Glipita 100 tablet
What is Glipita?Glipita is the preparation of Sitagliptin. Sitagliptin is a new oral agent approved by the USFDA to treat type 2 diabetes with diet & exercise. It belongs to a new class of antihyperglycemic, Dipeptidyl Dipeptidase-4 (DPP-4) inhibitors. This unique class of orally active agent targets the underlying pathophysiologic processes of type 2 diabetic patients and provides an excellent alternative to the traditional agents.How Glipita works in our body?Normally, when glucose appears in blood after meal, Incretin hormones (GLP-1 & GIP) are secreted from gut to stimulate pancreatic β cell for insulin secretion and to act on α cell for glucagon inhibition. Dipeptidyl Peptidase 4 (DPP-4), an enzyme present in plasma, inactivates GLP-1 & GIP to stop insulin secretion from pancreatic β cell and to increase uninterrupted glucagon secretion from pancreatic α cell. Sitagliptin inhibits plasma DPP-4 activity (i.e. inactivation of GLP & GIP) and thus, increases circulating levels of active GLP-1 and GIP by two-to-threefold. This in turn, increases insulin release from pancreatic β cell and decreases glucagon levels from pancreatic α cell in the circulation in a glucose-dependent manner. Therefore, Sitagliptin is the only oral drug that involves both pancreatic α & β cell in a complimentary mode of action and thus ensures effective glycemic control in type 2 diabetes.What is the indications of Glipita?Monotherapy- GLIPITA is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. Combination with Metformin- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with Metformin as initial therapy or when the single agent alone, with diet and exercise, does not provide adequate glycemic control. Combination with a Sulfonylurea- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with a sulfonylurea when treatment with the single agent alone, with diet and exercise, does not provide adequate glycemic control. Combination with a Thiazolidinediones- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with a thiazolidinedione when treatment with the single agent alone, with diet and exercise, does not provide adequate glycemic control. Combination with Metformin and a Sulfonylurea- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with Metformin and a sulfonylurea when dual therapy with these agents, with diet and exercise, does not provide adequate glycemic control.What is the dosage guideline for Glipita?The recommended dose of SITAGLIPTIN is 100 mg once daily as monotherapy or as combination therapy with Metformin, a sulfonylurea, a thiazolidinedione, or Metformin plus a sulfonylurea. SITAGLIPTIN can be taken with or without food. Patients with Renal Insufficiency- For patients with mild renal insufficiency (creatinine clearance [CrCl] ≥50 mL/min, approximately corresponding to serum creatinine levels of ≤1.7 mg/dL in men and ≤1.5 mg/dL in women), no dosage adjustment for SITAGLIPTIN is required. For patients with moderate renal insufficiency (CrCl ≥30 to <50 mL/min, approximately corresponding to serum creatinine levels of >1.7 to ≤3.0 mg/dL in men and >1.5 to ≤2.5 mg/dL in women), the dose of SITAGLIPTIN is 50 mg once daily. For patients with severe renal insufficiency (CrCl <30 mL/min, approximately corresponding to serum creatinine levels of >3.0 mg/dL in men and >2.5 mg/dL in women) or with end -stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of SITAGLIPTIN is 25 mg once daily. SITAGLIPTIN may be administered without regard to the timing of hemodialysis. Concomitant Use with a Sulfonylurea- When SITAGLIPTIN is used in combination with a sulfonylurea, a lower dose of sulfonylurea may be required to reduce the risk of hypoglycemia. Patients with Hepatic Insufficiency- No dosage adjustment is necessary for patients with mild to moderate hepatic insufficiency. SITAGLIPTIN has not been studied in patients with severe hepatic insufficiency. Elderly- No dosage adjustment is necessary for elderly patients. Pediatric population- There is no data on the use of SITAGLIPTIN in patients younger than 18 years of age and therefore not recommended.Is there any dosage guideline for special population like renal insufficient patient with type 2 diabetes?Dosage adjustments in patients with moderate, severe, or end-stage renal disease (ESRD)50 mg once daily Moderate25 mg once daily Severe and ESRDCrCl ≥30 to <50 mL/min ˜Serum Cr levels (mg/dL)CrCl <30 mL/min ˜Serum Cr levels (mg/dL)Men: >1.7 – ≤3.0 Women: >1.5 – ≤2.5Men: >3.0 Women: >2.5 or on dialysisWhat are the precautions should I follow?SITAGLIPTIN should not be used in patients with type 1 diabetes or for the trea..
