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Introduction About ISTAMET XR CP COMBIPACK
ISTAMET XR CP COMBIPACK is a combination of Metformin and Sitagliptin, which belongs to the group of medicines called Antidiabetic agents. It is used to control blood sugar levels in patients with type II diabetes mellitus, along with proper diet and exercise.
Type II diabetes mellitus is a chronic disease characterized by abnormally high levels of glucose in the blood. It is caused by inadequate production of a hormone called insulin (produced by the pancreas to metabolize glucose) in the body or by inadequate sensitivity of body cells to the actions of insulin.
Before taking ISTAMET XR CP COMBIPACK, inform your doctor if you have any liver, kidney, or heart problems. You must also inform your doctor if you have high blood cholesterol levels, severe systemic infections, or are severely dehydrated due to excessive vomiting or diarrhea recently.
During therapy with ISTAMET XR CP COMBIPACK, your doctor might regularly monitor your blood sugar levels and kidney functions to avoid the risk of unwanted side effects. He might also ask you to make certain lifestyle changes, such as following a healthy diet, regular physical exercise, and quitting alcohol consumption, to achieve better results.
ISTAMET XR CP COMBIPACK is not recommended for use in patients with severe, uncontrollable diabetes. It is also not suitable for use in patients with alcoholism, shock, or problems with breathing or blood circulation.
Consult your doctor before taking ISTAMET XR CP COMBIPACK if you are pregnant or breastfeeding. The most common side effects of taking ISTAMET XR CP COMBIPACK are low blood sugar levels, stomach upset, constipation, flatulence, metallic taste in the mouth, sore throat, stuffy nose, and joint pain. Consult your doctor if they bother you.
Uses Of ISTAMET XR CP COMBIPACK
- To manage type II diabetes mellitus
How ISTAMET XR CP COMBIPACK Works
ISTAMET XR CP COMBIPACK is an antidiabetic medicine. It contains two medicines, namely metformin and sitagliptin. Metformin makes the body more sensitive to insulin (a hormone involved in glucose metabolism). This helps our body cells utilize more of the circulating blood glucose. Additionally, it can stop glucose production by the liver and reduce its absorption in the body.
Teneligliptin controls blood sugar levels by blocking the actions of an enzyme called dipeptidyl peptidase (DPP)-4 that reduces insulin secretion in the body. Collectively, ISTAMET XR CP COMBIPACK controls blood sugar levels and improves glycemic control in patients with type II diabetes.
How to use ISTAMET XR CP COMBIPACK
Take ISTAMET XR CP COMBIPACK, preferably after meals or as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.
Your doctor will decide the correct dose and duration of therapy for you depending on your age, body weight, and disease condition. Do not stop taking ISTAMET XR CP COMBIPACK unless your doctor advises you to stop.
Side Effects Of ISTAMET XR CP COMBIPACK
Common
- hypoglycemia (low blood sugar)
- nausea, vomiting
- flatulence, diarrhea, constipation, stomach pain, and loss of appetite
- swelling of the hands and legs (edema)
- upper respiratory infections
- stuffy nose, sore throat
- joint pain, pain in the arms or legs
- metallic taste
Uncommon
- drowsiness, dizziness
- dry mouth
- headache
- skin itching
Stop taking ISTAMET XR CP COMBIPACK and consult your doctor immediately if you experience any of the following side effects:
- serious allergic reaction (such as hives, swelling of the face, lips, tongue, or throat causing difficulty breathing or swallowing)
- severe blistering of the skin (signs of an allergic skin reaction called bullous pemphigoid)
- signs of pancreatitis (severe and persistent pain in the stomach areas that might reach through to your back with or without nausea and vomiting)
- signs of lactic acidosis (cold hands or feet, dizziness or lightheadedness, slow or irregular heartbeat, weakness or tiredness, unusual muscle pain, trouble breathing, sleepiness or drowsiness, stomach pains, nausea or vomiting)
How To Manage Side Effects
Constipation
Taking ISTAMET XR CP COMBIPACK with meals may reduce the chances of constipation. However, if you experience constipation, eat plenty of fiber-rich foods, such as fresh fruits, vegetables, and cereals. Drink plenty of fluids. Exercise more regularly. Consult your doctor if this side effect bothers you.
