Treviamet

TREVIAMET 500 mg/50 mg film-coated tablets: Each film-coated tablet contains: Metformin Hydrochloride 500 mg, Sitagliptin (as phosphate) 50 mg.
TREVIAMET 1 g/50 mg film-coated tablets: Each film-coated tablet contains: Metformin Hydrochloride 1000 mg, Sitagliptin (as phosphate) 50 mg.

Adults with type 2 diabetes mellitus who are not responding well to their maximal tolerated dose of metformin alone or who are already receiving treatment with a combination of sitagliptin and metformin should consider using sitagliptin and metformin hydrochloride film-coated tablets as a supplement to diet and exercise to improve glycaemic control.
In individuals who are not satisfactorily managed on their maximal tolerated dose of both metformin and a sulphonylurea, sitagliptin and metformin hydrochloride film-coated tablets are suggested in conjunction with a sulphonylurea (i.e., triple combination treatment) as an addition to diet and exercise.
In individuals who are not getting enough exercise or food, sitagliptin and metformin hydrochloride film-coated tablets are recommended as a triple combination therapy along with a PPARγ agonist (thiazolidinedione).

Take Metformin Hydrochloride + Sitagliptin film-coated tablets orally twice daily with meals.
Based on the patient's current regimen, effectiveness, and tolerability, individually determine the dosage of Metformin Hydrochloride + Sitagliptin film-coated tablets.
The maximum recommended daily dosage for metformin HCl and sitagliptin is 2000 mg and 100 mg, respectively.
In individuals who are not on metformin therapy, a starting dose of 500 mg metformin HCl and 50 mg sitagliptin should be administered twice daily. Gradual dose escalation is advised to minimise metformin's gastrointestinal adverse effects.
For patients receiving metformin treatment already, the initial dose should consist of 50 mg of sitagliptin administered twice daily, for a total of 100 mg of metformin taken daily. In patients receiving twice a day 850 mg of metformin HCl.

It is permissible to use supportive measures in the event of an overdose, such as removing unabsorbed material from the gastrointestinal system, doing clinical monitoring, which may include getting an ECG, and initiating supportive medication if the patient's clinical situation dictates.
Diazeptin can be moderately adjusted. In clinical trials, during a 3- to 4-hour hemodialysis session, about 13.5% of the dosage was eliminated. If clinically suitable, prolonged hemodialysis might be taken into consideration. The dialyzability of sitagliptin by peritoneal dialysis is unknown.
Metformin overdoses have happened, involving over 50 grammes being consumed.
About 10% of instances included reports of instances include reports of hypoglycemia; however, no clear link between the medication and the condition has been found. It has been found that in about 32% of metformin overdose instances, lactic acidosis occurs.
Metformin can be dialyzed, and in optimal hemodynamic circumstances, its clearance can reach up to 170 mL/min.
Hemodialysis may therefore be helpful in clearing patients of accumulated medication if metformin overdosage is suspected.

Severe kidney impairment, defined as an eGFR <30 mL/min/1.73 m².
Acidosis of the metabolism, such as diabetic ketoacidosis.
A history of severe hypersensitivity reactions, such as anaphylaxis or edema, to metformin or sitagliptin.

Acidosis Lactic.
Pancreatitis: Acute pancreatitis, including hemorrhagic or necrotizing pancreatitis, both fatal and non-fatal, has been reported post-marketing. Put an immediate stop to Metformin Hydrochloride and Sitagliptin film-coated tablets if pancreatitis is suspected.
Heart Failure: Two other DPP-4 inhibitor class members have shown evidence of heart failure. Sitagliptin with metformin hydrochloride film-coated tablets should be carefully considered for patients with known heart failure risk factors. Keep an eye out for symptoms in patients.
Acute renal failure: Post-marketing reports have been made; dialysis may be necessary in certain cases. Evaluate renal function before starting Metformin Hydrochloride and Sitagliptin film-coated tablets, and at least once a year after that.
Insufficient Vitamin B: Metformin may cause vitamin B levels to drop. Measure vitamin B every two to three years and hematologic parameters once a year.
Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Using insulin and/or an insulin secretagogue together increases the risk of hypoglycemia. It might be necessary to use less insulin or insulin secretagogue.
Hypersensitivity Reactions: Following the release of a product, there have been reports of severe allergy reactions. Patients on DPP-4 inhibitors have been observed to get severe and incapacitating arthritis. Examine as a potential reason for excruciating joint pain, and stop using the medication if necessary.
Bullous Pemphigoid: Post-marketing reports of patients on DPP-4 inhibitors necessitated hospitalisation. Instruct patients to report any blisters or erosions that appear. Stop taking Sitagliptin and metformin hydrochloride film-coated tablets if bullous pemphigoid is detected.
Hepatic Impairment: Patients who have hepatic impairment should not use.
Use in the Elderly: Evaluate renal function more often.

Males and Females with Reproductive Potential: Inform premenopausal women about the possibility of becoming pregnant unintentionally.

Diarrhea, upper respiratory tract infection, and headache were the most frequent adverse effects seen in ≥5% of individuals started on Metformin Hydrochloride and Sitagliptin concurrently, and more often than in those treated with a placebo.

Inhibitors of carbonic anhydrase may raise the risk of lactic acidosis.
Drugs that decrease metformin clearance, such as cimetidine, ranolazine, vandetanib, and dolutegravir, may cause metformin to accumulate more frequently. Examine the advantages and disadvantages of using medications concurrently.
Metformin's impact on lactate metabolism may be enhanced by alcohol.
Advise patients not to drink too much alcohol.

Store at temperatures not exceeding 30°C.
Shelf Life: 30 months.
Special Precautions for Storage: This medicinal product does not require any special storage conditions.

Antidiabetic Agents

A10BD07 - metformin and sitagliptin ; Belongs to the class of combinations of oral blood glucose lowering drugs. Used in the treatment of diabetes.

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