Biguanide

15 Drugs classified under this drug class

Biguanide, Thiazolidinediones. Pioglitazone (as HCl) 15 mg, Metformin Hydrochloride 850 mg.
F.C. TABS.: 56. Adult. with normal renal funct. (GFR ≥ 90 mL/min): The recomm. dose of Competact is 30 mg/day pioglitazone plus 1,700 mg/day of metformin HCl (this dose is achievable with 1 tab. of 15 mg/850 mg, taken ×2/d.
Dose titration with pioglitazone (added to the optimal dose of metformin) should be consid. before the pt. is switched to this medication. See lit.
Second line tmt. of type 2 diabet. mell. adult pts., particularly overweight pts., who are unable to achieve suffic. glycaem. control at their maxim. tolerated dose of oral metformin alone.
After initiat. of the. with pioglitazone, pts. should be reviewed after 3-6 mnths. to assess adequacy of response to tmt. (e.g. reduct. in HbA1c). In pts. who fail to show an adequate response, pioglitazone should be discont. In light of potent. risks with prolong. ther., prescribers should confirm at subseq. routine reviews that the benefit of pioglitazone is maintain.
C/I: Hypersens. Cardiac fail./ history of card. fail. (NYHA stages I- IV). Current bladder cancer or a hist. of bladder cancer. Uninvestigated macroscop. haematuria. Acute/chron. dis. which may cause tissue hypoxia such as cardiac or respirat. fail., recent MF, shock. Hepat. impair. Acute alcohol intoxicat., alcoholism. Any type of acute metabol. acidos. (e.g. lactic acidosis, diabet. ketoacidosis). Diabet. pre-coma. Severe renal fail. (GFR < 30 mL/min). Acute conditions: Dehydrat., Sev. infec., Shock, Intravasc. administ. of iodinated contrast agents., Breast-feed.

Biguanide, DPP-4 Inhibitor. Vildagliptin 50 mg, Metformin Hydrochloride 500, 850, 1000 mg.
F.C. TABS: 60 x Vildagliptin 50 mg/
Metformin 500 mg; 60 x
Vildagliptin 50 mg/Metformin 850 mg;
Vildagliptin 50 mg/Metformin 1,000 mg.
Based on the pt. current dose of
Metformin, tmt. may be init. at either
50 mg /500 mg or 50 mg/850 mg or 50
mg/1000 mg tab. strength BID, one
tab. in the morning and evening. Pts
already receiving metformin +
vildagliptin from separate tabs: switch
to the equivalent combined tab. Daily
doses >100 mg of vildagliptin are not
recommend. See lit.
Tmt. type 2 diabetes mellitus in adult pts.
insuffic. controlled with max. tolerat.
dose Metformin alone or already treat.
with vildaliptin and Metformin as
separate tabs. In comb. with a
sulfonylurea as an adjunct to diet and
exercise in adult pts. inadeq. controlled
with metformin and a sulfonylurea. In
triple comb. ther. with insulin as an
adjunct to diet and exercise to improve
glycaemic control in adult pts.when
insulin at a stable dose and Metformin
alone do not provide adeq. glycaemic
control.
C/I: Hypersens., Diab. ketoacid., diabet.
pre-coma. Ren. fail. ,ren,dysfunc, (CrCl<
60 ml/min) dehydr., sev. infec., shock.
Intravasc. admin. of iod. contrast ag. Acute/ chron. dis. which may cause
tissue hypox., (e.g: Card. fail.). Resp. fail.,
recent MI, Hep. impair. Acute alcohol
intox., alcoholism. Lact.