Tk.25.00/=
Glipita 50 tablet
Glipita 50 tabletWhat is Glipita?Glipita is the preparation of Sitagliptin. Sitagliptin is a new oral agent approved by the USFDA to treat type 2 diabetes with diet & exercise. It belongs to a new class of antihyperglycemic, Dipeptidyl Dipeptidase-4 (DPP-4) inhibitors. This unique class of orally active agent targets the underlying pathophysiologic processes of type 2 diabetic patients and provides an excellent alternative to the traditional agents.How Glipita works in our body?Normally, when glucose appears in blood after meal, Incretin hormones (GLP-1 & GIP) are secreted from gut to stimulate pancreatic β cell for insulin secretion and to act on α cell for glucagon inhibition. Dipeptidyl Peptidase 4 (DPP-4), an enzyme present in plasma, inactivates GLP-1 & GIP to stop insulin secretion from pancreatic β cell and to increase uninterrupted glucagon secretion from pancreatic α cell. Sitagliptin inhibits plasma DPP-4 activity (i.e. inactivation of GLP & GIP) and thus, increases circulating levels of active GLP-1 and GIP by two-to-threefold. This in turn, increases insulin release from pancreatic β cell and decreases glucagon levels from pancreatic α cell in the circulation in a glucose-dependent manner. Therefore, Sitagliptin is the only oral drug that involves both pancreatic α & β cell in a complimentary mode of action and thus ensures effective glycemic control in type 2 diabetes.What is the indications of Glipita?Monotherapy- GLIPITA is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. Combination with Metformin- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with Metformin as initial therapy or when the single agent alone, with diet and exercise, does not provide adequate glycemic control. Combination with a Sulfonylurea- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with a sulfonylurea when treatment with the single agent alone, with diet and exercise, does not provide adequate glycemic control. Combination with a Thiazolidinediones- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with a thiazolidinedione when treatment with the single agent alone, with diet and exercise, does not provide adequate glycemic control. Combination with Metformin and a Sulfonylurea- GLIPITA is indicated in patients with type 2 diabetes mellitus to improve glycemic control in combination with Metformin and a sulfonylurea when dual therapy with these agents, with diet and exercise, does not provide adequate glycemic control.What is the dosage guideline for Glipita?The recommended dose of SITAGLIPTIN is 100 mg once daily as monotherapy or as combination therapy with Metformin, a sulfonylurea, a thiazolidinedione, or Metformin plus a sulfonylurea. SITAGLIPTIN can be taken with or without food. Patients with Renal Insufficiency- For patients with mild renal insufficiency (creatinine clearance [CrCl] ≥50 mL/min, approximately corresponding to serum creatinine levels of ≤1.7 mg/dL in men and ≤1.5 mg/dL in women), no dosage adjustment for SITAGLIPTIN is required. For patients with moderate renal insufficiency (CrCl ≥30 to <50 mL/min, approximately corresponding to serum creatinine levels of >1.7 to ≤3.0 mg/dL in men and >1.5 to ≤2.5 mg/dL in women), the dose of SITAGLIPTIN is 50 mg once daily. For patients with severe renal insufficiency (CrCl <30 mL/min, approximately corresponding to serum creatinine levels of >3.0 mg/dL in men and >2.5 mg/dL in women) or with end -stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of SITAGLIPTIN is 25 mg once daily. SITAGLIPTIN may be administered without regard to the timing of hemodialysis. Concomitant Use with a Sulfonylurea- When SITAGLIPTIN is used in combination with a sulfonylurea, a lower dose of sulfonylurea may be required to reduce the risk of hypoglycemia. Patients with Hepatic Insufficiency- No dosage adjustment is necessary for patients with mild to moderate hepatic insufficiency. SITAGLIPTIN has not been studied in patients with severe hepatic insufficiency. Elderly- No dosage adjustment is necessary for elderly patients. Pediatric population- There is no data on the use of SITAGLIPTIN in patients younger than 18 years of age and therefore not recommended.Is there any dosage guideline for special population like renal insufficient patient with type 2 diabetes?Dosage adjustments in patients with moderate, severe, or end-stage renal disease (ESRD)50 mg once daily Moderate25 mg once daily Severe and ESRDCrCl ≥30 to <50 mL/min ˜Serum Cr levels (mg/dL)CrCl <30 mL/min ˜Serum Cr levels (mg/dL)Men: >1.7 – ≤3.0 Women: >1.5 – ≤2.5Men: >3.0 Women: >2.5 or on dialysisWhat are the precautions should I follow?SITAGLIPTIN should not be used in patients with type 1 diabete..