Dizziness Or Drowsiness
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
Headache
Rest and relax. Keep yourself hydrated by drinking plenty of fluids, such as water or electrolytes. Applying a pain-relieving balm to your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
Hypoglycemia
Have foods rich in sugars, such as fruit juices, glucose drinks, candies, honey, or biscuits. Check your blood sugar after 10 minutes. If you have not reached your optimum level, take another sugary snack or drink and check your blood sugar levels once again. Contact your doctor if there is no improvement in your condition.
Warning & Precautions
Pregnancy
ContraindicatedISTAMET XR CP COMBIPACK is not recommended for use by pregnant women. Therefore, inform your doctor before taking ISTAMET XR CP COMBIPACK if you are pregnant, think you may be pregnant, or are planning to have a baby.
Breastfeeding
ContraindicatedISTAMET XR CP COMBIPACK is not recommended for use by breastfeeding women. However, consult your doctor before taking it.
Driving and Using Machines
Use with CautionDo not drive or operate any machines if you feel dizzy after taking ISTAMET XR CP COMBIPACK.
Alcohol
Consult your doctorAvoid consumption of alcohol while taking ISTAMET XR CP COMBIPACK, as it may increase the risk of unwanted side effects.
Kidney
ContraindicatedISTAMET XR CP COMBIPACK is not recommended for use in patients with severely reduced kidney functions. Therefore, consult your doctor before taking it.
Liver
Consult your doctorISTAMET XR CP COMBIPACK is not recommended for use in patients with severe liver problems. It should be used with caution in patients with gallstones. Therefore, consult your doctor before taking it.
Allergy
ContraindicatedDo not take ISTAMET XR CP COMBIPACK if you are allergic to metformin or sitagliptin.
Heart Disease
ContraindicatedISTAMET XR CP COMBIPACK is not recommended for use in patients with severe heart problems (such as acute heart failure or a recent heart attack). Therefore, consult your doctor before taking it.
Use In Pediatrics
ContraindicatedISTAMET XR CP COMBIPACK is not recommended for use in children and adolescents (aged below 18 years). However, consult your doctor before taking it.
Use In Geriatrics
Use with CautionISTAMET XR CP COMBIPACK should be used with caution in elderly patients (aged above 65 years). Therefore, consult your doctor before taking it.
Others
ISTAMET XR CP COMBIPACK is not recommended for use if you:
- have severe, uncontrollable diabetes
- have nausea, vomiting, diarrhea, or rapid weight loss
- have lactic acidosis or ketoacidosis (a buildup of lactic acid or ketones in the body)
- are dehydrated (due to drinking less fluid or having had severe vomiting or diarrhea during the recent days)
- have any severe systemic infection
- have shock or problems in blood circulation
- have problems in breathing
- are an alcoholic
- are scheduled for any X-rays in the upcoming days
Before taking ISTAMET XR CP COMBIPACK, inform your doctor if you:
- have or ever had pancreatitis (inflammation of the pancreas)
- have alcohol dependence
- have high blood lipid levels
- have type I diabetes mellitus (insulin-dependent diabetes)
- are about to have a major surgery
- are fasting
- are malnourished, starved, on an irregular diet, or feeling weak
- perform extreme muscle exercises
- have a vitamin B12 deficiency
Interactions
A. Drug-Drug interactions:
Before taking ISTAMET XR CP COMBIPACK, inform your doctor if you are taking any of the following medicines, such as:
- other medicines used to manage diabetes (Ex. glimepiride, glyburide, gliclazide, teneligliptin, rosiglitazone, pioglitazone)
- iodine contrast medium (used during X-rays)
- medicines used to manage asthma (Ex. salbutamol or terbutaline)
- corticosteroids (used to manage pain and inflammation) Ex. hydrocortisone, prednisolone
- diuretics (used to reduce edema and to manage hypertension) Ex. furosemide, hydrochlorothiazide
- medicines used to manage pain and inflammation (such as ibuprofen and celecoxib)
- medicines used to manage high blood pressure (such as atenolol, propranolol, captopril, enalapril, ramipril, lisinopril, losartan, valsartan, olmesartan, and telmisartan)
- alcohol-containing medicines (such as cough syrups)
- cimetidine (a medicine used to manage stomach ulcers)
- dolutegravir (a medicine used to manage HIV infection)
- ranolazine (a medicine used to manage chest pain)
- trimethoprim (a medicine used to manage bacterial infections)
- digoxin (a medicine used to manage an irregular heartbeat)
Overdosage:
If you or anyone else accidentally took more ISTAMET XR CP COMBIPACK, consult your doctor immediately or visit the nearby hospital. Symptoms of an overdose are feeling cold or uncomfortable, severe nausea or vomiting, stomach pain, unexplained weight loss, muscular cramps, and fast breathing.
