Sitomet 50/1000 | 1 Strip

✔️ Mode of Action

Sitagliptin (DPP-4 inhibitor):

Increases incretin hormone activity → stimulates insulin release, reduces glucagon secretion.

Metformin (Biguanide):

Decreases hepatic glucose production.

Reduces intestinal absorption of glucose.

Improves insulin sensitivity (increases peripheral glucose uptake/utilization).

Result: Improved glycemic control by targeting multiple mechanisms.

✔️ Side Effects

Common (1–10%)

• Diarrhea (2.4%)
• Abdominal pain (2.2%)
• Hypoglycemia (esp. with insulin/sulfonylurea) (2.1%)
• Nausea (1.3%), Vomiting (1.1%)
• Headache, sore throat, nasal congestion
• Upper respiratory tract infection

Rare/Serious

• Lactic acidosis (medical emergency)
• Severe hypersensitivity (anaphylaxis, angioedema, Stevens-Johnson syndrome)
• Rhabdomyolysis
• Acute renal failure
• Exfoliative skin disorders

✔️ Drug Interactions

↑ Hypoglycemia risk: Sulfonylureas, insulin.

May worsen glycemic control: Thiazide diuretics, corticosteroids, phenothiazines, oral contraceptives, sympathomimetics, niacin, CCBs, and isoniazid.

↓ Blood glucose: ACE inhibitors.

↑ Metformin levels: Cimetidine.

Fatal risk: Iodinated contrast agents (↑ lactic acidosis risk with metformin).

✔️ Contraindications

Severe renal dysfunction (serum creatinine >1.5 mg/dL in males; >1.4 mg/dL in females).

Metabolic acidosis (including diabetic ketoacidosis).

History of serious hypersensitivity to Sitagliptin, Metformin, or excipients.

✔️ Precautions & Warnings

• Not for type 1 diabetes or diabetic ketoacidosis.
• Discontinue if pancreatitis is suspected.
• Use caution in:
• Renal or hepatic impairment.
• Hypoxic states or major surgery.
• Alcohol use (↑ risk of lactic acidosis).
• Elderly patients.
• Long-term use (may ↓ affect Vitamin B12 absorption).

Pregnancy & lactation: Use only if benefits outweigh risks

✔️ Storage:

Do not store above 30°C. Keep away from light and out of the reach of children.