Daomin XR 500 mg Tab
Daomin XR 500 TabIndicationsMetformin Hydrochloride, as monotherapy, is indicated as an adjunct to diet to lower blood glucose especially in overweight patients with non-insulin-dependent diabetes mellitus (NIDDM) or type 2 diabetes mellitus whose hyperglycemia cannot be satisfactorily managed on diet alone. Metformin Hydrochloride may be used concomitantly with a sulfonylurea when diet and metformin hydrochloride or sulfonylureas alone do not result in adequate glycemic control.PharmacologyMetformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Metformin reduces hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis, and stimulates intracellular glycogen synthesis by acting on glycogen synthase. In muscle, it increases insulin sensitivity, improving peripheral glucose uptake and utilization. Metformin also delays intestinal glucose absorption. Metformin increases the transport capacity of all types of membrane glucose transporters (GLUTs) known to date.In humans, independently of its action on glycemia, metformin has favorable effects on lipid metabolism. This has been shown at therapeutic doses in controlled, medium-term or long-term clinical studies: Metformin reduces total cholesterol, LDL, cholesterol and triglycerides levels. Unlike sulfonylureas, metformin does not produce hypoglycemia in either patients with type 2 diabetes or normal subjects and does not cause hyperinsulinemia. With metformin therapy, insulin secretion remains unchanged while fasting insulin levels and daylong plasma insulin response may actually decrease.Children and adolescents-Monotherapy and combination with insulinMetformin tablets can be used in children from 10 years of age and adolescents.The usual starting dose is one tablet of 500 mg or 850 mg once daily, given during meals or after meals.After 10 to 15 days the should be adjusted on the basis of blood glucose measurements. A slow increase of dose may improve gastrointestinal tolerability. The maximum recommended dose of metformin is 2 g daily, taken as 2 or 3 divided doses.Combinations requiring precautions for use-Certain drugs tend to produce hyperglycemia and may lead to loss of glycemic control. These drugs include thiazide and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid. When such drugs are administered to a patient receiving Metformin HCl, the patient should be closely observed to maintain adequate glycemic control. Inform the patient and perform more frequent blood glucose monitoring, especially at the beginning of treatment. If necessary, adjust the dosage of the antidiabetic drug during therapy with the other drug and upon its discontinuation.Nifedipine appears to enhance the absorption of Metformin. Metformin has minimal effects on nifedipine. ACE-inhibitors may decrease the blood glucose levels. If necessary, adjust the dosage of the antidiabetic drug during therapy with the other drug and upon its discontinuation.ContraindicationsHypersensitivity to metformin hydrochloride or to any of the excipients of the medication.Diabetic ketoacidosis, diabetic pre-coma Renal failure or renal dysfunction (creatinine clearance < 60 mL/min)Acute conditions with the potential to alter renal function such as: dehydration, severe infection, shock, intravascular administration of iodinated contrast agents.Acute or chronic disease which may cause tissue hypoxia such as: cardiac or respiratory failure, recent myocardial infarction, shock Hepatic insufficiency, acute alcohol intoxication, alcoholism LactationSide EffectsMetformin may cause gastro-intestinal adverse effects like diarrhoea, anorexia, nausea & vomiting. Lactic acidosis and malabsorption of vitamin B12 may be occurred. Patients may experience a metallic taste and there may be weight loss, which in some diabetics could be an advantage.Overdose EffectsHypoglycemia has not been seen with metformin doses up to 85g, although lactic acidosis has occurred in such circumstances. High overdose or concomitant risks of metformin may lead to lactic acidosis. Lactic acidosis is a medical emergency and must be treated in hospital. The most effective method to remove lactate and metformin is hemodialysis...
