INTRODUCTION ABOUT ISTAMET D XR 500 TABLET

ISTAMET D XR 500 TABLET is used in the management of type II diabetes mellitus when diet, exercise, and therapy with conventional medicines does not result in adequate response. It contains a combination of three medicines, namely, Dapagliflozin, Metformin, and Sitagliptin that works by making your pancreas secrete more insulin, an hormone responsible for digesting glucose molecules and enables your body cells absorb more sugar from blood circulation.

Take ISTAMET D XR 500 TABLET as directed by your physician. Taking this medicine after meals helps to avoid stomach upset. Do not stop using ISTAMET D XR 500 TABLET without talking to your doctor. Prior to the management, your doctor may want you to take several blood tests to understand your existing kidney condition.

ISTAMET D XR 500 TABLET is not recommended for use during pregnancy or in breastfeeding women. It is also not suitable for use if you have respiratory failure, severe kidney disease, liver disease, heart failure, or a recent myocardial infarction. Therefore, consult your doctor before taking it.

The most common side effects of taking ISTAMET D XR 500 TABLET are hypoglycemia (low blood glucose level), nausea, vomiting, headache, flatulence, genital infections, and increased or more frequent urination. Consult your doctor if any of the side effects worsen.

USES OF ISTAMET D XR 500 TABLET

• Type II diabetes mellitus

HOW ISTAMET D XR 500 TABLET WORKS

ISTAMET D XR 500 TABLET is a combination of dapagliflozin, metformin, and sitagliptin. Dapagliflozin works by inhibiting the reabsorption of glucose in the kidneys, increasing urinary glucose excretion, and reducing blood glucose levels. Metformin decreases the amount of glucose you absorb from your food and the amount of glucose made by the liver. It also increases the body's response to insulin, a natural substance that controls the amount of glucose in the blood. Sitagliptin helps control blood sugar levels by increasing substances (incretins) in the body that make the pancreas release more insulin. It also signals the liver to stop producing sugar (glucose) when there is too much sugar in the blood.

DIRECTIONS FOR USE

• Take ISTAMET D XR 500 TABLET as advised by your physician.
• It can be taken with or without meals. However, taking this medicine with meals help reduce gastrointestinal discomfort
• Swallow this medicine whole with a glass of water, and do not crush or chew the medicine.
• Your doctor will decide the correct dose and duration for you depending on your age, body weight, and disease condition.
• Do not stop taking this medicine without consulting your doctor. Otherwise, your blood sugar will rise again.

SIDE EFFECTS OF ISTAMET D XR 500 TABLET

Common Side Effects of ISTAMET D XR 500 TABLET:

• Hypoglycemia (low blood glucose level)
• Nausea, vomiting
• Headache
• Flatulence
• Genital infections
• Increased or more frequent urination
• Drowsiness, dizziness
• Diarrhea, constipation
• Stomach pain
• Itching
• Dry mouth
• Decreased weight
• Thirst

Stop taking ISTAMET D XR 500 TABLET and consult your doctor immediately if you experience any of the following side effects:

• Symptoms of acute pancreatitis, such as severe and persistent abdominal pain that might reach through your back with or without nausea and vomiting
• Symptoms of allergic reactions such as rash, hives, blisters on the skin or peeling skin, and swelling of the face, lips, tongue, and throat that may cause difficulty breathing or swallowing
• Signs of bullous pemphigoid, such as blistering of the skin
• Symptoms of lactic acidosis include vomiting, abdominal pain, muscle cramps, a general feeling of not being well, severe tiredness, difficulty breathing, reduced body temperature, and a slow heartbeat
• The symptoms of diabetic ketoacidosis are nausea, vomiting, stomach pain, excessive thirst, fast and deep breathing, confusion, unusual sleepiness or tiredness, a sweet smell to your breath, a sweet or metallic taste in your mouth, or a different odour to your urine or sweat, or rapid weight loss
• Signs of severe infections of the urinary tract include fever, chills, a burning sensation during urination, pain in your back or side, and blood in your urine

HOW TO MANAGE SIDE EFFECTS

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before taking ISTAMET D XR 500 TABLET, inform your doctor if you are taking prescription, non-prescription, or herbal supplements.

• Sulphonylureas or with insulin (other medicines used to manage diabetes mellitus) Ex. glimepiride
• Ketoconazole and itraconazole (medicines used to manage fungal infections)
• Ritonavir (a medicine used to manage viral infections)
• Clarithromycin (a medicine used to manage bacterial infections)
• Corticosteroids (medicines used to manage pain and inflammatory conditions) like asthma and arthritis Ex. dexamethasone
• Medicines that increase urine production (diuretics) Ex. furosemide
• Medicines used to manage pain and inflammation (NSAIDs and COX-2-inhibitors, such as ibuprofen and celecoxib)
• Medicines for the management of high blood pressure (ACE inhibitors and angiotensin II receptor antagonists) Ex. enalapril, losartan
• Sympathomimetics (medicines used in the management of asthma) Ex. salbutamol
• Iodinated contrast agents or alcohol-containing medicines
• Medicines used to manage stomach problems, such as cimetidine
• Ranolazine, a medicine used to manage angina
• Dolutegravir, a medicine used to manage HIV infection
• Vandetanib, a medicine used to manage a specific type of thyroid cancer
• Digoxin (to manage irregular heartbeats and other heart problems)

Overdosage:

If you or anyone else accidentally took too much of this medicine, consult your doctor immediately. The symptoms of an overdose include hypoglycemia. Overdosage may cause lactic acidosis, and symptoms include feeling cold or uncomfortable, severe nausea or vomiting, stomach pain, unexplained weight loss, muscular cramps, or rapid breathing.

SYNOPSIS

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