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Janvia 100 mg Tab
Janvia 100 mg TabDescriptionJanvia (Sitagliptin) is an oral diabetes medicine that helps control blood sugar levels. Janvia (Sitagliptin) tablets contain the active ingredient Sitagliptin, which is a type of medicine called dipeptidyl peptidase 4 (DPP-4) inhibitor. It is used to treat people with type 2 or non-insulin dependent diabetes mellitus (NIDDM).CompositionJanvia 50: Each film-coated tablet contains Sitagliptin Phosphate Monohydrate INN 64.25 mg equivalent to 50 mg of SitagliptinJanvia 100: Each film-coated tablet contains Sitagliptin Phosphate Monohydrate INN 128.50 mg equivalent to 100 mg of SitagliptinIndicationJanvia (Sitagliptin) is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is also indicated for use in combination with Metformin, Sulfonylurea or Thiazolidinediones when diet and exercise plus the single agent does not provide adequate glycemic control.Dosage and AdministrationThe recommended dose of Janvia (Sitagliptin) is 100 mg once daily. Janvia can be taken with or without food.Patients with Renal InsufficiencyFor patients with mild renal insufficiency, no dosage adjustment for Janvia (Sitagliptin) is required. For patients with moderate renal insufficiencey, the dose of Janvia (Sitagliptin) is 50 mg once daily. For patients with severe renal insufficiency or with end-stage renal disease(ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Janvia (Sitagliptin) is 25 mg once daily.Pediatric UseSafety and effectiveness of Sitagliptin in pediatric patients under 18 years of age have not been established.Geriatric UseNo dosage adjustment is required based solely on age. The drug is excreted by the kidney. As elderly patients are more likely to have decreased renal function, caution should be taken in dose selection in the elderly.OR AS DIRECTED BY THE PHYSICIAN.Side EffectsThe most common adverse reactions are; upper respiratory tract infection, nasopharyngitis and headache. Hypoglycemia may occur in patients treated with the combination of Sitagliptin and sulfonylurea and add-on to insulin.ContraindicationHistory of a serious hypersensitivity reaction to Sitagliptin, such as anaphylaxis or angioedema and exfoliative skin conditions includingStevens-Johnson syndrome.PrecautionIf pancreatitis is suspected, Janvia should promptly be discontinued and appropriate management should be initiated. Dosage adjustment should recommended in patients with moderate or severe renal insufficiency and in patients with ESRD. Assessment of renal functionshould recommend prior to initiating Janvia (Sitagliptin). When Janvia is used in combination with a sulfonylurea or with insulin, medications known to cause hypoglycemia, a lower dose of sulfonylurea or insulin may be required to reduce the risk of hypoglycemia. If a hypersensitivity reaction is suspected, Janvia should discontinued.Use in Pregnancy and LactationPregnancyPregnancy Category: B. Safety of Sitagliptin in pregnant women has not been established. Sitagliptin should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus.Nursing motherIt is not known whether Sitagliptin is excreted in human milk, because many drugs are excreted in human milk, caution should be exercised when Sitagliptin is administered to a nursing woman.Drug InteractionCo-administration of Digoxin and Sitagliptin may slightly increase the mean peak drug concentration of Digoxin. But no dosage adjustment ofDigoxin or Sitagliptin is recommended.SupplyJanvia 50 : Each box contains 1x10 tablets in Alu-Alu blister strip.Janvia 100 : Each box contains 1x10 tablets in Alu-Alu blister strip...
