Metformin + Sitagliptin
Find more information about this combination medication at the webpages for Metformin and Sitagliptin
Type 2 Diabetes Mellitus
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Advisory
- This medicine contains a combination of 2 drugs Metformin and Sitagliptin.
- Metformin and Sitagliptin are both used to treat the same disease or symptom but work in different ways in the body.
- Most doctors will advise making sure that each individual medicine is safe and effective before using a combination form.
Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
None
Controlled Drug Substance
NO
Metformin + Sitagliptin
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Click HereSummary
Metformin and Sitagliptin are used to manage type 2 diabetes, which is a condition where the body does not use insulin properly, leading to high blood sugar levels. These medications help control blood sugar levels when diet and exercise alone are not enough.
Metformin works by decreasing the amount of sugar produced by the liver and improving the body's response to insulin, which is a hormone that helps control blood sugar levels. Sitagliptin works by increasing the levels of incretin hormones, which help the body produce more insulin after meals and reduce the amount of sugar made by the liver. Together, they provide a complementary effect to improve blood sugar control.
Metformin is usually taken in doses ranging from 500 mg to 2000 mg per day, divided into smaller doses with meals to reduce stomach upset. Sitagliptin is typically taken as a 100 mg tablet once daily. When combined, the dosage is adjusted based on individual needs, with a maximum of 100 mg of Sitagliptin and 2000 mg of Metformin per day.
Common side effects of Metformin include stomach upset, diarrhea, and nausea. Sitagliptin may cause symptoms like upper respiratory tract infections, headaches, and sore throat. Both medications can lead to low blood sugar, especially when taken with other diabetes medications.
Metformin should not be used in people with severe kidney problems due to the risk of lactic acidosis, which is a rare but serious condition where lactic acid builds up in the blood. Sitagliptin should be used cautiously in people with a history of pancreatitis, which is inflammation of the pancreas. Both medications should be used carefully in older adults and those with heart failure.
Indications and Purpose
What is combination of Metformin and Sitagliptin used for?
Metformin and sitagliptin are indicated for the management of type 2 diabetes mellitus. They are used to improve glycemic control in adults when diet and exercise alone are insufficient. Metformin is often the first-line treatment due to its effectiveness in reducing blood sugar levels and improving insulin sensitivity. Sitagliptin is added to enhance insulin secretion and reduce glucagon levels, providing a complementary effect to metformin's action.
How does combination of Metformin and Sitagliptin work?
Metformin works by decreasing glucose production in the liver, improving insulin sensitivity, and enhancing peripheral glucose uptake. Sitagliptin, a DPP-4 inhibitor, increases the levels of incretin hormones, which enhance insulin secretion and decrease glucagon levels in response to meals. Together, they provide a comprehensive approach to managing blood sugar levels in type 2 diabetes, with metformin primarily targeting insulin resistance and sitagliptin enhancing the body's natural insulin response.
How effective is combination of Metformin and Sitagliptin?
Clinical studies have demonstrated that metformin effectively lowers blood sugar levels by reducing hepatic glucose production and improving insulin sensitivity. Sitagliptin has been shown to enhance insulin secretion and reduce glucagon levels, leading to improved postprandial glucose control. When used together, they provide a complementary effect, improving overall glycemic control in patients with type 2 diabetes. The combination has been proven to significantly reduce HbA1c levels, a key indicator of long-term blood sugar control, in numerous clinical trials.
How does one know if combination of Metformin and Sitagliptin is working?
The benefit of metformin and sitagliptin is primarily assessed through regular monitoring of blood sugar levels, including fasting blood glucose and HbA1c tests, which provide an average blood sugar level over the past two to three months. Metformin's effectiveness is often seen in its ability to lower fasting glucose levels, while sitagliptin's benefit is measured by its impact on postprandial glucose levels. Together, they help achieve target HbA1c levels, indicating improved overall glycemic control.
Directions for Use
What is the usual dose of combination of Metformin and Sitagliptin?
The usual adult daily dose for metformin is typically between 500 mg to 2000 mg, taken in divided doses with meals to minimize gastrointestinal side effects. For sitagliptin, the standard dose is 100 mg once daily. When combined in a single tablet, the dosage is adjusted based on the patient's current treatment regimen and tolerability, with a maximum of 100 mg of sitagliptin and 2000 mg of metformin per day. Both medications are used to improve blood sugar control in type 2 diabetes, but they work through different mechanisms, making them effective when used together.
How does one take combination of Metformin and Sitagliptin?
