Viglimet 50/500 (30pcs Box)

Viglimet 50/500 is a drug cocktail that helps persons with type 2 diabetes mellitus manage their excessive blood sugar levels. This lessens your risk of developing significant diabetes problems like kidney damage and blindness and lowers your risk of a heart attack or stroke. It is possible to prescribe Viglimet 50/500 alone or in combination with other diabetes drugs. All diabetes medications perform at their peak when combined with a balanced diet and frequent exercise. Your illness, blood sugar levels, and any medications you are taking will all affect how much medication you receive. It helps to lower the possibility of getting an upset stomach if taken with meals. To maximize the benefits, you should take it consistently at the same time each day, and you shouldn't stop taking it unless your doctor advises you to. It is regulating your blood sugar levels and averts potential severe consequences.

Pharmacology

Vildagliptin works largely by blocking DPP-4 (Dipeptidyl peptidase-4), the enzyme that degrades the incretin hormones GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulin tropic polypeptide). Vildagliptin inhibits DPP-4 action quickly and completely, resulting in elevated fasting and postprandial endogenous levels of the incretin hormones GLP-1 and GIP. Vildagliptin enhances insulin production from pancreatic beta cells while decreasing glucagon secretion from alpha cells by raising endogenous levels of these incretin hormones. Increased incretin hormone levels cause a rise in the insulin/glucagon ratio during hyperglycemia, which leads to a reduction in fasting and postprandial hepatic glucose production, resulting in lower glycemia.

Metformin Hydrochloride is an oral antihyperglycemic medication of the biguanide class that is used to treat type 2 diabetes. It reduces both basal and postprandial plasma glucose levels. It has a different mode of action than sulfonylureas and does not cause hypoglycemia. Glucosamine reduces hepatic glucose synthesis, reduces intestinal glucose absorption, and increases insulin sensitivity by increasing peripheral glucose uptake and utilization.

Dosage & Administration

Type 2 DM oral Adults: Vildagliptin and Metformin may be started at 50 mg/500 mg or 50 mg/850 mg twice daily, 1 tab in the morning and the other in the evening, depending on the patient's current dose of Metformin. The recommended maximum daily dose is 2000 mg of metformin HCl and 100 mg of vildagliptin. Patients on Vildagliptin and Metformin separately may be switched to Vildagliptin & Metformin Combination, which contains the same doses of both medications. Hepatic impairment: Patients with hepatic impairment, especially those whose pre-treatment ALT or AST levels were greater than three times the upper limit of normal, are not advised to use this combination.

Child Dose

Not recommended in patients <18 years of age

Interaction

When Vildagliptin (100 mg once daily) was combined with Metformin Hydrochloride, no clinically significant pharmacokinetic interaction was detected (1,000 mg once daily). Vildagliptin has a minimal chance of causing medication interactions. Because vildagliptin is neither a cytochrome P (CYP) 450 enzyme substrate, nor does it inhibit or induce CYP 450 enzymes, it is unlikely to interact with co-medications that are CYP 450 enzyme substrates, inhibitors, or inducers. Following co-administration of vildagliptin with other oral antidiabetics (glibenclamide, pioglitazone, metformin hydrochloride), amlodipine, digoxin, ramipril, simvastatin, valsartan, or warfarin, no clinically significant interactions were identified. Furosemide, nifedipine, and glyburide, on the other hand, raise Metformin Cmax and blood AUC while having no effect on Metformin renal clearance.

Contraindications

Vildagliptin & Metformin is contraindicated in patients with:

• Hypersensitivity to the active substance or to any of the excipients
• Patients with Renal Impairment: Creatinine clearance
• Patients with acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
• Diabetic ketoacidosis should be treated with insulin
• Patients with type 1 diabetes

Side effects of Viglimet 50/500

• Nausea
• Vomiting
• Diarrhea
• Stomach pain
• Loss of appetite
• Dizziness
• Headache
• Trembling
• Metallic taste
• Hypoglycemia (low blood glucose level)

Pregnancy & Breastfeeding use

Pregnancy: There are no adequate data on the use of Vildagliptin & Metformin in pregnant women; hence the potential risk for humans is unknown.

Nursing Mothers: It is not known whether Vildagliptin is excreted in human milk. Due to a lack of human data, Vildagliptin & Metformin should not be used during lactation.

Precautions and Warning

Pediatric Use: A combination of Vildagliptin & Metformin is not recommended in patients 18 years of age.

Geriatric use: Their renal function is monitored regularly. A combination of Vildagliptin & Metformin has not been studied in patients >75 years. Therefore, the use of a Combination of Vildagliptin & Metformin is not recommended in this population.

Patients with renal impairment:  This combination should not be used in patients with renal failure or renal dysfunction, e.g. serum creatinine levels > 1.5 mg/dL (>135 micro mol/L) in males and > 1.4 mg/dL (>110 micro mol/L) in females. 

Patients with hepatic impairment:  This combination is not recommended in patients with hepatic impairment including patients with a pre-treatment ALT or AST >3 X the upper limit of normal.

Storage Condition

Keep out of the reach of children. Do not store above 25°C. Keep the original package in a cool & dry place in order to protect it from light and moisture.

Store in a cool and dry place. Protect from light and moisture. Keep out of the reach of the children.