Generic
Metformin Hydrochloride + Vildagliptin
43 brands available in the market
At a glance
Metformin Hydrochloride + Vildagliptin is a combination medicine that controls high blood sugar levels in type 2 diabetes mellitus. Metformin reduces glucose production and absorption, and Vildagliptin is a DPP-4 inhibitor that increases incretin hormone activity.
Description
Metformin is a biguanide that decreases hepatic glucose production, intestinal glucose absorption, and improves insulin sensitivity by increasing peripheral glucose uptake. Vildagliptin is a DPP-4 inhibitor that prevents inactivation of incretin hormones (GLP-1 and GIP), prolonging incretin activity in response to nutrient ingestion, which increases insulin sensitivity, decreases glucagon secretion, and improves beta-cell function.
Indications
- Type 2 diabetes mellitus - as an adjunct to diet and exercise to improve glycemic control (when metformin or vildagliptin alone is not adequate)
Therapeutic class
Combination Oral Hypoglycemic Preparations
Pharmacological class
Biguanide + DPP-4 Inhibitor
Pharmacology
Metformin reduces glucose production and absorption; Vildagliptin inhibits DPP-4 to prolong incretin hormone activity, increasing insulin sensitivity and decreasing glucagon secretion.
Mechanism of action
Controls blood sugar by reducing glucose production and absorption and increasing incretin activity.
Dosage
Adult Dose (Oral):
- Based on current metformin dose: 50/500 mg or 50/850 mg twice daily (morning and evening)
- Maximum daily dose: Vildagliptin 100 mg + Metformin 2000 mg
- Switching from separate tablets: Equivalent doses
Administration
- Swallow tablet whole; do not chew, crush or break
- Take with or just after food (to reduce stomach upset)
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Headache
- Tremor
- Dizziness
- Nausea
- Hypoglycemia
- Diarrhea, abdominal pain, loss of appetite
Precautions & warnings
- Inform doctor if symptoms of lactic acidosis occur (deep/rapid breathing, persistent nausea, vomiting, abdominal pain)
- Monitor blood sugar regularly to avoid hypoglycemia
- Avoid alcohol
- Monitor liver function tests (LFTs) before and periodically during treatment
- Discontinue if jaundice or signs of liver dysfunction develop
Contraindications
- Renal disease or dysfunction (males Cr >1.5 mg/dL, females >1.4 mg/dL)
- Acute myocardial infarction, septicemia
- Congestive heart failure
- Acute or chronic metabolic acidosis (including diabetic ketoacidosis)
- Hypersensitivity to components
Drug interactions
- Additive effect with sulfonylureas (hypoglycemia risk)
- Thiazide diuretics, corticosteroids, OCs may worsen glycemic control
- ACE inhibitors may reduce fasting blood glucose
- Cimetidine may increase serum levels
- Increased risk of lactic acidosis with iodinated contrast agents (potentially fatal)
Food interactions
Alcohol consumption with Metformin + Vildagliptin is unsafe.
Use in pregnancy
Use in Pregnancy: Metformin + Vildagliptin may be unsafe during pregnancy; animal studies have shown harmful effects on the fetus. Consult your doctor.
Use in lactation
Use in Lactation: Information regarding use during breastfeeding is not available; consult your doctor.
Pediatric use
Not recommended for children under 18 years (safety not established).
Geriatric use
Elderly require regular renal function monitoring due to potential decreased renal function; use only with normal renal function.
Renal / hepatic impairment
Renal Impairment: Do not use in renal failure or dysfunction (males Cr >1.5 mg/dL, females >1.4 mg/dL).
Hepatic Impairment: Not recommended in hepatic impairment (pre-treatment ALT or AST >3x ULN).
Overdose effects
Overdose may cause lactic acidosis; symptomatic and supportive treatment; hemodialysis is effective.
Storage conditions
Store in a cool and dry place, away from light; keep out of reach of children.
Chemical structure
Metformin Hydrochloride + Vildagliptin