose levels regularly.

Metformin Hydrochloride + Sitagliptin Indication - Uses and Benefits

The combination of Metformin Hydrochloride and Sitagliptin is indicated for the treatment of Type 2 diabetes mellitus in adults when adequate glycemic control cannot be achieved by diet and exercise alone or by either metformin or sitagliptin monotherapy. This combination therapy is especially useful for patients who are insulin-resistant and have high blood sugar levels due to inadequate insulin production or action.
- Metformin works by reducing hepatic glucose production, increasing insulin sensitivity, and enhancing peripheral glucose uptake.
- Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, works by enhancing the action of incretin hormones, which increase insulin secretion and decrease glucagon release in response to meals, improving overall glucose control.
The combination of these two medications helps to lower blood glucose levels through two complementary mechanisms: reducing glucose production by the liver and enhancing insulin secretion in response to meals. This results in better control of blood sugar levels throughout the day.

Metformin Hydrochloride + Sitagliptin Contraindications - Important Warnings

The combination of Metformin Hydrochloride and Sitagliptin is contraindicated in the following situations:
- Severe renal impairment (creatinine clearance < 30 mL/min): Metformin and sitagliptin are both cleared by the kidneys, and use in severe renal impairment increases the risk of lactic acidosis (from metformin) and drug accumulation (from sitagliptin).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis: This combination should not be used in patients with these conditions.
- Hypersensitivity to metformin, sitagliptin, or any component of the formulation: An allergic reaction could result in severe side effects.
- Liver disease: Patients with active liver disease or abnormal liver function tests should not use this combination.
- Pregnancy: The combination should not be used during pregnancy unless clearly needed. The safety of this combination during pregnancy has not been well established.
- Breastfeeding: Both drugs are excreted in breast milk, and while the effect on a nursing infant is not fully known, breastfeeding is generally not recommended during treatment.

Metformin Hydrochloride + Sitagliptin Side Effects - What to Expect

The combination of Metformin Hydrochloride and Sitagliptin can cause a range of side effects, both common and serious:
- Common side effects of metformin include gastrointestinal issues such as nausea, vomiting, diarrhea, and abdominal discomfort. These effects are generally mild and may resolve over time.
- Sitagliptin may cause headache, nasopharyngitis, or upper respiratory infections. These are generally mild and transient.
- Hypoglycemia: Though not common with sitagliptin alone, hypoglycemia may occur when used in combination with other antidiabetic drugs, especially insulin or sulfonylureas.
- Lactic acidosis: A serious and potentially life-threatening condition due to the accumulation of lactic acid, primarily a risk with metformin in patients with renal impairment, dehydration, or other risk factors. Symptoms include muscle pain, fatigue, difficulty breathing, and abdominal pain.
- Pancreatitis: Sitagliptin has been associated with a slight increase in the risk of pancreatitis, which can present as severe abdominal pain, nausea, and vomiting. Immediate medical attention should be sought if these symptoms occur.
- Allergic reactions: Both medications have been associated with rare allergic reactions, including rash, pruritus, and angioedema (swelling of the face or throat).
- Liver issues: Though rare, sitagliptin may cause elevated liver enzymes, and liver function tests should be monitored periodically during treatment.

Patients should report any unusual or severe symptoms, especially if they experience persistent gastrointestinal issues, signs of pancreatitis, or symptoms of lactic acidosis.

Metformin Hydrochloride + Sitagliptin Pregnancy Category ID - Safety Information

2

Metformin Hydrochloride + Sitagliptin Mode of Action - How It Works

Metformin Hydrochloride reduces hepatic glucose production, which is the liver's production of glucose from non-carbohydrate sources. It also improves insulin sensitivity, allowing for more efficient glucose uptake by peripheral tissues such as muscles and fat. These actions help to lower blood glucose levels and reduce overall insulin resistance.

