Sinjard-M
Generic Name : Empagliflozin + Metformin Hydrochloride
Indications
This tablet is indicated for the treatment of adults with type 2 diabetes mellitus as an adjunct to diet and exercise:
- In patients insufficiently controlled on their maximally tolerated dose of Metformin alone
- In combination with other medicinal products for the treatment of diabetes, in patients insufficiently controlled with Metformin and these medicinal products
- In patients already being treated with the combination of Empagliflozin and Metformin as separate tablets.
Pharmacology
Empagliflozin is an inhibitor of Sodium-Glucose Co-Transporter 2 (SGLT2). SGLT2 is the predominant transporter, responsible for reabsorption of glucose from the kidney back into the circulation. By inhibiting SGLT2, Empagliflozin reduces renal reabsorption of filtered glucose and lowers the renal threshold for glucose and thereby increases urinary glucose excretion.
Metformin Hydrochloride is a biguanide type oral antihyperglycemic drug, used in the management of type 2 diabetes. It lowers both basal and postprandial plasma glucose. It does not produce hypoglycemia. Metformin Hydrochloride decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by an increase in peripheral glucose uptake and utilization.
Dosage & Administration
The dosage should be individualized based on effectiveness and tolerability. Take this combination twice daily with meals. Dose escalation should be gradual to reduce the gastrointestinal side effects due to Metformin Hydrochloride. Maximum recommended daily dose of Metformin Hydrochloride is 2000 mg and Empagliflozin is 25 mg.
Recommended individualized starting dose:
- In patients on Metformin Hydrochloride, switch to this combination containing Empagliflozin 5 mg with a similar total daily dose of Metformin Hydrochloride.
- In patients on Empagliflozin, switch to this combination containing Metformin Hydrochloride 500 mg with a similar total daily dose of Empagliflozin.
- In patients already treated with Empagliflozin and Metformin Hydrochloride separately switch to this combination containing the same total daily doses of each component.
- In patients with volume depletion not previously treated with Empagliflozin, correct this condition before initiating this combination.
Extended-release formulations: Individualize starting dose based on the patient’s current drug regimen. Take film coated tablet twice daily with meal and extended-release formulations should be taken once daily with meal, with gradual dose escalation to reduce the Gl adverse effects due to Metformin. Adjust dosing based on effectiveness and tolerability while not exceeding the maximum recommended daily dose of Metformin Hydrochloride 2000 mg and Empagliflozin 25 mg.
Renal impaired patient: Assess renal function before initiating this combination. In patients with an eGFR below 45 mL/min/1.73 m2 is contraindicated.
Pediatric patients under 18 years of age: Safety and effectiveness in pediatric patients under 18 years of age have not been established.