Tk.6.00/=
Janmet 50/1000 mg Tab
Janmet 50/1000 mg TabDescriptionJanmet is an oral anti-diabetic drug that helps control blood sugar levels. Janmet contains a combination of Metformin and Sitagliptin.Metformin and Sitagliptin are oral diabetes medicines that help control blood sugar levels. Janmet is used along with diet and exercise to lower blood sugar in adults with type 2 diabetes (NIDDM).CompositionJanmet 500 : Each film-coated tablet contains Sitagliptin PhosphateMonohydrate INN 64.25 mg equivalent to 50 mg of Sitagliptin and Metformin Hydrochloride BP 500 mg. Janmet 1000 : Each film-coated tablet contains Sitagliptin PhosphateMonohydrate INN 64.25 mg equivalent to 50 mg of Sitagliptin and Metformin Hydrochloride BP 1000 mg.IndicationJanmet is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both Sitagliptin and Metformin is appropriate.Dosage and AdministrationJanmet should generally be given twice daily with meals, with gradual dose escalation, to reduce the gastrointestinal (GI) side effects due toMetformin.The recommended starting dose in patients not currently treated withMetformin is 50 mg Sitagliptin/500 mg Metformin hydrochloride twice daily.The starting dose in patients already treated with Metformin should provide Sitagliptin dosed as 50 mg twice daily (100 mg total daily dose) and the dose of Metformin already being taken. For patients takingMetformin 850 mg twice daily, the recommended starting dose ofJanmet is 50 mg Sitagliptin/1000 mg Metformin twice daily. Patients treated with an insulin secretagogue or insulinCo-administration of Janmet with an insulin secretagogue (e.g., sulfonylurea) or insulin may require lower doses of the insulin secretagogue or insulin to reduce the risk of hypoglycemia.Use in Specific PopulationsPediatric population- There is no data on the use of Sitagliptin in patients younger than 18 years of age and therefore not recommended.Geriatric Use- Janmet should be used with caution as age increases.Care should be taken in dose selection and should be based on careful and regular monitoring of renal function.Renal Insufficiency- A dosage adjustment is recommended in patientswith moderate or severe renal insufficiency and in patients with ESRD requiring hemodialysis or peritoneal dialysis.Impaired Hepatic Function- Janmet should generally be avoided in patients with clinical or laboratory evidence of hepatic disease.Use in Pancreatitis: Janmet has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking Janmet.OR AS DIRECTED BY THE PHYSICIAN.Side EffectsMost common side effects of Janmet are diarrhea, gas, headache, indigestion, nausea, sore throat, stomach upset, stuffy or runny nose, vomiting, and weakness.Severe allergic reactions (rash; hives; itching; difficulty swallowing or breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); chest pain or discomfort; decreased urination; dizziness or light-headedness; fast or difficult breathing; feeling of being unusually cold; general feeling of being unwell; muscle pain or weakness; red, blistered, swollen, or peelingskin; slow or irregular heartbeat; symptoms of pancreas inflammation (eg, severe stomach or back pain with or without nausea or vomiting); unusual drowsiness; unusual or persistent stomach pain or discomfort; unusual tiredness or weakness.ContraindicationJanmet is contraindicated in patients with hypersensitivity to the active substances or to any of the excipients, diabetic ketoacidosis, diabetic pre-coma, moderate and severe renal impairment [serum creatinine levels 1.5 mg/dL (males), 1.4 mg/dL (Females)].PrecautionJanmet may cause lactic acidosis, low blood sugar, and decreased vitamin B12 levels. Janmet warnings and precautions also extend to those who are allergic to any components of the drug, have metabolic or diabetic ketoacidosis, have kidney disease, or are about to have an x-ray procedure with contrast dye.Use in Pregnancy and LactationPregnancyPregnancy Category : B. Animal studies have failed to reveal evidence of fetal harm. There are no controlled data in human pregnancy.Sitagliptin-Metformin is only recommended for use during pregnancy when benefit outweighs risk.LactationThere are no data on the excretion of Sitagliptin-Metformin into human milk. It is recommended that caution should be used when administering Sitagliptin-Metformin to nursing women.Drug InteractionCationic agents that are eliminated by renal tubular secretion (e.g. cimetidine) may interact with Metformin by competing for common renal tubular transport systems. So, close monitoring of glycaemic control, dose adjustment within the recommended posology and changes in diabetic treatment should be considered when cationic agents that are eliminated by renal tubular secretion are co-administered. ..