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Janvia 50 mg Tab
Janvia 50 mg TabDescriptionJanvia (Sitagliptin) is an oral diabetes medicine that helps control blood sugar levels. Janvia (Sitagliptin) tablets contain the active ingredient Sitagliptin, which is a type of medicine called dipeptidyl peptidase 4 (DPP-4) inhibitor. It is used to treat people with type 2 or non-insulin dependent diabetes mellitus (NIDDM).CompositionJanvia 50: Each film-coated tablet contains Sitagliptin Phosphate Monohydrate INN 64.25 mg equivalent to 50 mg of SitagliptinJanvia 100: Each film-coated tablet contains Sitagliptin Phosphate Monohydrate INN 128.50 mg equivalent to 100 mg of SitagliptinIndicationJanvia (Sitagliptin) is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is also indicated for use in combination with Metformin, Sulfonylurea or Thiazolidinediones when diet and exercise plus the single agent does not provide adequate glycemic control.Dosage and AdministrationThe recommended dose of Janvia (Sitagliptin) is 100 mg once daily. Janvia can be taken with or without food.Patients with Renal InsufficiencyFor patients with mild renal insufficiency, no dosage adjustment for Janvia (Sitagliptin) is required. For patients with moderate renal insufficiencey, the dose of Janvia (Sitagliptin) is 50 mg once daily. For patients with severe renal insufficiency or with end-stage renal disease(ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Janvia (Sitagliptin) is 25 mg once daily.Pediatric UseSafety and effectiveness of Sitagliptin in pediatric patients under 18 years of age have not been established.Geriatric UseNo dosage adjustment is required based solely on age. The drug is excreted by the kidney. As elderly patients are more likely to have decreased renal function, caution should be taken in dose selection in the elderly.OR AS DIRECTED BY THE PHYSICIAN.Side EffectsThe most common adverse reactions are; upper respiratory tract infection, nasopharyngitis and headache. Hypoglycemia may occur in patients treated with the combination of Sitagliptin and sulfonylurea and add-on to insulin.ContraindicationHistory of a serious hypersensitivity reaction to Sitagliptin, such as anaphylaxis or angioedema and exfoliative skin conditions includingStevens-Johnson syndrome.PrecautionIf pancreatitis is suspected, Janvia should promptly be discontinued and appropriate management should be initiated. Dosage adjustment should recommended in patients with moderate or severe renal insufficiency and in patients with ESRD. Assessment of renal functionshould recommend prior to initiating Janvia (Sitagliptin). When Janvia is used in combination with a sulfonylurea or with insulin, medications known to cause hypoglycemia, a lower dose of sulfonylurea or insulin may be required to reduce the risk of hypoglycemia. If a hypersensitivity reaction is suspected, Janvia should discontinued.Use in Pregnancy and LactationPregnancyPregnancy Category: B. Safety of Sitagliptin in pregnant women has not been established. Sitagliptin should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus.Nursing motherIt is not known whether Sitagliptin is excreted in human milk, because many drugs are excreted in human milk, caution should be exercised when Sitagliptin is administered to a nursing woman.Drug InteractionCo-administration of Digoxin and Sitagliptin may slightly increase the mean peak drug concentration of Digoxin. But no dosage adjustment ofDigoxin or Sitagliptin is recommended.SupplyJanvia 50 : Each box contains 1x10 tablets in Alu-Alu blister strip.Janvia 100 : Each box contains 1x10 tablets in Alu-Alu blister strip...