Synopsis
| Drug | : | Metformin, Sitagliptin |
| Pharmacological Category | : | Biguanides, DPP-4 Inhibitors |
| Therapeutic Indication | : | Type II diabetes mellitus |
| Dosage Forms | : | Tablet, Capsule, Combi pack |
More Information
- Keep ISTAMET XR CP COMBIPACK out of the sight and reach of children
- Store ISTAMET XR CP COMBIPACK below 30°C
FAQs About ISTAMET XR CP COMBIPACK
Q: What is ISTAMET XR CP COMBIPACK used for?
A: ISTAMET XR CP COMBIPACK is an antidiabetic medicine used as an adjunct to diet and exercise to control blood sugar levels in patients with type II diabetes mellitus.
Q: How and when to take ISTAMET XR CP COMBIPACK?
A: Take ISTAMET XR CP COMBIPACK, preferably after meals or as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration of therapy for you depending on your age, body weight, and disease condition.
Q: How long should I take ISTAMET XR CP COMBIPACK?
A: You need to take ISTAMET XR CP COMBIPACK as long as your doctor or physician prescribes you the medicine. Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight, and disease condition.
Q: What is the best time to take ISTAMET XR CP COMBIPACK?
A: ISTAMET XR CP COMBIPACK must be taken with meals to avoid gastrointestinal side effects.
Q: What should I do if I forget to take a dose of ISTAMET XR CP COMBIPACK?
A: If you forgot to take a dose of ISTAMET XR CP COMBIPACK, take it as soon as you remember. However, if it is time for the next dose of ISTAMET XR CP COMBIPACK, skip the missed dose and take the next one regularly. Do not take a double dose of ISTAMET XR CP COMBIPACK to compensate for the missed ones.
Q: What are the most common side effects of taking ISTAMET XR CP COMBIPACK?
A: The most common side effects of taking ISTAMET XR CP COMBIPACK are low blood sugar levels, stomach upset, constipation, flatulence, metallic taste in the mouth, sore throat, stuffy nose, and joint pain. Consult your doctor if they bother you.
Q: Can I stop taking ISTAMET XR CP COMBIPACK without consulting your doctor?
A: No. You should not stop taking ISTAMET XR CP COMBIPACK without consulting your doctor because it may lead to a reversal of symptoms. If you feel better after using ISTAMET XR CP COMBIPACK, consult your doctor for advice.
Q: Will taking a higher dose of ISTAMET XR CP COMBIPACK be more effective?
A: No, taking a higher dose of ISTAMET XR CP COMBIPACK will not be effective; rather, it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.
Q: What precautions do I need to follow while taking ISTAMET XR CP COMBIPACK?
A: Before taking ISTAMET XR CP COMBIPACK, inform your doctor if you have any liver, kidney, or heart problems. You must also inform your doctor if you have high blood cholesterol levels, severe systemic infections, or are severely dehydrated due to excessive vomiting or diarrhea recently. Along with the therapy, follow the diet and lifestyle changes advised by your doctor to achieve better results. Consult your doctor before taking ISTAMET XR CP COMBIPACK if you are pregnant or breastfeeding.
Q: Can I take medication for high blood pressure along with ISTAMET XR CP COMBIPACK?
A: It is not advisable to take medicines to control blood pressure while taking ISTAMET XR CP COMBIPACK without consulting your doctor. Therefore, consult your doctor before taking any antihypertensive such as beta blockers (Ex. atenolol, propranolol) along with ISTAMET XR CP COMBIPACK, as they have known interactions with ISTAMET XR CP COMBIPACK.