Tk.18.04/=
Janmet 50/500 mg Tab
Janmet 50/500 mg TabDescriptionJanmet is an oral anti-diabetic drug that helps control blood sugar levels. Janmet contains a combination of Metformin and Sitagliptin.Metformin and Sitagliptin are oral diabetes medicines that help control blood sugar levels. Janmet is used along with diet and exercise to lower blood sugar in adults with type 2 diabetes (NIDDM).CompositionJanmet 500 : Each film-coated tablet contains Sitagliptin PhosphateMonohydrate INN 64.25 mg equivalent to 50 mg of Sitagliptin and Metformin Hydrochloride BP 500 mg. Janmet 1000 : Each film-coated tablet contains Sitagliptin PhosphateMonohydrate INN 64.25 mg equivalent to 50 mg of Sitagliptin and Metformin Hydrochloride BP 1000 mg.IndicationJanmet is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both Sitagliptin and Metformin is appropriate.Dosage and AdministrationJanmet should generally be given twice daily with meals, with gradual dose escalation, to reduce the gastrointestinal (GI) side effects due toMetformin.The recommended starting dose in patients not currently treated withMetformin is 50 mg Sitagliptin/500 mg Metformin hydrochloride twice daily.The starting dose in patients already treated with Metformin should provide Sitagliptin dosed as 50 mg twice daily (100 mg total daily dose) and the dose of Metformin already being taken. For patients takingMetformin 850 mg twice daily, the recommended starting dose ofJanmet is 50 mg Sitagliptin/1000 mg Metformin twice daily. Patients treated with an insulin secretagogue or insulinCo-administration of Janmet with an insulin secretagogue (e.g., sulfonylurea) or insulin may require lower doses of the insulin secretagogue or insulin to reduce the risk of hypoglycemia.Use in Specific PopulationsPediatric population- There is no data on the use of Sitagliptin in patients younger than 18 years of age and therefore not recommended.Geriatric Use- Janmet should be used with caution as age increases.Care should be taken in dose selection and should be based on careful and regular monitoring of renal function.Renal Insufficiency- A dosage adjustment is recommended in patientswith moderate or severe renal insufficiency and in patients with ESRD requiring hemodialysis or peritoneal dialysis.Impaired Hepatic Function- Janmet should generally be avoided in patients with clinical or laboratory evidence of hepatic disease.Use in Pancreatitis: Janmet has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking Janmet.OR AS DIRECTED BY THE PHYSICIAN.Side EffectsMost common side effects of Janmet are diarrhea, gas, headache, indigestion, nausea, sore throat, stomach upset, stuffy or runny nose, vomiting, and weakness.Severe allergic reactions (rash; hives; itching; difficulty swallowing or breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); chest pain or discomfort; decreased urination; dizziness or light-headedness; fast or difficult breathing; feeling of being unusually cold; general feeling of being unwell; muscle pain or weakness; red, blistered, swollen, or peelingskin; slow or irregular heartbeat; symptoms of pancreas inflammation (eg, severe stomach or back pain with or without nausea or vomiting); unusual drowsiness; unusual or persistent stomach pain or discomfort; unusual tiredness or weakness.ContraindicationJanmet is contraindicated in patients with hypersensitivity to the active substances or to any of the excipients, diabetic ketoacidosis, diabetic pre-coma, moderate and severe renal impairment [serum creatinine levels 1.5 mg/dL (males), 1.4 mg/dL (Females)].PrecautionJanmet may cause lactic acidosis, low blood sugar, and decreased vitamin B12 levels. Janmet warnings and precautions also extend to those who are allergic to any components of the drug, have metabolic or diabetic ketoacidosis, have kidney disease, or are about to have an x-ray procedure with contrast dye.Use in Pregnancy and LactationPregnancyPregnancy Category : B. Animal studies have failed to reveal evidence of fetal harm. There are no controlled data in human pregnancy.Sitagliptin-Metformin is only recommended for use during pregnancy when benefit outweighs risk.LactationThere are no data on the excretion of Sitagliptin-Metformin into human milk. It is recommended that caution should be used when administering Sitagliptin-Metformin to nursing women.Drug InteractionCationic agents that are eliminated by renal tubular secretion (e.g. cimetidine) may interact with Metformin by competing for common renal tubular transport systems. So, close monitoring of glycaemic control, dose adjustment within the recommended posology and changes in diabetic treatment should be considered when cationic agents that are eliminated by renal tubular secretion are co-administered. J..
