Vildagliptin + Metformin Hydrochloride

Vildagliptin + Metformin Hydrochloride is a dpp-4 inhibitor + biguanide combination — oral antidiabetic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Vildagliptin + Metformin Hydrochloride is used, together with diet and exercise, in adults with type 2 diabetes mellitus when:

• Metformin alone, at the highest tolerated dose, no longer controls blood sugar adequately
• The patient already takes vildagliptin and metformin as separate tablets and one combined is more convenient
• Additional control is needed alongside a sulfonylurea or insulin, under close medical supervision

It is not used in type 1 diabetes or diabetic ketoacidosis. Suitability depends on your kidney and liver function, so blood tests are usually done before your doctor prescribes it.

Vildagliptin + Metformin Hydrochloride is usually taken twice daily — morning and evening — with or just after meals, which reduces the stomach upset caused by metformin. The strength is selected by your doctor according to your current treatment, kidney function and liver tests; never choose or change the strength yourself.

• Swallow the whole with water; do not crush or chew.
• If you miss a dose, take it with your next meal; if it is nearly time for the next dose, skip the missed one — never double up.
• Liver and kidney tests may be repeated during treatment; attend them as advised, and never stop the medicine on your own.

Common side effects include nausea, vomiting, diarrhoea, stomach discomfort, loss of appetite and a metallic taste — mainly from metformin, usually settling within the first weeks. Vildagliptin may cause dizziness, headache or mild tremor. Other possible effects:

• Low blood sugar when used with a sulfonylurea or insulin
• Vitamin B12 deficiency with long-term metformin use
• Skin rash, itching or small blisters — report these to your doctor

Rare but serious: liver inflammation (yellow eyes or skin, dark urine, unusual tiredness, upper-right abdominal pain), pancreatitis (severe persistent stomach pain) and lactic acidosis (unusual muscle pain, rapid breathing, severe weakness, feeling cold). Stop the medicine and seek urgent medical care if these occur.

Important precautions with Vildagliptin + Metformin Hydrochloride:

• Liver tests are advised before starting and periodically during treatment, because vildagliptin can rarely affect the liver. Report yellowing of eyes or skin, dark urine or unusual fatigue immediately.
• Kidney tests are needed before and during treatment; metformin accumulates if kidneys weaken.
• During vomiting, diarrhoea, fever or dehydration, and before contrast-dye scans or major surgery, contact your doctor — the medicine may be paused temporarily.
• Avoid heavy alcohol use, and keep glucose handy if you also take insulin or a sulfonylurea.

Continue your diet and exercise plan, and never stop Vildagliptin + Metformin Hydrochloride on your own even when you feel well.

Inform your doctor and pharmacist of every medicine you take, including herbal and over-the-counter products. Key interactions of Vildagliptin + Metformin Hydrochloride:

• Alcohol — raises the risk of lactic acidosis and low blood sugar; avoid heavy drinking.
• Iodinated contrast dye for CT scans or angiograms — the medicine is usually paused around the procedure.
• Medicines that affect the kidneys — NSAID painkillers, diuretics, ACE inhibitors and ARBs — may need monitoring.
• Insulin and sulfonylureas — greater risk of hypoglycaemia; doses may be adjusted.
• Steroids, thyroid hormones and some diuretics can raise blood sugar and weaken the effect, so control may need re-checking.

Do not take Vildagliptin + Metformin Hydrochloride if you have:

• Allergy to vildagliptin, metformin or any other ingredient
• Liver disease or significantly raised liver enzymes before treatment
• Severely reduced kidney function or are on dialysis
• Metabolic acidosis, including diabetic ketoacidosis
• Severe dehydration, severe infection, shock, or conditions causing low tissue oxygen such as recent heart attack, uncontrolled heart failure or severe breathing problems
• Alcohol dependence or acute alcohol intoxication

Vildagliptin + Metformin Hydrochloride is not used in type 1 diabetes. Your doctor will choose an alternative if any of these apply.

Vildagliptin + Metformin Hydrochloride is not recommended during pregnancy. Pregnant women with diabetes are usually treated with insulin, which offers precise control and the best-documented safety for the baby. If you become pregnant or plan to conceive while on Vildagliptin + Metformin Hydrochloride, inform your doctor promptly so your treatment can be changed safely — do not stop diabetes treatment abruptly, because high blood sugar also harms the baby.

Metformin passes into breast milk in small amounts and data on vildagliptin are lacking, so this combination is generally avoided while breastfeeding unless your doctor decides otherwise after weighing the benefits and risks.

Store Vildagliptin + Metformin Hydrochloride below 30°C in a cool, dry place, protected from direct sunlight and moisture. Keep the in its original blister or container until use, and avoid humid places such as the bathroom or kitchen.

• Keep all medicines out of the reach and sight of children.
• Do not use the medicine after the expiry date printed on the pack.
• Do not throw unused medicine into household waste or drains; ask your pharmacist about safe disposal.