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Siglita 100 mg tablet
Indication:Management of type 2 diabetes mellitus.Dosage & Administration:The recommended dose of Siglita™ is 100 mg once daily. Siglita™ can be taken with or without food.For patients with mild renal insufficiency (creatinine clearance [CrCl] 50 mL/min) no dosage adjustment for Siglita™ is required.For patients with moderate renal insufficiency (CrCl 30 to <50 mL/min), the dose of Siglita™ is 50 mg once daily.For patients with severe renal insufficiency (CrCl <30 mL/min) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Siglita™ is 25 mg once daily.Siglita™ may be administered without regard to the timing of hemodialysis.Preparation:Siglita™ Tablet: Box containing 20 tablets in blister pack...
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Siglita 50 mg tablet
Indication:Management of type 2 diabetes mellitus.Dosage & Administration:The recommended dose of Siglita™ is 100 mg once daily. Siglita™ can be taken with or without food.For patients with mild renal insufficiency (creatinine clearance [CrCl] 50 mL/min) no dosage adjustment for Siglita™ is required.For patients with moderate renal insufficiency (CrCl 30 to <50 mL/min), the dose of Siglita™ is 50 mg once daily.For patients with severe renal insufficiency (CrCl <30 mL/min) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Siglita™ is 25 mg once daily.Siglita™ may be administered without regard to the timing of hemodialysis.Preparation:Siglita™ Tablet: Box containing 20 tablets in blister pack...
Tk.18.05/=
Sitagil 100
Sitagil 100 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.IndicationsSitagil is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Sitagil is indicated as monotherapy and also indicated for use in combination with metformin, sulfonylurea or thiazolidinediones when diet and exercise plus the single agent does not result in adequate glycemic control.Dosage & Administration- The recommended dose of Sitagliptin is 100 mg once daily. Sitagliptin can be taken with or without food.- For patients with mild renal insufficiency ( creatinine clearance [CrCl]>50ml/min), no dosage adjustment is required.- For patients with moderate renal insufficiency ( CrCl.>30 to <50 ml/min women), the dose of Sitagliptin is 50 mg once daily.- For patients with severe renal insufficiency (CrCl<30 ml/min) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Sitagliptin is 25 mg once daily.Pediatric Use:Safety and effectiveness of Sitagliptin in pediatric patients under 18 years of age have not been established.Geriatric Use:No overall differences in safety or effectiveness were observed between subjects over 65 years. The drug is excreted by the kidney. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in the elderly.Side EffectsAdverse reactions like upper respiratory tract infection, nasopharyngitis, and headache can occur. Hypoglycemia occurs in patients treated with the combination of Sitagliptin and sulfonylurea, with or without Metformin.Precautions- Dosage adjustment is recommended in patients with moderate or severe renal insufficiency and in patients with ESRD.- When used with a sulfonylurea a lower dose of sulfonylurea may be required to reduce the risk of hypoglycemia.Use in Pregnancy & LactationPregnanacy: Safety in pregnant women has not been established. Sitagliptin should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus.Nursing mothers: It is not known whether Sitagliptin is secreted in human milk, it should not be administered to a breast feeding woman.Drug InteractionThere was a slight increase in the area under the curve and mean peak drug concentration of Digoxin with the co-administration of 100 mg Sitagliptin for 10 days.Over DoseIn the event of an overdose, it is reasonable to employ the usual supportivemeasures as dictated by the patient’s clinical status. Sitagliptin is modestly dialyzable. Prolonged hemodialysis may be considered if clinically appropriate...