Tk.16.04/=
Nobesit 500
Nobesit 500 TabDescriptionNobesit is a biguanide type oral antihyperglycemic drug used in the management of type 2 diabetes. It lowers both basal and postprandial plasma glucose. Its mechanism of action is different from those of sulfonylureas and it does not produce hypoglycemia. Nobesit decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by an increase in peripheral glucose uptake and utilization.IndicationsNobesit, as monotherapy, is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes. Nobesit is also indicated for use in combination therapy with an oral hypoglycemic agent or insulin when diet and exercise plus the single agent do not result in adequate glycemic control.Dosage & AdministrationDosage of Nobesit or Nobesit XR must be individualized on the basis of both effectiveness and tolerance, while not exceeding the maximum recommended daily doses. The maximum recommended daily dose of Nobesit is 2550 mg in adults and 2000 mg in pediatric patients (10-16 years of age); the maximum recommended daily dose of Nobesit XR in adults is 2000 mg.AdultsThe usual starting dose of Nobesit is 500 mg twice a day or 850 mg once a day, given with meals. Dosage increases should be made in increments of 500 mg weekly or 850 mg every 2 weeks, up to a total of 2000 mg per day, given in divided doses. For those patients requiring additional glycemic control, Nobesit may be given to a maximum daily dose of 2550 mg per day. Doses above 2000 mg may be better tolerated given three times a day with meals.The usual starting dose of Nobesit XR is 500 mg once daily with the meal. Dosage increases should be made in increments of 500 mg weekly, up to a maximum of 2000 mg once daily with the meal. For those patients requiring additional glycaemic control, a trial of Nobesit XR 1000 mg twice daily should be considered.PediatricsThe usual starting dose of Nobesit is 500 mg twice a day, given with meals. Dosage increases should be made in increments of 500 mg weekly up to a maximum of 2000 mg per day, given in divided doses. Safety and effectiveness of Nobesit XR in pediatric patients have not been established.Nobesit XR tablets must be swallowed whole and never crushed or chewed.Side EffectsGastrointestinal symptoms (30% patients) such as diarrhea, nausea, vomiting, abdominal bloating, flatulence and anorexia are the most common reactions to Metformin. These symptoms are generally transient and resolve spontaneously during continued treatment. Because gastrointestinal symptoms during therapy initiation appear to be dose-related, they may be decreased by gradual dose escalation and by having patients taken Metformin with meals.Rarely lactic acidosis (approximately 0.03 cases/1000 patient-year) can occur due to Metformin accumulation during treatment with Metformin.PrecautionsMetformin is known to be substantially excreted by the kidney and the risk of Metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. Thus, patients with serum creatinine levels above the upper limit of normal for their age should not receive Metformin.Use in Pregnancy & LactationPregnancy: Safety in pregnant woman has not been established. Metformin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Nursing Mother: It is not known whether Metformin is secreted in human milk. Because many drugs are excreted in human milk, it should not be administered to a breast feeding woman.Over DoseHypoglycemia has not been seen even with ingestion of up to 85 grams of Metformin, although lactic acidosis has occurred in such circumstances. Hemodialysis may be useful for removal of accumulated drug from patients in whom Metformin overdose is suspected...
Tk.4.00/=
Nobesit 850 mg Tab
Nobesit 850 TabDescriptionNobesit is a biguanide type oral antihyperglycemic drug used in the management of type 2 diabetes. It lowers both basal and postprandial plasma glucose. Its mechanism of action is different from those of sulfonylureas and it does not produce hypoglycemia. Nobesit decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by an increase in peripheral glucose uptake and utilization.IndicationsNobesit, as monotherapy, is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes. Nobesit is also indicated for use in combination therapy with an oral hypoglycemic agent or insulin when diet and exercise plus the single agent do not result in adequate glycemic control.Dosage & AdministrationDosage of Nobesit or Nobesit XR must be individualized on the basis of both effectiveness and tolerance, while not exceeding the maximum recommended daily doses. The maximum recommended daily dose of Nobesit is 2550 mg in adults and 2000 mg in pediatric patients (10-16 years of age); the maximum recommended daily dose of Nobesit XR in adults is 2000 mg.AdultsThe usual starting dose of Nobesit is 500 mg twice a day or 850 mg once a day, given with meals. Dosage increases should be made in increments of 500 mg weekly or 850 mg every 2 weeks, up to a total of 2000 mg per day, given in divided doses. For those patients requiring additional glycemic control, Nobesit may be given to a maximum daily dose of 2550 mg per day. Doses above 2000 mg may be better tolerated given three times a day with meals.The usual starting dose of Nobesit XR is 500 mg once daily with the meal. Dosage increases should be made in increments of 500 mg weekly, up to a maximum of 2000 mg once daily with the meal. For those patients requiring additional glycaemic control, a trial of Nobesit XR 1000 mg twice daily should