Istamet 50mg/500mg Tablet

About

Janumet (or Istamet) combines sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, and metformin hydrochloride, a biguanide, for the comprehensive treatment of type 2 diabetes mellitus. Sitagliptin works by increasing incretin hormone levels, which enhance glucose-dependent insulin secretion and suppress glucagon release, thereby improving pancreatic function. Metformin primarily reduces hepatic glucose production, decreases intestinal glucose absorption, and improves peripheral insulin sensitivity without directly stimulating insulin secretion. This synergistic combination addresses multiple pathophysiological defects in type 2 diabetes, leading to significantly improved glycemic control. It is indicated as an adjunct to diet and exercise for patients whose diabetes is not adequately controlled by metformin or sitagliptin alone, or for those already on both medications who require a convenient fixed-dose regimen.

Uses

• Management of type 2 diabetes mellitus.
• Adjunct to diet and exercise.
• Improved glycemic control.
• For patients inadequately controlled on monotherapy.

Directions For Use

Take this medicine orally, twice daily with meals, as directed by your healthcare provider.
Swallow the tablet whole with water; do not crush or chew.

Benefits

• Comprehensive blood glucose control.
• Addresses multiple pathways of hyperglycemia.
• Reduces both fasting and post-prandial glucose.
• May contribute to modest weight loss (due to metformin).
• Lower risk of hypoglycemia compared to insulin or sulfonylureas.
• Improves insulin sensitivity and pancreatic beta-cell function.

Side Effects

• Nausea
• Diarrhea
• Abdominal pain
• Headache
• Upper respiratory tract infection
• Metallic taste
• Vitamin B12 deficiency (long-term metformin)
• Lactic acidosis (rare but serious, due to metformin)
• Pancreatitis (rare, due to sitagliptin)
• Joint pain
• Hypoglycemia (especially with other agents)
• Rash

Safety Measures

• Alcohol - Avoid excessive alcohol intake, as it can increase the risk of lactic acidosis, a serious side effect of metformin.
• Pregnancy - Generally not recommended during pregnancy; insulin is often preferred for glycemic control in pregnant women with diabetes.
• Breastfeeding - Metformin is excreted in breast milk; sitagliptin's excretion is unknown. Consult a doctor to weigh risks and benefits.
• Liver - Contraindicated in severe hepatic impairment due to increased risk of lactic acidosis with metformin.
• Kidney - Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73m²) due to metformin accumulation and lactic acidosis risk.
• Lung - Use with caution in severe acute or chronic lung disease, as hypoxia can increase the risk of lactic acidosis.

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