Metformin should be taken with meals to reduce gastrointestinal side effects, while sitagliptin can be taken with or without food. Patients are advised to maintain a consistent diet and exercise routine to optimize the effectiveness of these medications. There are no specific food restrictions, but excessive alcohol consumption should be avoided as it can increase the risk of lactic acidosis with metformin. Regular monitoring of blood sugar levels is important to ensure the medications are working effectively.
For how long is combination of Metformin and Sitagliptin taken?
Metformin and sitagliptin are typically used as long-term treatments for managing type 2 diabetes. The duration of use depends on the individual's response to the medication and their overall diabetes management plan. Both medications are intended for ongoing use to maintain blood sugar control, and they are often continued indefinitely unless contraindications or adverse effects arise. Regular monitoring by a healthcare provider is essential to ensure their continued effectiveness and safety.
How long does it take for combination of Metformin and Sitagliptin to work?
Metformin and sitagliptin work together to improve blood sugar control in people with type 2 diabetes. Metformin starts working within a few days, but it may take up to two weeks to see the full effect on blood sugar levels. Sitagliptin, on the other hand, begins to work within a few hours of taking a dose, as it helps increase insulin production and decrease glucose production in the liver. Together, they provide a complementary effect, with metformin primarily reducing glucose production in the liver and sitagliptin enhancing insulin secretion in response to meals.
How does one store combination of Metformin and Sitagliptin?
Metformin and sitagliptin do not require refrigeration. They should be stored at room temperature, between 20°C to 25°C (68°F to 77°F), with excursions permitted to 15°C to 30°C (59°F to 86°F). It is important to keep them in their original packaging, away from moisture and heat, to maintain their effectiveness. Both medications should be kept out of reach of children.
Warnings and Precautions
Are there harms and risks from taking combination of Metformin and Sitagliptin?
Common side effects of metformin include gastrointestinal issues such as diarrhea, nausea, and abdominal discomfort. Sitagliptin may cause upper respiratory tract infections, headache, and nasopharyngitis. Both medications can lead to hypoglycemia, especially when combined with other diabetes medications like insulin or sulfonylureas. Significant adverse effects include the risk of lactic acidosis with metformin and pancreatitis with sitagliptin. Patients should be monitored for these conditions and advised to report any unusual symptoms to their healthcare provider.
Can I take combination of Metformin and Sitagliptin with other prescription drugs?
Metformin can interact with drugs that affect renal function, such as NSAIDs and certain antihypertensives, increasing the risk of lactic acidosis. Sitagliptin may interact with drugs that affect the DPP-4 enzyme, although significant interactions are rare. Both medications can increase the risk of hypoglycemia when used with insulin or sulfonylureas. Patients should inform their healthcare provider of all medications they are taking to manage potential interactions effectively.
Can I take combination of Metformin and Sitagliptin with vitamins or supplements?
Metformin can interfere with the absorption of vitamin B12, potentially leading to deficiency over long-term use. Patients taking metformin should have their vitamin B12 levels monitored periodically and consider supplementation if necessary. There are no significant interactions between sitagliptin and vitamins or supplements. However, patients should always inform their healthcare provider about all supplements they are taking to avoid potential interactions and ensure optimal management of their diabetes.
Can I take combination of Metformin and Sitagliptin if I am pregnant?
Metformin has been used during pregnancy and is generally considered safe, with no clear association with major birth defects. However, sitagliptin's safety during pregnancy is not well established, and there is limited data on its effects. Pregnant women should discuss the potential risks and benefits of these medications with their healthcare provider. Managing blood sugar levels is crucial during pregnancy, and alternative treatments may be considered if necessary.
Can I take combination of Metformin and Sitagliptin while breastfeeding?
Metformin is present in breast milk in small amounts, but it is generally considered safe for use during breastfeeding, as no adverse effects have been reported in breastfed infants. There is limited information on the excretion of sitagliptin in human milk, and its safety during breastfeeding is not well established. Therefore, caution is advised, and the potential benefits and risks should be discussed with a healthcare provider. Breastfeeding mothers should consult their doctor before using these medications.
Who should avoid taking combination of Metformin and Sitagliptin?
Metformin is contraindicated in patients with severe renal impairment due to the risk of lactic acidosis. It should also be used cautiously in those with liver disease or a history of alcohol abuse. Sitagliptin is contraindicated in patients with a history of pancreatitis. Both medications should be used with caution in elderly patients and those with heart failure. Patients should be informed of the symptoms of lactic acidosis and pancreatitis and advised to seek medical attention if they experience these symptoms.
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