be considered.PediatricsThe usual starting dose of Nobesit is 500 mg twice a day, given with meals. Dosage increases should be made in increments of 500 mg weekly up to a maximum of 2000 mg per day, given in divided doses. Safety and effectiveness of Nobesit XR in pediatric patients have not been established.Nobesit XR tablets must be swallowed whole and never crushed or chewed.Side EffectsGastrointestinal symptoms (30% patients) such as diarrhea, nausea, vomiting, abdominal bloating, flatulence and anorexia are the most common reactions to Metformin. These symptoms are generally transient and resolve spontaneously during continued treatment. Because gastrointestinal symptoms during therapy initiation appear to be dose-related, they may be decreased by gradual dose escalation and by having patients taken Metformin with meals.Rarely lactic acidosis (approximately 0.03 cases/1000 patient-year) can occur due to Metformin accumulation during treatment with Metformin.PrecautionsMetformin is known to be substantially excreted by the kidney and the risk of Metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. Thus, patients with serum creatinine levels above the upper limit of normal for their age should not receive Metformin.Use in Pregnancy & LactationPregnancy: Safety in pregnant woman has not been established. Metformin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Nursing Mother: It is not known whether Metformin is secreted in human milk. Because many drugs are excreted in human milk, it should not be administered to a breast feeding woman.Over DoseHypoglycemia has not been seen even with ingestion of up to 85 grams of Metformin, although lactic acidosis has occurred in such circumstances. Hemodialysis may be useful for removal of accumulated drug from patients in whom Metformin overdose is suspected...
Tk.6.00/=
Nobesit XR 1gm
Nobesit XR 1gm tabDescriptionNobesit is a biguanide type oral antihyperglycemic drug used in the management of type 2 diabetes. It lowers both basal and postprandial plasma glucose. Its mechanism of action is different from those of sulfonylureas and it does not produce hypoglycemia. Nobesit decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by an increase in peripheral glucose uptake and utilization.IndicationsNobesit, as monotherapy, is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes. Nobesit is also indicated for use in combination therapy with an oral hypoglycemic agent or insulin when diet and exercise plus the single agent do not result in adequate glycemic control.Dosage & AdministrationDosage of Nobesit or Nobesit XR must be individualized on the basis of both effectiveness and tolerance, while not exceeding the maximum recommended daily doses. The maximum recommended daily dose of Nobesit is 2550 mg in adults and 2000 mg in pediatric patients (10-16 years of age); the maximum recommended daily dose of Nobesit XR in adults is 2000 mg.AdultsThe usual starting dose of Nobesit is 500 mg twice a day or 850 mg once a day, given with meals. Dosage increases should be made in increments of 500 mg weekly or 850 mg every 2 weeks, up to a total of 2000 mg per day, given in divided doses. For those patients requiring additional glycemic control, Nobesit may be given to a maximum daily dose of 2550 mg per day. Doses above 2000 mg may be better tolerated given three times a day with meals.The usual starting dose of Nobesit XR is 500 mg once daily with the meal. Dosage increases should be made in increments of 500 mg weekly, up to a maximum of 2000 mg once daily with the meal. For those patients requiring additional glycaemic control, a trial of Nobesit XR 1000 mg twice daily should be considered.PediatricsThe usual starting dose of Nobesit is 500 mg twice a day, given with meals. Dosage increases should be made in increments of 500 mg weekly up to a maximum of 2000 mg per day, given in divided doses. Safety and effectiveness of Nobesit XR in pediatric patients have not been established.Nobesit XR tablets must be swallowed whole and never crushed or chewed.Side EffectsGastrointestinal symptoms (30% patients) such as diarrhea, nausea, vomiting, abdominal bloating, flatulence and anorexia are the most common reactions to Metformin. These symptoms are generally transient and resolve spontaneously during continued treatment. Because gastrointestinal symptoms during therapy initiation appear to be dose-related, they may be decreased by gradual dose escalation and by having patients taken Metformin with meals.Rarely lactic acidosis (approximately 0.03 cases/1000 patient-year) can occur due to Metformin accumulation during treatment with Metformin.PrecautionsMetformin is known to be substantially excreted by the kidney and the risk of Metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. Thus, patients with serum creatinine levels above the upper limit of normal for their age should not receive Metformin.Use in Pregnancy & LactationPregnancy: Safety in pregnant woman has not been established. Metformin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Nursing Mother: It is not known whether Metformin is secreted in human milk. Because many drugs are excreted in human milk, it should not be administered to a breast feeding woman.Over DoseHypoglycemia has not been seen even with ingestion of up to 85 grams of Metformin, although lactic acidosis has occurred in such circumstances. Hemodialysis may be useful for removal of accumulated drug from patients in whom Metformin overdose is suspected...
