ISTAMET XR Tablet 10's

Introduction About ISTAMET XR TABLET

Istamet XR Tablet is a combination medicine formulated to support adults with Type II Diabetes Mellitus in managing blood sugar levels effectively. It contains sitagliptin, which helps regulate insulin release after meals, and metformin (extended release), which reduces excess glucose production by the liver and improves the body’s response to insulin. The extended-release formulation ensures gradual absorption, helping maintain steady blood sugar control throughout the day. This makes Istamet XR particularly suitable for patients seeking once-daily convenience along with lifestyle interventions like diet and exercise.

Istamet XR Tablet is ideal for adult patients whose blood sugar is not sufficiently controlled by diet and exercise alone. It is also used in patients who may benefit from a combination therapy approach without taking multiple pills separately. The medicine should be taken once daily with a main meal, swallowed whole with water, and not crushed or chewed. Consistent daily dosing, combined with regular monitoring of blood sugar, helps optimize its effectiveness and minimize risks.

Precautions and warnings include regular monitoring of kidney function, especially in elderly patients and caution in patients with liver or heart conditions. Alcohol should be limited or avoided, and dehydration should be prevented by maintaining adequate fluid intake. Patients should inform their doctor about all other medicines they are taking to avoid potential interactions. Low blood sugar (hypoglycaemia) is possible, especially if meals are skipped or combined with other sugar-lowering medicines, so monitoring for symptoms like dizziness, hunger, or sweating is important.

For pregnant or breastfeeding women, Istamet XR should be used only under strict medical supervision, as safety depends on individual circumstances and blood sugar control requirements. Common side effects are usually mild and may include stomach upset, nausea, mild diarrhoea, or bloating, which often improve as the body adjusts. Serious side effects are rare, but patients should seek immediate medical attention if they experience unusual fatigue, muscle cramps, rapid breathing, or allergic reactions. Regular check-ups and adherence to prescribed dosing make Istamet XR Tablet an effective and convenient option for managing Type II diabetes.

Uses Of ISTAMET XR TABLET

• Used to manage type II diabetes mellitus

Benefits of ISTAMET XR TABLET

Istamet XR Tablet for Type II Diabetes Mellitus

Istamet XR Tablet is used in adults with Type II Diabetes to help maintain balanced blood sugar levels when diet and lifestyle changes are not enough. It combines sitagliptin and metformin XR, which work together to improve insulin response and reduce excess glucose from the liver. The extended-release form allows once-daily dosing for steady blood sugar control. It should be taken as prescribed, alongside a healthy diet, regular exercise, and routine monitoring.

How ISTAMET XR TABLET Works

Mechanism of Action of Istamet XR Tablet

Istamet XR Tablet contains a combination of sitagliptin and metformin in an extended-release form. Sitagliptin works by increasing the levels of natural incretin hormones in the body, which help regulate insulin release after meals and reduce excess glucose production. This supports better control of post-meal blood sugar levels.

Metformin acts by lowering the amount of glucose released by the liver and improving the body’s sensitivity to insulin, helping cells use glucose more effectively. The extended-release (XR) formulation allows the medicine to be released slowly over time, providing steady action throughout the day and improving tolerability with convenient dosing.

How to use ISTAMET XR TABLET

How to Take Istamet XR Tablet

• Take Istamet XR Tablet exactly as prescribed by your doctor.
• It is usually taken once daily with a main meal.
• Swallow the tablet whole with a glass of water.
• Do not crush, chew, or break the extended-release tablet.
• Take the medicine at the same time each day for consistency.
• Follow dietary and lifestyle advice given by your healthcare provider.

What if I forgot to take ISTAMET XR TABLET

• Take the missed dose as soon as you remember.
• If it is close to the time for your next scheduled dose, skip the missed one.
• Do not take two tablets together to make up for a missed dose.
• Resume your regular dosing schedule the next day.
• If you miss doses frequently, inform your doctor for proper guidance.

Overdose

If you or someone else accidentally takes more Istamet XR Tablet than prescribed, seek medical attention immediately or go to the nearest hospital. Signs of an overdose may include feeling unusually cold or unwell, severe nausea or vomiting, abdominal pain, unexpected weight loss, muscle cramps, and rapid breathing.

Side Effects Of ISTAMET XR TABLET

Common side effects of Istamet XR Tablet:

• hypoglycaemia (low blood sugar)
• flatulence, diarrhoea, constipation, stomach pain, and loss of appetite
• swelling of the hands and legs (edema)
• metallic taste
• drowsiness, dizziness
• dry mouth

When to Seek Medical Attention?

