Duvel Plus (50/1000mg) 14 Tablets

Duvel Plus (50/1000mg) 14 Tablets

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  • Manufacturer MARTIN DOW PHARMACEUTICALS (PVT.) LTD.
  • Generic Name Metformin, Sitagliptin

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Product Information

  • Description
  • Ingredients
  • Drug Class
  • Dosage Form
  • Uses
  • Dosage
  • In case of Overdose
  • Missed Dose
  • How To Use
  • When Not to Use
  • Side Effects
  • Precautions & Warnings
  • Drug Interactions
  • Food Interactions
  • Storage/Disposal
  • Quick Tips, if any
  • Laboratory Screening
  • Description

    Metformin 1000mg primarily works by reducing glucose production in the liver and enhancing insulin sensitivity in peripheral tissues. It inhibits the mitochondrial respiratory chain complex I, leading to reduced ATP production and decreased hepatic glucose output. Additionally, metformin improves insulin-mediated glucose uptake in skeletal muscle and adipose tissue. On the other hand, Sitagliptin 50mg, a dipeptidyl peptidase-4 (DPP-4) inhibitor, acts by blocking the breakdown of incretin hormones such as GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide). This inhibition results in elevated levels of these hormones, which stimulate insulin secretion in a glucose-dependent manner, suppress glucagon secretion, and slow gastric emptying, ultimately leading to improved glycemic control.

  • Ingredients

    Metformin, Sitagliptin
  • Drug Class

    Biguanide, DPP-4 inhibitor.

  • Dosage Form

    Tablet

  • Uses

    The following are the uses of Metformin 1000mg, Sitagliptin 50mg Tablet:

    • Used for controlling blood sugar levels in type 2 diabetes.
    • Used to enhance insulin sensitivity and reduce glucose production in the liver.
    • Used to improve glycemic control by regulating blood sugar levels.
    • Used to lower the risk of cardiovascular events in diabetic patients.
    • Used for weight management, as it can aid in weight loss or prevent weight gain.
    • Used to promote the release of insulin and improve overall insulin function.
    • Used to delay the progression of prediabetes to type 2 diabetes.
    • Used to manage diabetes and prevent diabetic complications when combined with a healthy diet and lifestyle.
  • Dosage

    Tailoring Treatment for Optimal Health, Prescribed Medication Dosage is:

    • The recommended dose of Sitagliptin for treating type 2 diabetes is 50 mg once daily.
    • The recommended dose of Metformin is 1000 mg once daily.
    • Always take medications as prescribed by your doctor.
    • Depending on the severity of your condition, your doctor will determine the best dosage and approach to managing your disease.
    • For any specific concerns, questions, or alterations in your condition, contact your medical practitioner.
  • In case of Overdose

    In the case of an overdose of Metformin 1000mg and Sitagliptin 50mg Tablet, it is important to seek medical advice promptly. Symptoms may include severe nausea, vomiting, abdominal pain, and in some cases, lactic acidosis. Individuals may also experience hypoglycemia, characterized by dizziness, sweating, and confusion. Immediate treatment should focus on supportive care, and medical professionals may administer gastric lavage or activated charcoal to prevent further absorption.

  • Missed Dose

    In the case of a missed dose of Metformin 1000mg, it is generally recommended to take the missed dose as soon as you remember, provided it does not nearly overlap with the timing of your next scheduled dose. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. For Sitagliptin 50mg, if you miss a dose, take it as soon as you remember, but if it's close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.

  • How To Use

    To take the Metformin 1000mg and Sitagliptin 50mg Tablet, swallow one tablet whole with a full glass of water, preferably during or after a meal, exactly as prescribed by your healthcare provider, typically once or twice a day.

  • When Not to Use

    Following are the conditions/situations when Metformin 1000mg and Sitagliptin 50mg Tablet should not be taken:

    • Avoid if you have a known allergy to Metformin, Sitagliptin, or any other similar medications.
    • Not suitable for individuals with a history of diabetic ketoacidosis.
    • Should not be used in patients with severe kidney problems or kidney failure.
    • Contraindicated in patients with a history of pancreatitis or gallstones.
    • Not recommended for individuals with severe or uncontrolled heart failure.
    • Avoid if you have recently had a heart attack or are experiencing angina (chest pain).
    • Should not be used if you are scheduled for a surgery or any medical procedure.
    • Not suitable for individuals with severe dehydration or a recent history of alcohol abuse.
  • Side Effects

    The side effects of Metformin 1000mg, Sitagliptin 50mg Tablet may include:

    • Nausea and vomiting
    • Diarrhea
    • Stomach pain or discomfort
    • Loss of appetite
    • Metallic taste in the mouth
    • Headache
    • Weakness or fatigue
    • Skin reactions, such as rash or itching
  • Precautions & Warnings

    Following are the precautions and warnings for Metformin 1000mg, Sitagliptin 50mg Tablet:

    • Not recommended for individuals with a known allergy to Metformin or Sitagliptin or any of the tablet's components.
    • Patients with kidney or liver problems should use this medication with caution, as it may require dosage adjustments under medical supervision.
    • Exercise caution if you have a history of pancreatitis, as this medication can increase the risk of pancreatitis.
    • Monitor blood glucose levels regularly, especially during times of stress, illness, or surgery, as the medication's effectiveness may change.
    • Avoid excessive alcohol consumption while taking this medication, as it can increase the risk of lactic acidosis.
    • Patients with a history of heart disease should inform their doctor, as this medication may rarely cause a serious heart-related side effect.
    • Discontinue the medication and seek medical attention if you experience any signs of lactic acidosis, such as unusual muscle pain, trouble breathing, stomach discomfort, feeling cold, or dizziness.
    • Inform your healthcare provider about all the medications you are taking to avoid potential drug interactions.
  • Drug Interactions

    Following are the drug interactions for Metformin 1000mg and Sitagliptin 50mg Tablet:

    • Metformin may interact with contrast agents used in diagnostic procedures, increasing the risk of lactic acidosis. Temporary discontinuation of Metformin may be recommended before certain imaging tests.
    • Alcohol intake can increase the risk of lactic acidosis with Metformin, and should be avoided or used with caution.
    • Sitagliptin may increase the effects of sulfonylureas and insulin, leading to low blood sugar (hypoglycemia). Blood sugar monitoring is advised.
    • The combination of Sitagliptin with other antidiabetic medications like pioglitazone or rosiglitazone may increase the risk of fluid retention and heart-related issues.
    • Caution is advised when using Metformin with other nephrotoxic drugs, as it may affect kidney function.
    • Metformin can interact with certain medications like corticosteroids and diuretics, increasing the risk of hypoglycemia or hyperglycemia.
    • Sitagliptin may have increased plasma concentrations when used with strong CYP3A4 inhibitors, requiring dose adjustments.
  • Food Interactions

    Following are the food interactions for Metformin 1000mg, Sitagliptin 50mg Tablet:

    • Alcohol consumption should be limited as it can increase the risk of lactic acidosis, especially in those with kidney issues.
    • Avoid excessive consumption of high-fat foods as they can reduce the absorption of Sitagliptin, impacting its effectiveness.
    • Grapefruit and grapefruit juice should be consumed with caution as they may affect the metabolism of Sitagliptin, potentially altering its blood levels.
    • Maintain a balanced diet, focusing on whole grains, fruits, vegetables, and lean proteins, to support the medication's blood sugar-lowering effects.
    • Avoid a high-sugar diet as it can counteract the blood sugar-lowering effects of the medication.
    • Stay well-hydrated, especially when increasing fiber intake, to prevent gastrointestinal side effects.
    • Consult a dietician or healthcare provider for personalized dietary recommendations based on your specific health conditions.
  • Storage/Disposal

    Metformin 1000mg, Sitagliptin 50mg tablets should be stored in a cool and dry place, preferably at room temperature, ensuring protection from light and moisture. The original container should be tightly sealed to maintain its integrity and prevent contamination. It is crucial to avoid storing the medication in the bathroom or near heat sources as temperature fluctuations can impact its effectiveness. Always adhere to the expiration date, and for proper disposal, refrain from flushing or pouring it down the drain. Consult a pharmacist or healthcare professional for appropriate disposal methods, and keep the medication securely stored away from children to prevent accidental consumption. Responsible storage and disposal practices are vital to ensure safety and maintain the integrity of the medication.

  • Quick Tips, if any

    Following are the quick tips for Metformin 1000mg, Sitagliptin 50mg Tablet:

    • Always take the medication as directed by your doctor; do not adjust the dosage without medical advice.
    • Take the tablet with a full glass of water to aid in swallowing.
    • Maintain a consistent daily routine for taking the medication for better effectiveness.
    • It can be taken with or without food, but be consistent with your choice.
    • If you experience nausea, consider taking the tablet with food to minimize discomfort.
    • Do not crush or chew the tablet; swallow it whole.
    • Store the medication in a cool, dry place, away from direct sunlight and moisture.
  • Laboratory Screening

    When taking both Sitagliptin and Metformin, it is important to undergo specific lab tests to ensure the medication is working effectively and to monitor for any potential side effects. These tests are crucial for individuals taking Metformin, as the medication can affect blood sugar, ketone, kidney, and thyroid levels. The first lab test, blood sugar monitoring, is essential for individuals taking Metformin, as it is a common medication for type 2 diabetes. This test determines fasting blood sugar levels and HbA1c levels, both of which are important for monitoring the average blood sugar levels over time. Normally, fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c) tests are conducted to monitor these levels. The second lab test, ketone testing, is particularly important for individuals taking Metformin, as the medication can cause lactic acidosis in rare cases. This test allows for the presence of ketones in the blood, which can be a marker for diabetic ketoacidosis. The third lab test, kidney function tests, is critical for individuals taking Metformin. This is because Metformin is excreted by the kidneys; therefore, it is important to monitor kidney function. Serum creatinine and estimated glomerular filtration rate (eGFR) tests are conducted to assess kidney function and determine if the dosage needs to be adjusted. The fourth lab test, thyroid function tests, is important for individuals taking Metformin because hypothyroidism is a potential side effect of the medication. Periodic testing of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) is recommended for early detection and management. It is imperative to never miss or skip a lab test while taking medications like Sitagliptin and Metformin. These tests help in monitoring the effectiveness of the medicines and facilitate any necessary changes to a patient's

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