Tk.9.00/=
Nobesit XR 500
Nobesit XR 500 TabDescriptionNobesit is a biguanide type oral antihyperglycemic drug used in the management of type 2 diabetes. It lowers both basal and postprandial plasma glucose. Its mechanism of action is different from those of sulfonylureas and it does not produce hypoglycemia. Nobesit decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by an increase in peripheral glucose uptake and utilization.IndicationsNobesit, as monotherapy, is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes. Nobesit is also indicated for use in combination therapy with an oral hypoglycemic agent or insulin when diet and exercise plus the single agent do not result in adequate glycemic control.Dosage & AdministrationDosage of Nobesit or Nobesit XR must be individualized on the basis of both effectiveness and tolerance, while not exceeding the maximum recommended daily doses. The maximum recommended daily dose of Nobesit is 2550 mg in adults and 2000 mg in pediatric patients (10-16 years of age); the maximum recommended daily dose of Nobesit XR in adults is 2000 mg.AdultsThe usual starting dose of Nobesit is 500 mg twice a day or 850 mg once a day, given with meals. Dosage increases should be made in increments of 500 mg weekly or 850 mg every 2 weeks, up to a total of 2000 mg per day, given in divided doses. For those patients requiring additional glycemic control, Nobesit may be given to a maximum daily dose of 2550 mg per day. Doses above 2000 mg may be better tolerated given three times a day with meals.The usual starting dose of Nobesit XR is 500 mg once daily with the meal. Dosage increases should be made in increments of 500 mg weekly, up to a maximum of 2000 mg once daily with the meal. For those patients requiring additional glycaemic control, a trial of Nobesit XR 1000 mg twice daily should be considered.PediatricsThe usual starting dose of Nobesit is 500 mg twice a day, given with meals. Dosage increases should be made in increments of 500 mg weekly up to a maximum of 2000 mg per day, given in divided doses. Safety and effectiveness of Nobesit XR in pediatric patients have not been established.Nobesit XR tablets must be swallowed whole and never crushed or chewed.Side EffectsGastrointestinal symptoms (30% patients) such as diarrhea, nausea, vomiting, abdominal bloating, flatulence and anorexia are the most common reactions to Metformin. These symptoms are generally transient and resolve spontaneously during continued treatment. Because gastrointestinal symptoms during therapy initiation appear to be dose-related, they may be decreased by gradual dose escalation and by having patients taken Metformin with meals.Rarely lactic acidosis (approximately 0.03 cases/1000 patient-year) can occur due to Metformin accumulation during treatment with Metformin.PrecautionsMetformin is known to be substantially excreted by the kidney and the risk of Metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. Thus, patients with serum creatinine levels above the upper limit of normal for their age should not receive Metformin.Use in Pregnancy & LactationPregnancy: Safety in pregnant woman has not been established. Metformin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Nursing Mother: It is not known whether Metformin is secreted in human milk. Because many drugs are excreted in human milk, it should not be administered to a breast feeding woman.Over DoseHypoglycemia has not been seen even with ingestion of up to 85 grams of Metformin, although lactic acidosis has occurred in such circumstances. Hemodialysis may be useful for removal of accumulated drug from patients in whom Metformin overdose is suspected...
Tk.6.00/=
Sitagil M 50/1000 ER
Sitagil M 50/1000 ER Tab.DescriptionSitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, which exerts its action by slowing the inactivation of incretin hormones. Incretin hormones, including glucagon-like peptide-1(GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are released by the intestine throughout the day and levels are increased in response to a meal. These hormones are rapidly inactivated by the enzyme, DPP-4. The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. When blood glucose concentrations are normal or elevated, GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells by intracellular signaling pathways involving cyclic AMP. GLP-1 also lowers glucagon secretion from pancreatic alpha cells, leading to reduced hepatic glucose production. The pharmacologic mechanism of action of Metformin is different from other classes of oral antihyperglycemic agents. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and increases peripheral glucose uptake and utilization.IndicationsSitagliptin + Metformin ER is a dipeptidyl peptidase-4 (DPP-4) inhibitor and biguanide combination product indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both Sitagliptin and Metformin extended release is appropriate.Dosage & AdministrationMay adjust the dosing based on effectiveness and tolerability while not exceeding the maximum recommended daily dose of 100 mg Sitagliptin and 2000 mg Metformin extended release.Administer once daily with a meal preferably in the evening. Gradually escalate the dose to reduce the gastrointestinal side effects due to Metformin. Maintain the same total daily dose of Sitagliptin and Metformin when changing between Sitagliptin + Metformin ER, without exceeding the maximum recommended daily dose of 2000 mg Metformin extended release.Swallow whole. Never split, crush or chew.Side Effects• The most common adverse reactions reported in ≥5% of patients simultaneously started on Sitagliptin and Metformin and more commonly than in patients treated with placebo were diarrhea, upper respiratory tract infection, and headache.• Adverse reactions reported in ≥5% of patients treated with Sitagliptin in combination with Sulfonylurea and Metformin and more commonly than in patients treated with placebo in combination with Sulfonylurea and Metformin were hypoglycemia and headache.• Hypoglycemia was the only adverse reaction reported in ≥5% of patients treated with Sitagliptin in combination with insulin and Metformin and more commonly than in patients treated with placebo in combination with insulin and Metformin.PrecautionsDo not use the combination of Sitagliptin & Metformin in patients with hepatic disease. Before initiating the combination and at least annually thereafter, assess renal function and verify as normal. May need to discontinue the combination and temporarily use insulin during periods of stress and decreased intake of fluids and food as may occur with fever, trauma, infection or surgery.Use in Pregnancy & Lactation• There are no adequate and well-controlled studies in pregnant women with Sitagliptin + Metformin ER or its individual components; therefore, the safety of Sitagliptin + Metformin ER in pregnant women is not known. Sitagliptin + Metformin ER should be used during pregnancy only if clearly needed.• It is not known whether Sitagliptin or Metformin are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Sitagliptin + Metformin ER is administered to a nursing woman.Drug InteractionCarbonic anhydrase inhibitors should be used with caution treated with Sitagliptin + Metformin ER, as the risk of lactic acidosis may increase.Careful patient monitoring and dose adjustment of Sitagliptin + Metformin ER and/or the interfering drug is recommended in patients who are taking cationic medications that are excreted via the proximal renal tubular secretory system.Over DoseSitagliptinThere is no experience with doses above 800 mg in clinical studies. In the event of an overdose, it is reasonable to employ the usual supportive measures, e.g., remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring (including obtaining an electrocardiogram), and institute supportive therapy as indicated by the patient\\\'s clinical status.Prolonged hemodialysis may be considered if clinically appropriate. It is not known if Sitagliptin is dialyzable by peritoneal dialysis.Metformin HydrochlorideOverdose of Metformin Hydrochloride has occurred, including ingestion of amounts greater than 50 grams. Hypoglycemia was reported in approximately 10% of cases, but no causal association with Metformin Hydrochloride has been established. Lactic acidosis has been reported in approximately 32% of Metformin overdose cas..
