Acantha Plus/Acantha Max

Adult w/ type 2 DM as adjunct to diet & exercise to improve glycaemic control in patients inadequately controlled on their max tolerated dose of metformin alone or those already being treated w/ the combination of sitagliptin & metformin. As triple combination therapy w/ sulphonylurea as adjunct to diet & exercise in patients inadequately controlled on their max tolerated dose; w/ peroxisome proliferator-activated receptor γ (PPARγ) agonist (ie, thiazolidinedione) as adjunct to diet & exercise in patients inadequately controlled on their max tolerated dose. As add-on to insulin (ie, triple combination therapy) as adjunct to diet & exercise to improve glycaemic control in patients when stable dose of insulin & metformin alone do not provide adequate glycaemic control.

Individualized dosage. Max recommended daily dose is sitagliptin 100 mg & metformin 2,000 mg. Patient not currently treated w/ metformin Initially sitagliptin 50 mg & metformin 500 mg bid w/ gradual dose escalation to reduce GI side effects. Patient already treated w/ metformin Sitagliptin 50 mg bid & dose of metformin already being taken. Patient taking metformin HCl 850 mg bid Initially sitagliptin 50 mg & metformin 1 g bid.

Should be taken with food.

History of serious hypersensitivity reaction (eg, anaphylaxis or angioedema). Metabolic acidosis, including diabetic ketoacidosis. Severe renal impairment (eGFR <30 mL/min/1.73 m²).

Hypersensitivity reactions; promptly stop medication & institute appropriate monitoring & treatment. Lactic acidosis. Discontinue if pancreatitis is suspected. Discontinue therapy if severe & disabling arthralgia or bullous pemphigoid has been reported. Consider risks & benefits in patients who have known risk factors for heart failure. Risk of hypoglycemia when used in combination w/ insulin &/or insulin secretagogue. Discontinue at time of, or prior to, iodinated contrast imaging procedures. Avoid use in patients w/ hepatic impairment. Not recommended in patients w/ eGFR between 30 & <45 mL/min/1.73 m². Assess renal function w/ eGFR prior to initiation, & at least annually. Acute renal failure sometimes requiring dialysis. Potential unintended pregnancy in premenopausal females. Metformin: May lower vit B levels. Measure hematologic parameters annually & vit B at 2-3 yr intervals.

Diarrhea, URTI, headache.

Increased risk of lactic acidosis w/ carbonic anhydrase inhibitors. Metformin: May increase metformin accumulation w/ drugs that reduce metformin clearance (eg, ranolazine, vandetanib, dolutegravir & cimetidine). Potentiated effect on lactate metabolism w/ alcohol.

Antidiabetic Agents

A10BD07 - metformin and sitagliptin ; Belongs to the class of combinations of oral blood glucose lowering drugs. Used in the treatment of diabetes.

Rx