Stop taking 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 light-headedness, 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

Dizziness Or Drowsiness

• Stay Hydrated: Drink water throughout the day, as dehydration can cause fatigue and sleepiness.
• Move Around: Take short walks or do light stretching to improve blood flow and wake up your body.
• Consume Small, Balanced Snacks: Foods with protein and complex carbs (like nuts or whole-grain toast) can provide sustained energy.
• Deep Breathing Exercises: Practice a few minutes of deep, rhythmic breathing to increase oxygen supply and alertness.
• Natural Light Exposure: Step outside or sit near a window; sunlight helps regulate your body’s internal clock.
• Cold Water Splash: Washing your face with cold water can help refresh and reduce sleepiness.
• Limit Heavy or Sugary Meals: Large or sugary meals can cause post-meal drowsiness; opt for lighter meals.
• Short Power Nap: A 10–20-minute nap can restore alertness without affecting nighttime sleep.Bottom of Form

Dry Mouth

• Stay Hydrated: Drink plenty of water throughout the day to keep your mouth moist.
• Chew Sugar-Free Gum: Chewing stimulates saliva production and helps keep the mouth moist.
• Suck on Sugar-Free Lozenges or Hard Candies: Helps increase saliva flow naturally.
• Use Aloe Vera Juice: Rinse your mouth with a small amount of aloe vera juice to soothe dryness.
• Avoid Caffeine and Alcohol: These can worsen dryness, so limit coffee, tea, and alcohol.
• Humidify Your Room: Using a humidifier adds moisture to the air, especially while sleeping.
• Eat Water-Rich Foods: Include fruits and vegetables like cucumber, watermelon, and oranges.
• Practice Good Oral Hygiene: Brush and floss regularly to prevent irritation and infections.

Loss Of Appetite

• Ginger Tea: Sip warm ginger tea or chew a small piece of fresh ginger to stimulate digestion and appetite.
• Mint Leaves: Chew fresh mint leaves or drink mint-infused water to enhance taste and appetite.
• Lemon Water: Drink warm water with a few drops of lemon juice before meals to improve digestion.
• Small, Frequent Meals: Eat light meals every 2–3 hours instead of heavy meals to gradually increase appetite.
• Carrot or Beetroot Juice: Fresh vegetable juices can improve digestion and nutrient absorption.
• Fennel Seeds: Chew a teaspoon of fennel seeds after meals to reduce bloating and improve hunger signals.
• Avoid Stress: Relaxation, deep breathing, or light exercise can help improve appetite.

Warning & Precautions

Pregnancy

Contraindicated

Istamet XR Tablet is not recommended for use by pregnant women. Therefore, inform your doctor before taking this medicine if you are pregnant, think you may be pregnant, or are planning to have a baby. 

Breastfeeding

Contraindicated

Istamet XR Tablet is not recommended for use by breastfeeding women. Consult your doctor for advice.

Driving and Using Machines

Use with Caution

Do not drive or operate any machines if you feel dizzy after taking Istamet XR Tablet.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking Istamet XR Tablet, as it may increase the risk of unwanted side effects.

Kidney

Contraindicated

Istamet XR Tablet is not recommended for use in patients with severely reduced kidney functions.

Liver

Consult your doctor

Istamet XR Tablet is not recommended for use in patients with severe liver problems. It should be used with caution in patients with gallstones.

Allergy

Contraindicated

Do not take Istamet XR Tablet if you are allergic to metformin or sitagliptin or any other ingredients of this medicine.

Heart Disease

Contraindicated

Istamet XR Tablet is not recommended for use in patients with severe heart problems (such as acute heart failure or a recent heart attack).  

Use In Pediatrics

Contraindicated

Istamet XR Tablet is not recommended for use in children and adolescents (aged below 18 years).  

Use In Geriatrics

Use with Caution

Istamet XR Tablet should be used with caution in elderly patients (aged above 65 years).

Other Warnings for ISTAMET XR TABLET

Before taking the medicine, 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

Who should not take ISTAMET XR TABLET

Istamet XR Tablet is not recommended for use if you:

• have severe, uncontrollable diabetes
• have nausea, vomiting, diarrhoea, or rapid weight loss
• have lactic acidosis or ketoacidosis (a buildup of lactic acid or ketones in the body)
• are dehydrated
• 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

Safety Advice

• Risk of Low Blood Sugar (Hypoglycaemia): Risk increases if meals are skipped or used with other sugar-lowering medicines. Watch for sweating, shaking, hunger, or confusion.
• Dehydration: Avoid fluid loss from vomiting, diarrhoea, or heavy sweating. Ensure adequate daily fluid intake.
• During Fever or Severe Infections: Blood sugar levels may become unstable. Temporary medical guidance may be required.
• Before Surgery or Medical Procedures: Inform your doctor about Istamet XR use.  Temporary stoppage may be advised.
• Use with Contrast Dye Tests: Extra caution is needed during contrast imaging tests. Kidney function checks and temporary pause may be required.
• Nutritional Status: Follow a balanced, regular meal plan. Irregular eating may affect blood sugar levels.
• Long-Term Use Monitoring: Regular checks of blood sugar and kidney function are important. Do not change the dose without medical advice.

