Istamet XR CP Combipack is a combination drug of Sitagliptin (DPP4 inhibitors) and Metformin (Biguanides), belonging to the class of anti-diabetic agents used to treat type II diabetes. Type 2 diabetes is a condition in which either the body stops producing enough insulin (the hormone which helps to decrease sugar levels in the blood), or there is resistance to the action of insulin. As a result, insulin is produced in large amounts, but it cannot act on the body's organs.

Sitagliptin belongs to the class of dipeptidyl peptidase-4 (DPP-4) inhibitors that work by increasing the amounts of certain natural substances that lower blood sugar when it is high. Another medicine, Metformin, belongs to the class of biguanides that lower glucose production in the liver, delay glucose absorption from the intestines, and increase the body's sensitivity to insulin. Thus, Istamet XR CP Combipack controls blood glucose levels from rising to very high levels after meals.

Istamet XR CP Combipack should be taken with food to avoid an upset stomach. Istamet XR CP Combipack should be taken at the same time of the day each time for best results. For better advice, your doctor will decide what dose should be taken, and it can change in time depending on your condition. The most common side effect of Istamet XR CP Combipack is hypoglycemia (low blood glucose levels), characterised by dizziness, sweating, palpitations, hunger pangs, dry mouth and skin etc. So, to avoid hypoglycemia, you should not miss meals and should also carry some form of sugar with you. Other side effects include taste change, nausea, diarrhoea, stomach pain, headache, and upper respiratory symptoms.

Istamet XR CP Combipack should not be stopped even if you feel better, without consulting the doctor as your sugar level keeps changing. If you stop taking Istamet XR CP Combipack abruptly, it may increase your sugar levels, which could further increase the risk of eyesight loss (retinopathy), kidney (nephropathy) and nerve damage (neuropathy). Istamet XR CP Combipack should not be taken if you have type 1 diabetes mellitus or severe kidney or liver disease. Please inform your doctor if you have any type of heart disease, are planning to get pregnant or are breastfeeding.

Istamet XR CP Combipack helps the pancreas produce more insulin, effectively utilise insulin, and decrease the excess sugar the liver makes. It helps control the rise of blood sugar levels after a meal. Besides this, it does not cause weight gain in prolonged use. Istamet XR CP Combipack plays a vital role in controlling blood sugar levels. It prevents serious complications of diabetes like eyesight loss (retinopathy), kidney (nephropathy), nerve damage (neuropathy), diabetic foot ulcer and delayed wound healing.

• Low blood sugar
• Runny nose
• Sore throat
• Upper lung infection
• Diarrhoea
• Nausea
• Vomiting
• Gas
• Stomach upset
• Indigestion
• General weakness
• Headache

Istamet XR CP Combipack should not be used in patients with type 1 diabetes or with diabetic ketoacidosis. Some diabetic patients, while taking Istamet XR CP Combipack , might develop a rare but serious condition called lactic acidosis. In this condition, too much lactic acid accumulates in the blood, which can damage the workings of your liver and kidneys, which are required to eliminate excess lactic acid from the blood. Before you start taking Istamet XR CP Combipack , tell your doctor if you’ve ever had pancreatitis (inflammation of the pancreas), kidney disease, and low vitamin B12 levels. Istamet XR CP Combipack , when used with insulin, Istamet XR CP Combipack may lower the blood sugar level, leading to hypoglycaemia, which can be fatal. In this case, your doctor may adjust the dose by lowering the insulin dose or Istamet XR CP Combipack . Prolonged intake of Istamet XR CP Combipack may lower your thyroid-stimulating hormone (TSH); hence, an annual check-up of TSH is recommended. In rare cases, you may also develop a serious skin reaction known as bullous pemphigoid that requires immediate medical attention. Tell your doctor if you will have a diagnostic test with an injection of dye or X-ray contrast agent. You should stop using Istamet XR CP Combipack briefly before an X-ray procedure.

Drug-Drug Interactions: Istamet XR CP Combipack interacts with an anti-depressant (bupropion), drugs used to treat glaucoma, antibiotics (cephalexin, ciprofloxacin), anti-acidity drugs (cimetidine), heart condition drugs (digoxin), anti-HIV drugs (dolutegravir), ethanol, saliva reducing drugs (glycopyrrolate), iodinated X-ray contrast agents, anti-epileptic drugs (topiramate, lamotrigine), heart-related chest medicine (ranolazine). Other drug interactions can contribute to increased low blood sugar, including sex hormones (androgens), anti-oxidants (alpha-lipoic acid), pain killers (aspirin), anti-TB drugs (prothionamide), growth hormones (pegvisomant), and other antidiabetic medicines.

Drug-Food Interactions: Intake of excessive alcoholic beverages may increase the chance of a life-threatening condition known as Lactic Acidosis. So, avoid intake of alcoholic beverages with Istamet XR CP Combipack .

Drug-Disease Interactions: People affected with heart diseases (like congestive heart failure and myocardial infarction), Vitamin B12 deficiency, and alcoholism should avoid intake of Istamet XR CP Combipack .

• CIMETIDINE
• DIGOXIN
• DOLUTEGRAVIR
• RANOLAZINE

• Include starchy veggies, proteins, and whole grains in your diet.
• Eat at regular intervals. Do not take a long gap between a meal or snack.
• Monitor your blood sugar level regularly.
• If you feel that your blood sugar level is going down and you are feeling weak, immediately eat sugar candies or drink sugary beverages. It will help to balance the blood sugar level in your body. So, it is advisable to keep sugar candies with you.
• Invest in at least 150 min of moderate-intensity physical activity or one hour and 15 minutes of high-intensity exercise every week.
• Lose weight gradually to achieve a healthy body mass index (18.5 to 24.9).
• Replace refined carbohydrate-containing foods with whole grain foods and increase the intake of fruits, veggies, and other fibre-enriched foods.
• Reduce intake of saturated fat (or hidden fats) in food like chips, crisps, pastries, biscuits, and samosas. Choose omega-3 fatty acid-containing oils for daily cooking. For frying, you can use palm oil, mustard oil, groundnut oil, rice bran oil, and safflower oil.
• Do not take stress as it may elevate your blood sugar level. You can adopt stress management techniques like mindfulness to control stress-related blood sugar changes.
• Opt for low-fat dairy products (low-fat yoghurt, fat-free milk, cheese, etc.).
• Keep your blood pressure as normal (140/90) as possible. As it reduces the risk of cardiovascular diseases in diabetes patients.

Type 2 diabetes is a condition where the body cannot make sufficient insulin, or the insulin it makes doesn't work properly or is utilized by our body. This can cause high blood sugar levels (hyperglycaemia). Symptoms of type 2 diabetes include increased thirst, frequent urination at night, slow wound healing, increased hunger, fatigue, and blurred vision. In some cases, there may be weight gain, while in rare cases, weight loss may be observed. The complication of type 2 diabetes also includes neuropathy (nerve problems), nephropathy (kidney problems), retinopathy (damaged retina of eyes or blindness), loss of limbs, sexual dysfunction, and an increase in the chance of heart attack or stroke.