Q: What should I do if I experience low blood sugar after taking ISTAMET XR CP COMBIPACK?
A: Low blood sugar is a common side effect of taking ISTAMET XR CP COMBIPACK. If you experience any signs of low blood sugar levels (such as increased hunger, sweating, shakiness, weakness, or an irregular heartbeat), consume a sugary snack or sugar drink immediately. Consult your doctor if the symptom does not improve.
Q: Can ISTAMET XR CP COMBIPACK be taken with insulin?
A: Co-administration of ISTAMET XR CP COMBIPACK with insulin is considered risky as it increases the chance of hypoglycemia (decreased blood sugar levels). Therefore, consult your doctor before taking it.
Q: Can ISTAMET XR CP COMBIPACK be used in pregnant women?
A: ISTAMET XR CP COMBIPACK is not recommended for use by pregnant women. Therefore, consult your doctor for advice.
Q: How do I take ISTAMET XR CP COMBIPACK?
A: You must take ISTAMET XR CP COMBIPACK as advised by your physician. Try to take this medicine, preferably after meals, and swallow it with a glass of water. Do not crush or chew the medicine.
Q: How much ISTAMET XR CP COMBIPACK should I take?
A: ISTAMET XR CP COMBIPACK should be used only under medical supervision. Your doctor will decide the correct dose and duration of therapy for you depending on your age, body condition, and severity of the disease.
Q: Can ISTAMET XR CP COMBIPACK cause constipation?
A: Yes. Constipation is a common side effect of using ISTAMET XR CP COMBIPACK. Eat plenty of fiber-rich foods, such as fresh fruits, vegetables, and cereals, as well as drink plenty of water and exercise more regularly when taking this medicine. Contact your doctor if this side effect bothers you.
References
1. KD. Tripathi. Insulin, Oral Hypoglycaemic Drugs and Glucagon. Essentials of medical pharmacology. Seventh edition. 2013. Page – 274 & 275.
2. Erin L. St. Onge, Shannon Miller and Elizabeth Clements. Sitagliptin/Metformin (Janumet) as Combination Therapy in the Treatment of Type-2 Diabetes Mellitus. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. December 2012. [Accessed on 19th January 2024] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3541863/
3. Chitrabhanu Ballav and Stephen C.L. Gough. Safety and Efficacy of Sitagliptin-Metformin in Fixed Combination for the Treatment of Type 2 Diabetes Mellitus. Libertas Academica. 2013. [Accessed on 19th January 2024] https://journals.sagepub.com/doi/pdf/10.4137/CMED.S7314
4. Merck Sharp & Dohme (UK) Limited. Electronic Medicines Compendium (EMC) [Revised in February 2022] [Accessed on 19th January 2024] https://www.medicines.org.uk/emc/files/pil.564.pdf
5. Merck & Co., Inc. JANUMET® (sitagliptin and metformin hydrochloride) tablets, for oral use. [Revised in July 2022] [Accessed on 19th January 2024] https://www.merck.com/product/usa/pi_circulars/j/janumet/janumet_pi.pdf
6. Milpharm Limited. Electronic Medicines Compendium (EMC). [Revised in June 2020] [Accessed on 19th January 2024] https://www.medicines.org.uk/emc/files/pil.594.pdf
7. Rx Farma Limited. Electronic Medicines Compendium (EMC). [Revised in September 2019] [Accessed on 19th January 2024] https://www.medicines.org.uk/emc/files/pil.11951.pdf
8. Organon Pharma (UK) Limited. Electronic Medicines Compendium (EMC). [Revised in November 2021] [Accessed on 19th January 2024] https://www.medicines.org.uk/emc/files/pil.7887.pdf
Useful Diagnostic Tests
- HbA1C, Also known as Glycated Hemoglobin, Glycosylated Hemoglobin
- Blood Glucose Fasting (FBS)
- Random Blood Sugar (RBS)
- Post Prandial Blood Sugar (PPBS)
- Insulin-Fasting
- Insulin Postprandial (PP)
- Vital Diabetes Care
- Extended Diabetes Care
- Advance Diabetes Care
- Comprehensive Diabetes Care
Author Details