Diet and Lifestyle Advice

• Healthy Eating Habits: Eat a balanced diet with portion control. Choose whole grains, vegetables, lean proteins, and fibre-rich foods. Limit sugary, fried, and refined foods.
• Meal Timing: Eat meals at regular times. Do not skip meals. Take the tablet with food as advised.
• Hydration: Drink enough water daily. Prevent dehydration due to heat, vomiting, or diarrhoea. Avoid sugary drinks.
• Physical Activity: Stay active with walking, yoga, or cycling. Aim for 30 minutes of moderate activity most days. Seek medical advice before intense exercise.
• Weight Management: Maintain a healthy weight. Prefer gradual and sustainable weight control. Avoid crash diets.
• Smoking: Avoid smoking. Quitting supports overall health.
• Stress Management: Manage stress with relaxation techniques. Ensure adequate sleep and routine.
• Regular Monitoring: Check blood sugar as advised. Track symptoms and lifestyle habits. Attend regular follow-ups.

1. Istamet XR Tablet Vs Janumet XR Tablet

2. Istamet XR Tablet Vs Galvus Met XR/ Galvus Met

Drug - Drug interaction

1. Insulin and Sulfonylureas (e.g., Glimepiride, Gliclazide)

• Interaction: Increased risk of low blood sugar when used together.
• Management: Dose adjustment and regular blood sugar monitoring may be advised.

2. Diuretics (e.g., Furosemide, Hydrochlorothiazide)

• Interaction: May affect blood sugar control and increase dehydration risk.
• Management: Maintain hydration and monitor blood sugar and kidney function.

3. Corticosteroids (e.g., Prednisolone, Dexamethasone)

• Interaction: Can raise blood sugar levels and reduce medicine effectiveness.
• Management: Blood sugar monitoring and dose review may be required.

4. Beta-Blockers (e.g., Metoprolol, Propranolol)

• Interaction: May mask symptoms of low blood sugar such as tremors or palpitations.
• Management: Monitor blood sugar closely and watch for other warning signs like sweating.

5. Cationic Medicines (e.g., Cimetidine)

• Interaction: May increase metformin levels in the body.
• Management: Dose adjustment or alternative medicines may be considered.

6. Contrast Media (Iodinated Contrast Agents)

• Interaction: Increased risk of kidney-related side effects when used with metformin.
• Management: Temporary discontinuation before and after imaging tests may be advised.

7. Digoxin

• Interaction: Sitagliptin may slightly increase digoxin levels.
• Management: Monitoring may be advised in patients using both medicines.

Drug - Food interaction

1. High-Sugar Foods and Sugary Drinks

• Interaction: Excessive intake may counteract blood sugar control and reduce overall effectiveness.
• Management: Limit sweets, desserts, sweetened beverages, and refined carbohydrates.

2. High-Fat Meals

• Interaction: Very fatty meals may delay digestion and affect how the extended-release tablet is absorbed.
• Management: Prefer balanced meals rather than heavy, oily foods, especially at dosing time.

3. Irregular or Skipped Meals

• Interaction: Skipping meals may increase the risk of low blood sugar when the medicine is active.
• Management: Maintain regular meal timing and avoid prolonged fasting.

4. Low-Calorie or Crash Diets

• Interaction: Extreme calorie restriction may lead to unstable blood sugar levels.
• Management: Follow a sustainable, doctor-recommended meal plan.

5. Grapefruit and Grapefruit Juice

• Interaction: May affect blood sugar balance in some individuals.
• Management: Consume in moderation and monitor blood sugar response.

Synopsis

More Information

FAQs About ISTAMET XR TABLET

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 6th January 2026]

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 6th January 2026] 

4. Merck & Co., Inc. JANUMET® (sitagliptin and metformin hydrochloride) tablets, for oral use. [Revised in July 2022] [Accessed on 6th January 2026]

User Feedback

Useful Diagnostic Tests

• Random Blood Sugar (RBS)
• Fasting Blood Sugar (FBS)
• Post Prandial Blood Sugar (PPBS)
• Sugar Risk Package
• HbA1C, Also known as Glycated Hemoglobin, Glycosylated Hemoglobin

Author Details

Written By Srilekha. R - B.Pharm

Reviewed For Accuracy By Dr. Jaya Prabakaran - MBBS, MD (Diabetology and Family Medicine)

Last updated on 18 Nov 2024 | 12:26 PM(IST)