سعر سيتاجليفورم 50/1000مجم 30 قرص 2024

Sitagliform 50/1000 mg film-coated tablets, pack of 30 (P & C Labs, Egypt): fixed-dose combination of sitagliptin 50 mg (DPP-4 inhibitor) and metformin 1000 mg (biguanide) for type 2 diabetes.

• Adjunct to diet and exercise to improve glycaemic control in type 2 diabetes mellitus (not for type 1 diabetes; not studied in patients with a history of pancreatitis)Population: AdultsDailyMed (U.S. National Library of Medicine)

• Most common adverse reactions (>=5% in patients simultaneously started on sitagliptin and metformin, more than placebo): diarrhoea, upper respiratory tract infection and headache.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Severe renal impairment (eGFR below 30 mL/min/1.73 m2); acute or chronic metabolic acidosis including diabetic ketoacidosis; history of serious hypersensitivity to sitagliptin/metformin, sitagliptin or metformin (e.g. anaphylaxis, angioedema).International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• BOXED WARNING - lactic acidosis: postmarketing metformin-associated lactic acidosis has resulted in death, hypothermia, hypotension and resistant bradyarrhythmias; risk factors include renal impairment, certain drugs (e.g. carbonic anhydrase inhibitors), age >=65, contrast studies, surgery, hypoxic states, excessive alcohol, hepatic impairment and mitochondrial disease. If suspected, discontinue immediately and hospitalise; prompt haemodialysis is recommended.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• Pancreatitis (including fatal haemorrhagic or necrotising): observe for signs and stop promptly if suspected. Heart failure has been associated with DPP-4 inhibitors. Acute renal failure: assess renal function before and at least annually. Vitamin B12 deficiency: measure haematological parameters annually and B12 every 2-3 years. Hypoglycaemia risk with insulin or insulin secretagogues (lower doses may be needed). Serious hypersensitivity (anaphylaxis, angioedema, Stevens-Johnson syndrome), severe arthralgia and bullous pemphigoid have been reported.International label, equivalent 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, e.g. ranolazine, vandetanib, dolutegravir, cimetidine)Increased metformin exposure and lactic acidosis risk; consider benefits and risks of concomitant use.DailyMed (U.S. National Library of Medicine)
• AlcoholPotentiates the effect of metformin on lactate metabolism; warn patients against alcohol intake.DailyMed (U.S. National Library of Medicine)

• Limited data with sitagliptin/metformin in pregnant women are insufficient to inform drug-associated risk; published metformin studies have not reported a clear association with major birth defects or miscarriage; poorly controlled diabetes carries maternal and fetal risks.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)
• No information on the combination in human milk; limited studies report metformin in human milk without reported adverse effects on breastfed infants; sitagliptin is present in rat milk and possibly in human milk.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Sitagliptin: DPP-4 inhibitor believed to act by slowing the inactivation of incretin hormones (e.g. GLP-1, GIP), increasing and prolonging their action (US JANUMET label).
• Metformin: