Sitagliptin (DPP-4 inhibitor): Prolongs action of incretin hormones (GLP-1 & GIP), enhancing insulin release and suppressing glucagon in a glucose-dependent manner.
Metformin (Biguanide): Lowers hepatic glucose output, reduces intestinal glucose absorption, and improves peripheral glucose uptake & utilization.
đ Together, they provide complementary mechanisms for better glycemic control.
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Adjunct to diet and exercise for glycemic control in adults with type 2 diabetes mellitus where both sitagliptin and metformin therapy is appropriate.
â ī¸ Not effective in type 1 diabetes or diabetic ketoacidosis.
â ī¸ Safety not established in patients with history of pancreatitis.
Film-coated tablet:
Max: Sitagliptin 100 mg + Metformin 2000 mg daily.
Usually twice daily with meals; start low and escalate gradually to minimize GI side effects.
New patients: 50/500 mg twice daily, titrate as tolerated.
Patients already on metformin: dose adjusted to match current regimen.
Extended-release tablet:
Once daily with evening meal.
Max: Sitagliptin 100 mg + Metformin XR 2000 mg.
Patients on multiple XR tablets should take both together once daily.
With insulin/secretagogues: May require lower insulin or sulfonylurea dose to avoid hypoglycemia
Common: Diarrhea, nausea/vomiting, abdominal discomfort, headache, URTI, nasopharyngitis.
Combination therapy: Hypoglycemia (when used with sulfonylurea/insulin).
Rare: Hypersensitivity reactions (angioedema, anaphylaxis, Stevens-Johnson syndrome).
Cationic drugs (renal elimination): Use cautiously.
Phenprocoumon: Metformin may reduce anticoagulant effect â monitor INR.
Levothyroxine: Can decrease hypoglycemic effect of metformin â monitor glucose levels.
Renal impairment (elevated serum creatinine or reduced clearance).
Acute or chronic metabolic acidosis (incl. ketoacidosis).
History of hypersensitivity to sitagliptin, metformin, or formulation.
Temporary discontinuation required before iodinated contrast procedures.
Category B. Use only if clearly needed during pregnancy.
Unknown if excreted in human milk â caution in nursing mothers.
Store below 25°C, in a cool dry place, protected from light.
Keep out of reach of children.
Use only on prescription of a registered physician.
â ī¸Disclaimer:
At ePharma, weâre committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.