Sitagliptin + Metformin Hydrochloride
Rx
Generic NameSitagliptin Phosphate + Metformin Hydrochloride
Therapeutic ClassDPP-4 Inhibitor + Biguanide
Common StrengthSitagliptin 50 mg / 100 mg + Metformin 500 mg / 1000 mg per tablet
Max / 24hSitagliptin 100 mg + Metformin 2000 mg/day (adjust per tolerance)
PregnancyUse only if clearly needed
Indications ▼
Type 2 Diabetes Mellitus (T2DM): Indicated as an adjunct to diet and exercise to improve glycemic control in adults inadequately controlled on metformin alone or sitagliptin alone. Combination therapy improves HbA1c with low risk of hypoglycemia.
Combination Therapy: Useful in patients requiring dual therapy; offers complementary mechanisms—metformin reduces hepatic glucose production, sitagliptin enhances incretin-mediated insulin secretion.
Pediatric Use: Approved for children ≥10 years for T2DM; dose adjustment may be required based on renal function.
Mechanism & Pharmacokinetics ▼
Mechanism: Sitagliptin inhibits DPP-4, increasing GLP-1 and GIP levels, enhancing glucose-dependent insulin secretion. Metformin decreases hepatic gluconeogenesis and increases peripheral glucose uptake. The combination provides additive glycemic control without significant hypoglycemia risk.
Pharmacokinetics: Sitagliptin: peak ~1–4 h, renal excretion, half-life ~12 h. Metformin: absorbed in small intestine, peak ~2–3 h, excreted unchanged in urine, half-life ~6 h. Dose adjustment required in renal impairment.
Dosage & Administration ▼
| Indication | Dose | Frequency |
|---|---|---|
| Adults with T2DM | Sitagliptin 50–100 mg + Metformin 500–1000 mg | Twice daily with meals |
| Pediatric ≥10 yrs | Weight-based; Sitagliptin 50 mg + Metformin 500 mg | Twice daily with meals |
| Renal Impairment (eGFR 30–50) | Reduce Metformin dose; Sitagliptin per renal adjustment | Twice daily |
Note: Take with meals to reduce gastrointestinal side effects. Adjust dose based on renal function and glycemic response. Avoid abrupt discontinuation.
Side Effects ▼
Gastrointestinal: nausea, vomiting, diarrhea, abdominal discomfort
Nasopharyngitis, headache
Rare: lactic acidosis (from metformin), pancreatitis (from sitagliptin), hypersensitivity reactions
Hypoglycemia risk increases if combined with insulin or sulfonylureas
Contraindications ▼
Hypersensitivity to sitagliptin, metformin, or excipients
Renal failure or eGFR <30 mL/min/1.73 m²
Lactic acidosis risk factors: severe infection, dehydration, hepatic impairment
Type 1 diabetes or diabetic ketoacidosis
Drug Interaction ▼
Insulin or sulfonylureas: increased risk of hypoglycemia; dose adjustment may be needed
Cationic drugs eliminated by renal tubular secretion (e.g., amiloride, digoxin): may reduce metformin elimination
Other DPP-4 inhibitors: additive effect not recommended
Pregnancy & Lactation ▼
Use only if clearly needed; limited human data available
Breastfeeding: caution advised; metformin excreted in milk, sitagliptin unknown
Clinical / Research Summary ▼
Clinical Role: Combination oral therapy for T2DM; effective in patients inadequately controlled on monotherapy
Advantage: Complementary mechanism; low hypoglycemia risk when not combined with insulin/sulfonylureas; weight-neutral
Limitation: Gastrointestinal side effects from metformin; caution in renal impairment; rare pancreatitis from sitagliptin
Monitoring: Blood glucose, renal function, gastrointestinal tolerance, signs of lactic acidosis, hypersensitivity reactions
Patient Counseling Points ▼
Take with meals to reduce GI upset
Maintain diet, exercise, and regular glucose monitoring
Report severe nausea, vomiting, abdominal pain, or unusual fatigue (possible lactic acidosis)
Monitor for hypoglycemia if on insulin or sulfonylureas
Storage & Handling ▼
Store below 30°C
Protect from moisture and light
Keep out of reach of children
Brand Names (Bangladesh & Global) ▼
Glipita‑M
Glipita‑M XR
Glucodip‑M XR
Janmet
Incrit‑M
Sitavia‑M
Sitazid‑M
Sitomet
Siglimet
Sliptin‑M
Sitadus‑M
Sitaglap‑M
Sitafit
Sitacret‑M
SGN Plus
Taglimet
Medical Disclaimer: For educational purposes only. Not a substitute for professional medical advice.
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