Biguanide. Metformin Hydrochloride 850 mg.
CAPLETS: 30
Adult: 1 caplet twice a day, with/aft.
meals; can adjust gradually up to 3
caplets daily taken as divided doses.
Elderly: not indicated when renal
function is impaired. See lit.
Diet-failed, non-insulin dependent
diabetic patients, especially if
overweight, either alone as initial
therapy or in combination with a
sulfonylurea. Occasionally, as adjuvant
therapy in insulin-dependent diabetic
patients particularly who are usually
obese and not well controlled with
insulin.
C/I: Hypersens. moder.- sev.renal fail. or
renal dysfunc., renal dis.which may also
result from cond. such as cardiovasc.
collapse (shock), acute dis.
e.g.dehydration (diarrhea, vomit., fever),
severe infect. and/or hypoxic states
(septicemia, urin.infec., pneumopathy),
hypoxic states: cardiovasc.collapse
(shock) from whatever cause, acute
congest. heart fail. acute MI, other cond.
characterized by hypoxemia (any sev.
resp. disturb.), hep. fail., since sev. hep. dysfunc. has been assoc. with some
cases of lactic acidosis. Pts. with clin. or
lab. evidence of hep. dis. Should be
tempor. withheld in pts. undergoing rad.
studies involv. paren. admin. of
iodinated contrast materials except for
fluorescein photoretinog. which does
not necessitate metformin withhold.
Exces. alcohol intake, acute or chronic.
Acute or chronic metab. acidosis, includ.
diabetic ketoacidosis, with or without
coma. 2 days before elective major
surgery, and for 2 days follow. surg. or
any traum. cond. Hist. of lact. acidosis.
Lacta.Uncontrol. diabetes, with e.g.
severe hyperglyc., nausea, vom.,
dehydration, rapid weight loss. Impair.
func. of the heart or recent heart attack,
stroke. Blood clot in the lungs. Pancreas
inflam. Pts. over 80 yrs. old and not yet
passed kidney funct. assess. See lit..

Biguanide, DDP-4 Inhibitor. Metformin Hydrochloride 1,000 mg, Sitagliptin 50 mg.
TABS: 56. 2 x dly with meals. Graduate
dosage to avoid GI side effects. Max.
dly dose: 100 mg sitagliptin/2,000 mg
metformin HCl.
Adjunct to diet/excercise to improve
glycemic control in type 2 diabetes
mellitus, when tmt. with both sitagliptin
and metformin approp. Not to be used in
type 1 diabetes or tmt. diabet.
ketoacidos. Not studied in history
pancreatit. See lit.
C/I: Ren. dis./dysfunct.; acute/chron.
metabol. acidos. (incl. diabet. acidos.)
with/out coma, hypersens., discont.
when undergoing radiolog. studies
involving IV admin. or iodinated contrast
materials.

Biguanide, DPP-4 Inhibitor. Metformin Hydrochloride 500 mg, Sitagliptin 50 mg.
TABS: 56. 2 x dly with meals. Graduate
dosage to avoid GI side effects. Max.
dly dose: 100 mg sitagliptin/2,000 mg
metformin HCl.
Adjunct to diet/excercise to improve
glycemic control in type 2 diabetes
mellitus, when tmt. with both sitagliptin
and metformin approp. Not to be used in
type 1 diabetes or tmt. diabet.
ketoacidos. Not studied in history
pancreatit. See lit.
C/I: Ren. dis./dysfunct.; acute/chron.
metabol. acidos. (incl. diabet. acidos.)
with/out coma, hypersens., discont.
when undergoing radiolog. studies
involving IV admin. or iodinated contrast
materials.

Biguanide, DPP-4 Inhibitor. Metformin Hydrochloride 850 mg, Sitagliptin 50 mg.
TABS: 56. 2 x dly with meals. Graduate
dosage to avoid GI side effects. Max.
dly dose: 100 mg sitagliptin/2,000 mg
metformin HCl.
Adjunct to diet/excercise to improve
glycemic control in type 2 diabetes
mellitus, when tmt. with both sitagliptin
and metformin approp. Not to be used in
type 1 diabetes or tmt. diabet.
ketoacidos. Not studied in history
pancreatit. See lit.
C/I: Ren. dis./dysfunct.; acute/chron.
metabol. acidos. (incl. diabet. acidos.)
with/out coma, hypersens., discont.
when undergoing radiolog. studies
involving IV admin. or iodinated contrast
materials.