Sitagliptin+metformin
About Sitagliptin+metformin
Sitagliptin+metformin 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, Sitagliptin+metformin controls blood glucose levels from rising to very high levels after meals.
Sitagliptin+metformin should be taken with food to avoid an upset stomach. Sitagliptin+metformin 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 Sitagliptin+metformin 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.
Sitagliptin+metformin should not be stopped even if you feel better, without consulting the doctor as your sugar level keeps changing. If you stop taking Sitagliptin+metformin abruptly, it may increase your sugar levels, which could further increase the risk of eyesight loss (retinopathy), kidney (nephropathy) and nerve damage (neuropathy). Sitagliptin+metformin 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.
Uses of Sitagliptin+metformin
Medicinal Benefits
Sitagliptin+metformin 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. Sitagliptin+metformin 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.
Directions for Use
Storage
Side Effects of Sitagliptin+metformin
- Low blood sugar
- Runny nose
- Sore throat
- Upper lung infection
- Diarrhoea
- Nausea
- Vomiting
- Gas
- Stomach upset
- Indigestion
- General weakness
- Headache
Drug Warnings
Sitagliptin+metformin should not be used in patients with type 1 diabetes or with diabetic ketoacidosis. Some diabetic patients, while taking Sitagliptin+metformin, 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 Sitagliptin+metformin, tell your doctor if you’ve ever had pancreatitis (inflammation of the pancreas), kidney disease, and low vitamin B12 levels. Sitagliptin+metformin, when used with insulin, Sitagliptin+metformin 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 Sitagliptin+metformin. Prolonged intake of Sitagliptin+metformin 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 Sitagliptin+metformin briefly before an X-ray procedure.
Drug Interactions
Drug-Drug Interactions: Sitagliptin+metformin 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 Sitagliptin+metformin.
Drug-Disease Interactions: People affected with heart diseases (like congestive heart failure and myocardial infarction), Vitamin B12 deficiency, and alcoholism should avoid intake of Sitagliptin+metformin.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionAvoid consumption of alcohol while on treatment with Sitagliptin+metformin.
Pregnancy
cautionSitagliptin+metformin is only recommended during pregnancy when the benefit outweighs the risk. Please consult your doctor before starting Sitagliptin+metformin if you are pregnant or planning to conceive.
Breast Feeding
cautionConsult your doctor; Sitagliptin+metformin should be used in breastfeeding mothers only if the benefits outweigh the risks.
Driving
cautionDrive only if you are physically stable and mentally focussed, If you experience drowsiness after taking these medications you should not drive or operate any machinery or vehicles.
Liver
cautionIf you have or have a history or evidence of any liver-related diseases, please consult the doctor before taking medicine.
Kidney
cautionIf you have or had a history or evidence of any kidney-related diseases, please consult the doctor before taking medicine.
Children
cautionIt is advisable to consult a doctor before using it.
Habit Forming
Diet & Lifestyle Advise
- 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.
Patients Concern
Disease/Condition Glossary
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.
FAQs
Sitagliptin+metformin is used to treat Type 2 Diabetes Mellitus.
Sitagliptin belongs to the class of dipeptidyl peptidase-4 (DPP-4) inhibitors, which increase the amounts of certain natural substances that lower blood sugar when it is high. Another medicine, Metformin, belongs to the class of biguanides, which lowers glucose production in the liver, delays glucose absorption from the intestines and increases the body's sensitivity to insulin. Together, it prevent blood glucose levels from rising to very high after meals.
Increased hunger, increased thirst, frequent urination (usually at night), unexplained weight loss, fatigue, blurred vision, slow wound/sores healing, and frequent infections are the signs of type 2 diabetes. Please consult your doctor if you notice such symptoms.
No. Sitagliptin+metformin is only prescribed for the treatment of type 2 diabetes, also called 'non-insulin-dependent diabetes'.
Sitagliptin+metformin needs be taken with food to avoid stomach upset. Take it as prescribed by your doctor.
Do not crush or chew Sitagliptin+metformin as it may release all of the medicine at once and cause side effects. It should be taken as whole with food or as advised by the doctor.
Generally, Sitagliptin+metformin does not cause low blood sugar. It can cause low blood sugar if taken along with other antidiabetic medicines, if you are doing heavy exercise or taking low-calorie food. Symptoms of low blood sugar include sudden sweating, blurring of vision, shaking, hunger, increased heartbeat, dizziness, or tingling sensation in your hands or feet. If you experience low blood sugar while taking Sitagliptin+metformin, consult your doctor.
To increase your blood sugar quickly, eat sugar, candy, honey, or drink fruit juice or non-diet soda. If you have sudden sweating, blurry vision, shaking, dizziness, increased heartbeat, or hunger.
Long-term use of Sitagliptin+metformin can lead to Vitamin B12 deficiency. It interferes with the absorption of Vitamin B12 in the stomach. If left untreated, it may lead to anemia and nerve problems, which can cause the patient to feel tingling sensation and numbness in hands and feet, urinary problems, weakness, change in mental status and difficulty in maintaining balance (ataxia). Some researchers recommend intake of vitamin B12 from external sources at least once a year, to avoid such problems.
Sitagliptin+metformin may cause side effects such as headache, nausea, vomiting, diarrhoea, low blood sugar, or upper respiratory tract infection. If these side effects persist or worsen, please consult your doctor.
Sitagliptin+metformin should be avoided in patients with known allergy to any of the components or excipients in it and in patients with severe liver impairment, kidney impairment, congestive heart failure, diabetic ketoacidosis or lactic acidosis.
No, it is not safe to take alcohol while using Sitagliptin+metformin as it may increase the chance of a life-threatening condition known as lactic acidosis.
Store Sitagliptin+metformin at room temperature. Protect from light and moisture. Keep it out of reach of children.
Yes, the use of Sitagliptin+metformin can lead to lactic acidosis. It is a life threatening condition caused by the increased levels of lactic acid in the blood. It is also known as MALA (Metformin associated lactic acidosis). It is a rare side effect of metformin and thus, it is avoided in patients with underlying kidney disease, elderly patients or who take large amounts of alcohol. Symptoms of lactic acidosis may include muscle pain or weakness, tiredness, dizziness, difficulty in breathing, feeling of cold in arms and legs, stomach pain, nausea, vomiting, or slow heart rate. If you have these symptoms, stop taking Sitagliptin+metformin and consult your doctor immediately.
Sitagliptin+metformin can lower the chance of severe complications such as nerve problems, kidney damage, blindness, limb amputations, and heart diseases by controlling high blood sugar.
You are recommended to consult your doctor before taking other medications with Sitagliptin+metformin to avoid drug interactions.
Avoid alcohol consumption while taking Sitagliptin+metformin and ensure regular monitoring of kidney function. Always take Sitagliptin+metformin as prescribed by your doctor.
