Janumet 50/1000 mg 56 tablets

Available at Pharmaegy Pharmacy. Use as directed by your doctor.

Janumet 50/1000 mg 56 tablets Composition: Each tablet contains: Sitagliptin 50 mg Metformin hydrochloride 1000 mg Excipients: microcrystalline cellulose, polyvinylpyrrolidone (povidone), sodium stearyl fumarate, sodium lauryl sulfate, purified water. Properties: The drug is a combination of two hypoglycemic drugs with complementary mechanisms of action, designed to improve glycemic control in patients with type 2 diabetes mellitus: sitagliptin, an inhibitor of the enzyme dipeptidyl peptidase-4 (DPP-4), and metformin, a representative of the biguanide class. Metformin is a hypoglycemic drug that increases glucose tolerance in patients with type 2 diabetes mellitus by reducing basal and postprandial blood glucose concentrations. Its pharmacological mechanisms of action differ from those of other classes of oral hypoglycemic drugs. Metformin reduces glucose synthesis in the liver, reduces glucose absorption in the intestine, and increases insulin sensitivity by enhancing peripheral glucose uptake and utilization. Unlike sulfonylurea derivatives, metformin does not cause hypoglycemia in patients with type 2 diabetes mellitus or in healthy individuals (except in certain circumstances) and does not cause hyperinsulinemia. During treatment with metformin, insulin secretion does not change, while fasting insulin concentration and daily plasma insulin concentration may decrease. Sitagliptin is an orally active, highly selective inhibitor of the DPP-4 enzyme, intended for the treatment of type 2 diabetes mellitus. The pharmacological effects of the class of DPP-4 inhibitor drugs are mediated by the activation of incretins. By inhibiting DPP-4, sitagliptin increases the concentration of two known active hormones of the incretin family: glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). Incretins are part of the internal physiological system of glucose homeostasis regulation. At normal or elevated blood glucose concentrations, GLP-1 and GIP promote increased insulin synthesis and secretion by pancreatic β-cells. GLP-1 also inhibits glucagon secretion by pancreatic α-cells, thereby reducing glucose synthesis in the liver. This mechanism of action differs from that of sulfonylurea derivatives, which stimulate insulin release even at low blood glucose concentrations, which is fraught with the development of sulfonylurea-induced hypoglycemia not only in patients with type 2 diabetes mellitus, but also in healthy individuals. Sitagliptin at therapeutic concentrations does not inhibit the activity of related enzymes DPP-8 or DPP-9. Sitagliptin differs in chemical structure and pharmacological action from analogues of GPP-1, insulin, sulfonylurea derivatives or meglitinides, biguanides, peroxisome proliferator-activated receptor gamma (PPARγ) agonists, alpha-glucosidase inhibitors, and amylin analogues. Indications: As initial therapy for patients with type 2 diabetes mellitus to improve glycemic control if diet and exercise regimen do not provide adequate control; as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes who have not achieved adequate control with metformin or sitagliptin monotherapy, or after unsuccessful combination therapy with two drugs. Combination therapy For patients with type 2 diabetes mellitus to improve glycemic control in combination with sulfonylurea derivatives (triple combination: metformin + sitagliptin + sulfonylurea derivative) when diet and exercise regimen in combination with two of these three drugs (metformin, sitagliptin, or sulfonylurea derivatives) do not lead to adequate glycemic control; in combination with thiazolidinediones (peroxisome proliferator-activated PPARγ receptor agonists) when diet and exercise in combination with two of these three drugs (metformin, sitagliptin, or thiazolidinedione) do not result in adequate glycemic control; in combination with insulin, when diet and exercise combined with insulin do not lead to adequate glycemic control. Method of administration and dosage: The method of administration and dosage regimen of a particular drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. The use of a particular drug form must strictly comply with the indications for use and dosage regimen. Contraindications: Type 1 diabetes mellitus; kidney disease or reduced kidney function (with serum creatinine concentrations >1.5 mg/dL and >1.4 mg/dL in men and women, respectively, or reduced CC (<60 mL/min), including due to cardiovascular collapse (shock), acute myocardial infarction or septicemia; acute conditions associated with a risk of renal impairment, such as dehydration (due to diarrhea, vomiting), fever, severe infectious diseases, hypoxic conditions (shock, sepsis, renal infections, bronchopulmonary diseases); acute or chronic metabolic acidosis, including diabetic ketoacidosis (with or without coma); clinically pronounced manifestations of acute and chronic diseases that can lead to the development of tissue hypoxia (including heart or respiratory failure, acute myocardial infarction); extensive surgical operations and injuries when insulin therapy is indicated; liver failure, impaired liver function; chronic alcoholism, acute alcohol poisoning; pregnancy, lactation; lactic acidosis (including history); use for at least 48 hours before and 48 hours after radioisotope or X-ray examinations with the administration of iodine-containing contrast agents; adherence to a hypocaloric diet (less than 1000 kcal/day); children and adolescents under 18 years of age; hypersensitivity to sitagliptin, metformin, or any of the components of the drug. Precautions: Metformin and sitagliptin are excreted mainly by the kidneys. The risk of metformin accumulation and lactic acidosis increases in proportion to the degree of renal impairment, therefore, the drug should not be prescribed to patients with serum creatinine concentrations above the upper age limit of normal. In elderly patients, due to age-related decline in renal function, the minimum dose of the drug should be used to achieve adequate glycemic control. In elderly patients, especially those aged ≥80 years, renal function should be monitored regularly. Before starting therapy with the drug, as well as at least once a year after the start of treatment, normal kidney function should be confirmed by appropriate tests. In patients at risk of developing renal dysfunction, kidney function should be monitored more frequently, and if symptoms of renal dysfunction are detected, the drug should be discontinued. Side effects: -headache, -dizziness; -hypoglycemia; -constipation; -upper respiratory tract infections and nasopharyngitis; -osteoarthritis and pain in the extremities; -mild leukocytosis due to an increase in the number of neutrophils (not considered clinically significant). Storage: Store at a temperature not exceeding 30 degrees Celsius in a dry place. Packaging: Cardboard box containing 14, 28, or 56 tablets.