Tk.28.00/=
Sitagil 25
Sitagil 25 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.IndicationsSitagil is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Sitagil is indicated as monotherapy and also indicated for use in combination with metformin, sulfonylurea or thiazolidinediones when diet and exercise plus the single agent does not result in adequate glycemic control.Dosage & Administration- The recommended dose of Sitagliptin is 100 mg once daily. Sitagliptin can be taken with or without food.- For patients with mild renal insufficiency ( creatinine clearance [CrCl]>50ml/min), no dosage adjustment is required.- For patients with moderate renal insufficiency ( CrCl.>30 to <50 ml/min women), the dose of Sitagliptin is 50 mg once daily.- For patients with severe renal insufficiency (CrCl<30 ml/min) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Sitagliptin is 25 mg once daily.Pediatric Use:Safety and effectiveness of Sitagliptin in pediatric patients under 18 years of age have not been established.Geriatric Use:No overall differences in safety or effectiveness were observed between subjects over 65 years. The drug is excreted by the kidney. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in the elderly.Side EffectsAdverse reactions like upper respiratory tract infection, nasopharyngitis, and headache can occur. Hypoglycemia occurs in patients treated with the combination of Sitagliptin and sulfonylurea, with or without Metformin.Precautions- Dosage adjustment is recommended in patients with moderate or severe renal insufficiency and in patients with ESRD.- When used with a sulfonylurea a lower dose of sulfonylurea may be required to reduce the risk of hypoglycemia.Use in Pregnancy & LactationPregnanacy: Safety in pregnant women has not been established. Sitagliptin should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus.Nursing mothers: It is not known whether Sitagliptin is secreted in human milk, it should not be administered to a breast feeding woman.Drug InteractionThere was a slight increase in the area under the curve and mean peak drug concentration of Digoxin with the co-administration of 100 mg Sitagliptin for 10 days.Over DoseIn the event of an overdose, it is reasonable to employ the usual supportivemeasures as dictated by the patient’s clinical status. Sitagliptin is modestly dialyzable. Prolonged hemodialysis may be considered if clinically appropriate...
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Sitagil 50
Sitagil 50 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.IndicationsSitagil is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Sitagil is indicated as monotherapy and also indicated for use in combination with metformin, sulfonylurea or thiazolidinediones when diet and exercise plus the single agent does not result in adequate glycemic control.Dosage & Administration- The recommended dose of Sitagliptin is 100 mg once daily. Sitagliptin can be taken with or without food.- For patients with mild renal insufficiency ( creatinine clearance [CrCl]>50ml/min), no dosage adjustment is required.- For patients with moderate renal insufficiency ( CrCl.>30 to <50 ml/min women), the dose of Sitagliptin is 50 mg once daily.- For patients with severe renal insufficiency (CrCl<30 ml/min) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Sitagliptin is 25 mg once daily.Pediatric Use:Safety and effectiveness of Sitagliptin in pediatric patients under 18 years of age have not been established.Geriatric Use:No overall differences in safety or effectiveness were observed between subjects over 65 years. The drug is excreted by the kidney. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in the elderly.Side EffectsAdverse reactions like upper respiratory tract infection, nasopharyngitis, and headache can occur. Hypoglycemia occurs in patients treated with the combination of Sitagliptin and sulfonylurea, with or without Metformin.Precautions- Dosage adjustment is recommended in patients with moderate or severe renal insufficiency and in patients with ESRD.- When used with a sulfonylurea a lower dose of sulfonylurea may be required to reduce the risk of hypoglycemia.Use in Pregnancy & LactationPregnanacy: Safety in pregnant women has not been established. Sitagliptin should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus.Nursing mothers: It is not known whether Sitagliptin is secreted in human milk, it should not be administered to a breast feeding woman.Drug InteractionThere was a slight increase in the area under the curve and mean peak drug concentration of Digoxin with the co-administration of 100 mg Sitagliptin for 10 days.Over DoseIn the event of an overdose, it is reasonable to employ the usual supportivemeasures as dictated by the patient’s clinical status. Sitagliptin is modestly dialyzable. Prolonged hemodialysis may be considered if clinically appropriate...
Tk.15.00/=
Sitagil M 100/1000 ER
Sitagil M 100/1000 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 cas..
Tk.35.00/=
