Sitamet SR 500mg

• Sitamet SR 500 mg is a combination medication used to manage type 2 diabetes mellitus.
• It contains two active ingredients: sitagliptin (50 mg) and metformin hydrochloride (500 mg).
• This combination helps control blood sugar levels in adults when diet and exercise alone are insufficient.

Active Ingredients and Mechanism of Action:

• Sitagliptin: Belongs to the class of dipeptidyl peptidase-4 (DPP-4) inhibitors. It works by increasing the levels of incretin hormones, which stimulate insulin release from the pancreas and decrease glucagon production, thereby reducing blood glucose levels.

• Metformin Hydrochloride: A biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and enhances insulin sensitivity, leading to improved glucose uptake and utilization by peripheral tissues.

Indications:

Sitamet SR is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, especially when treatment with both sitagliptin and metformin is appropriate. It is not recommended for patients with type 1 diabetes or diabetic ketoacidosis.

Dosage and Administration:

The dosage should be individualized based on the patient’s current treatment regimen, effectiveness, and tolerability. The maximum recommended daily dose is 100 mg of sitagliptin and 2000 mg of metformin. Sitamet SR should be taken once daily with meals, preferably in the evening, to reduce gastrointestinal side effects associated with metformin.

Side Effects:

Common side effects may include:

• Diarrhea
• Upper respiratory tract infection
• Headache
• Nausea

• Stomach pain

These side effects are generally mild and tend to resolve over time. However, metformin has been associated with a rare but serious condition called lactic acidosis, characterized by muscle pain, breathing difficulties, and abdominal discomfort. Patients should seek immediate medical attention if these symptoms occur.

Contraindications:

Sitamet SR is contraindicated in patients with:

• Severe renal impairment
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis

• Known hypersensitivity to sitagliptin, metformin, or any of the excipients in the formulation

Precautions:

• Renal Function: Assess renal function before initiating treatment and periodically thereafter. Use with caution in patients with renal impairment.
• Hepatic Impairment: Not recommended for patients with hepatic impairment due to the risk of lactic acidosis.

• Alcohol Intake: Advise patients to limit alcohol consumption, as it can increase the risk of lactic acidosis.

Drug Interactions:

Caution is advised when co-administering Sitamet SR with medications that can affect renal function, result in significant hemodynamic change, or interfere with metformin disposition, such as:

• Cationic drugs (e.g., amiloride, digoxin)
• Carbonic anhydrase inhibitors (e.g., topiramate)

• Drugs that may affect glycemic control (e.g., corticosteroids, diuretics)

Use in Specific Populations:

• Pregnancy: There are limited data on the use of Sitamet SR in pregnant women. It should be used during pregnancy only if clearly needed.
• Lactation: Metformin is excreted into human milk; it is unknown if sitagliptin is excreted. A decision should be made whether to discontinue nursing or to discontinue the drug.

• Pediatrics: Safety and effectiveness in pediatric patients have not been established.

Storage:

Store Sitamet SR at room temperature, away from moisture and heat. Keep out of reach of children.

Availability:

Sitamet SR is available in Nepal and is manufactured by Nepal Pharmaceuticals Pvt. Ltd.

Note: This information is intended for educational purposes and should not replace professional medical advice. Consult a healthcare provider for personalized recommendations.