Tk.18.00/=
Sitagil M 50/500 ER
Sitagil M 50/500 ER TabDescriptionSitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, which exerts its action by slowing the inactivation of incretin hormones. Incretin hormones, including glucagon-like peptide-1(GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are released by the intestine throughout the day and levels are increased in response to a meal. These hormones are rapidly inactivated by the enzyme, DPP-4. The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. When blood glucose concentrations are normal or elevated, GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells by intracellular signaling pathways involving cyclic AMP. GLP-1 also lowers glucagon secretion from pancreatic alpha cells, leading to reduced hepatic glucose production. The pharmacologic mechanism of action of Metformin is different from other classes of oral antihyperglycemic agents. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and increases peripheral glucose uptake and utilization.IndicationsSitagliptin + Metformin ER is a dipeptidyl peptidase-4 (DPP-4) inhibitor and biguanide combination product indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both Sitagliptin and Metformin extended release is appropriate.Dosage & AdministrationMay adjust the dosing based on effectiveness and tolerability while not exceeding the maximum recommended daily dose of 100 mg Sitagliptin and 2000 mg Metformin extended release.Administer once daily with a meal preferably in the evening. Gradually escalate the dose to reduce the gastrointestinal side effects due to Metformin. Maintain the same total daily dose of Sitagliptin and Metformin when changing between Sitagliptin + Metformin ER, without exceeding the maximum recommended daily dose of 2000 mg Metformin extended release.Swallow whole. Never split, crush or chew.Side Effects• The most common adverse reactions reported in ≥5% of patients simultaneously started on Sitagliptin and Metformin and more commonly than in patients treated with placebo were diarrhea, upper respiratory tract infection, and headache.• Adverse reactions reported in ≥5% of patients treated with Sitagliptin in combination with Sulfonylurea and Metformin and more commonly than in patients treated with placebo in combination with Sulfonylurea and Metformin were hypoglycemia and headache.• Hypoglycemia was the only adverse reaction reported in ≥5% of patients treated with Sitagliptin in combination with insulin and Metformin and more commonly than in patients treated with placebo in combination with insulin and Metformin.PrecautionsDo not use the combination of Sitagliptin & Metformin in patients with hepatic disease. Before initiating the combination and at least annually thereafter, assess renal function and verify as normal. May need to discontinue the combination and temporarily use insulin during periods of stress and decreased intake of fluids and food as may occur with fever, trauma, infection or surgery.Use in Pregnancy & Lactation• There are no adequate and well-controlled studies in pregnant women with Sitagliptin + Metformin ER or its individual components; therefore, the safety of Sitagliptin + Metformin ER in pregnant women is not known. Sitagliptin + Metformin ER should be used during pregnancy only if clearly needed.• It is not known whether Sitagliptin or Metformin are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Sitagliptin + Metformin ER is administered to a nursing woman.Drug InteractionCarbonic anhydrase inhibitors should be used with caution treated with Sitagliptin + Metformin ER, as the risk of lactic acidosis may increase.Careful patient monitoring and dose adjustment of Sitagliptin + Metformin ER and/or the interfering drug is recommended in patients who are taking cationic medications that are excreted via the proximal renal tubular secretory system.Over DoseSitagliptinThere is no experience with doses above 800 mg in clinical studies. In the event of an overdose, it is reasonable to employ the usual supportive measures, e.g., remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring (including obtaining an electrocardiogram), and institute supportive therapy as indicated by the patient\\\'s clinical status.Prolonged hemodialysis may be considered if clinically appropriate. It is not known if Sitagliptin is dialyzable by peritoneal dialysis.Metformin HydrochlorideOverdose of Metformin Hydrochloride has occurred, including ingestion of amounts greater than 50 grams. Hypoglycemia was reported in approximately 10% of cases, but no causal association with Metformin Hydrochloride has been established. Lactic acidosis has been reported in approximately 32% of Metformin overdose cases..
Tk.16.00/=
Viglimet 50/500 mg Tablet
Viglimet 50/500 mg TabletIndication:Management of type 2 diabetes mellitus.Dosage & Administration:Adults: Based on the patient's current dose of Metformin, Combination of Vildagliptin & Metformin may be initiated at either 50 mg/500 mg or 50 mg/850 mg twice daily, 1 tab in the morning and the other in the evening. The recommended daily dose is 100 mg Vildagliptin plus 2000 mg Metformin HCl. Patients receiving Vildagliptin and Metformin from separate tablets may be switched to Combination of Vildagliptin & Metformin containing the same doses of each component. Doses higher than 100 mg of Vildagliptin are not recommended. There is no clinical experience of Vildagliptin and Metformin in triple combination with other antidiabetic agents. Taking Combination Show more Preparation:ViglimetTM 50/500 Tablet: Each box contains 30 tablets in blister pack.ViglimetTM 50/850 Tablet: Each box contains 30 tablets in blister pack...
Tk.18.00/=