سعر ميليتوفيكس ميت 12.5/1000مجم 30 قرص 2026

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• Adjunct to diet and exercise to improve glycaemic control in adults and children aged 10 years and older with type 2 diabetes mellitus (SYNJARDY immediate-release tablets).Population: Adults and children 10 years and older with type 2 diabetesDailyMed (U.S. National Library of Medicine)
• Empagliflozin component: to reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease; cardiovascular death and hospitalisation for heart failure in adults with heart failure; and sustained eGFR decline, end-stage kidney disease, cardiovascular death and hospitalisation in adults with chronic kidney disease at risk of progression (all limited to type 2 diabetes because of the metformin component).Population: Adults with type 2 diabetesDailyMed (U.S. National Library of Medicine)

• Most common with empagliflozin (5% or more): urinary tract infections and female genital fungal infections. Most common with metformin (more than 5%): diarrhoea, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia and headache.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Severe renal impairment (eGFR below 30 mL/min/1.73 m2).International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Hypersensitivity to empagliflozin, metformin or any excipient (reactions such as angioedema have occurred).International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Boxed warning: metformin-associated lactic acidosis, which can be fatal; risk factors include renal impairment, carbonic anhydrase inhibitors such as topiramate, age 65 or older, contrast studies, surgery, hypoxic states, excessive alcohol, hepatic impairment and mitochondrial disease. If suspected, stop the drug and give supportive care in hospital; prompt haemodialysis is recommended.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Ketoacidosis (including in type 2 diabetes): assess for ketoacidosis regardless of blood glucose and stop if suspected; consider ketone monitoring in patients at risk. Not for type 1 diabetes.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Volume depletion and hypotension; genitourinary infections including urosepsis, pyelonephritis, necrotising fasciitis of the perineum (Fournier's gangrene) and genital fungal infections; hypoglycaemia when combined with insulin or insulin secretagogues.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Carbonic anhydrase inhibitors (topiramate, zonisamide, acetazolamide, dichlorphenamide)May increase the risk of lactic acidosis; consider more frequent monitoring.DailyMed (U.S. National Library of Medicine)
• Drugs that reduce metformin clearance (OCT2/MATE inhibitors such as ranolazine, vandetanib, dolutegravir, cimetidine)May increase metformin exposure and lactic acidosis risk; consider benefit and risk.DailyMed (U.S. National Library of Medicine)
• Insulin and insulin secretagogues (e.g., sulfonylureas)Higher risk of hypoglycaemia; a lower dose of insulin or the secretagogue may be needed.DailyMed (U.S. National Library of Medicine)

• Not recommended during the second and third trimesters because animal data showed adverse renal effects of empagliflozin; data in pregnant women are insufficient to determine a risk of birth defects or miscarriage, and published metformin studies have not shown a clear association.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Not recommended while breastfeeding: metformin is present in human milk and empagliflozin may affect the developing infant kidney.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Empagliflozin: Inhibits SGLT2 in the proximal renal tubule, reducing renal reabsorption of filtered glucose and lowering the renal threshold for glucose, thereby increasing urinary glucose excretion (US label).
• Metformin: Decreases hepatic glucose production, decreases intestinal glucose absorption and improves insulin sensitivity by increasing peripheral glucose uptake and utilization; insulin secretion remains unchanged (US label).