Sitagliptin, a DPP-4 inhibitor, enhances the body’s own insulin production by inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4), which breaks down incretins (hormones that promote insulin release). By blocking DPP-4, sitagliptin prolongs the activity of incretins, leading to increased insulin secretion and decreased glucagon release after meals. This helps to lower blood glucose levels by promoting insulin release in response to elevated glucose levels and inhibiting excess glucose production from the liver.

Together, these drugs work synergistically: metformin addresses insulin resistance and reduces glucose production, while sitagliptin improves the body’s natural insulin secretion, resulting in better control of blood glucose.

Metformin Hydrochloride + Sitagliptin Drug Interactions - What to Avoid

The combination of Metformin Hydrochloride and Sitagliptin can interact with several medications, altering their effectiveness or increasing the risk of side effects:
- Other antidiabetic drugs (e.g., insulin, sulfonylureas): There is an increased risk of hypoglycemia, especially if insulin or sulfonylureas are used in combination with this treatment. Dose adjustments of other antidiabetic agents may be needed.
- Corticosteroids, diuretics, and beta-blockers: These may alter blood glucose levels, making it more difficult to control diabetes. Corticosteroids, for example, may increase blood sugar levels.
- ACE inhibitors and angiotensin II receptor antagonists: May enhance the glucose-lowering effects of metformin, requiring closer monitoring of blood glucose levels.
- Cimetidine: This medication, which reduces stomach acid, may increase metformin levels, increasing the risk of lactic acidosis.
- Rifampin: A CYP3A4 inducer, may reduce the effectiveness of sitagliptin by decreasing its concentration in the blood.
- Digoxin: May increase the plasma concentration of digoxin when used together with sitagliptin, requiring more frequent monitoring of digoxin levels.
- Alcohol: Excessive alcohol consumption can increase the risk of lactic acidosis with metformin. Drinking alcohol in moderation is recommended while on this therapy.

Patients should always inform their healthcare provider of all medications, including over-the-counter drugs and supplements, to prevent dangerous drug interactions.

Metformin Hydrochloride + Sitagliptin Adult Dose - Recommended Dosage

For adults, the typical dose of Metformin Hydrochloride + Sitagliptin combination tablets is as follows:
- Metformin: The starting dose is generally 500 mg once or twice daily with meals. The dose may be gradually increased, usually by 500 mg increments weekly, to a maximum of 2,000-2,500 mg per day, depending on the patient's tolerance and glycemic control.
- Sitagliptin: The standard dose is 100 mg once daily. If the patient has renal impairment, the dose of sitagliptin may be reduced to 50 mg once daily for moderate renal dysfunction (creatinine clearance 30-50 mL/min), or 25 mg once daily for severe renal impairment (creatinine clearance < 30 mL/min).

Metformin Hydrochloride + Sitagliptin Child Dose - Dosage for Children

The combination of Metformin Hydrochloride + Sitagliptin is not typically recommended for pediatric patients under 18 years old. Metformin can be prescribed to children aged 10 years and older with Type 2 diabetes, but the combination with sitagliptin has not been extensively studied in children. If this combination is considered for pediatric use, it should be done under close supervision by a healthcare provider, with careful monitoring of blood glucose levels and potential side effects.

It is essential to consult a healthcare provider before starting treatment with Metformin Hydrochloride + Sitagliptin to ensure its safety and efficacy for each individual patient.

Metformin Hydrochloride + Sitagliptin Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment, dosage adjustments are essential:
- Severe renal impairment (creatinine clearance < 30 mL/min): Both metformin and sitagliptin should generally be avoided in this population due to the increased risk of lactic acidosis from metformin and drug accumulation from sitagliptin.
- Moderate renal impairment (creatinine clearance 30-50 mL/min): The dose of Sitagliptin should be reduced to 50 mg once daily. Metformin should be used with caution and monitored regularly, adjusting the dose to avoid complications.
- Mild renal impairment (creatinine clearance 50-80 mL/min): Both drugs can generally be used at standard doses, but careful monitoring of renal function is recommended.