Emfogen M XR 5 mg+1000 mg (Tablet (Extended Release))
Unit Price: ৳ 20.00 (2 x 6: ৳ 240.00)
Strip Price: ৳ 120.00
Medicine Details
| Category | Details |
|---|---|
| Generic | Empagliflozin metformin hydrochloride |
| Company | General pharmaceuticals ltd |
| Also available as |
Indications
- treatment of adults with type 2 diabetes mellitus
- adjunct to diet and exercise
Mode of Action
- inhibitor of Sodium-Glucose Co-Transporter 2 (SGLT2)
- reduces renal reabsorption of glucose
- lowers renal threshold for glucose
- increases urinary glucose excretion
- oral antihyperglycemic drug
- lowers basal and postprandial plasma glucose
- does not produce hypoglycemia
- decreases hepatic glucose production
- decreases intestinal absorption of glucose
- improves insulin sensitivity
- increases peripheral glucose uptake and utilization
Dosage & Administration
- individualized based on effectiveness and tolerability
- take twice daily with meals
- dose escalation should be gradual
- maximum recommended daily dose of Metformin Hydrochloride: 2000 mg, Empagliflozin: 25 mg
- extended-release formulations available
- renal function assessment required before initiation
- contraindicated in patients with eGFR below 45 mL/min/1.73 m2
- not established for pediatric patients under 18 years of age
Interaction
- with diuretics may increase urine volume and frequency of voids
- with insulin or insulin secretagogues increases risk for hypoglycemia
- monitoring glycemic control with urine glucose tests not recommended
- drugs that reduce Metformin clearance may increase its accumulation
- carbonic anhydrase inhibitors may increase risk of lactic acidosis
- drugs affecting glycemic control should be closely observed
- alcohol can potentiate the effect of Metformin on lactate metabolism
Contraindications
- hypersensitivity to Empagliflozin and Metformin
- acute metabolic acidosis
- diabetic pre-coma
- severe renal failure (GFR <30 ml/min)
- conditions altering renal function
- disease causing tissue hypoxia
- hepatic impairment
- acute alcohol intoxication
- alcoholism
Side Effects
- urinary tract infection
- female genital mycotic infections
- diarrhea
- nausea/vomiting
- flatulence
- abdominal discomfort
- indigestion
- asthenia
- headache
- hypoglycemia
- vaginal moniliasis
- vulvovaginitis
- balanitis
- urinary tract infection
- thirst
- taste disturbance
- pruritus
- rash
- increased urination
- serum lipids increased
- volume depletion
- urticaria
- dysuria
- blood creatinine increased
- glomerular filtration rate decreased
- haematocrit increased
- diabetic ketoacidosis
Pregnancy & Lactation
- advised females of potential risk to fetus during second and third trimesters
- not recommended during breastfeeding
Precautions & Warnings
- lactic acidosis reported in postmarketing cases
- hypotension risk in certain patient groups
- ketoacidosis assessment required before initiation
- consider temporary discontinuation in settings of reduced oral intake or fluid losses
- increased risk for urinary tract infections
- consider dose adjustment to reduce risk of hypoglycemia
- Metformin Hydrochloride may lower vitamin B12 levels
- monitor and treat increased LDL-C as appropriate
- no conclusive evidence of macrovascular risk reduction
Overdose Effects
- Empagliflozin did not show any toxicity in controlled clinical studies
- Metformin overdose may lead to lactic acidosis
- treatment should be initiated based on patient's clinical status
- haemodialysis may be effective for Metformin removal
Therapeutic Class
- Combination Oral hypoglycemic preparations
Storage Conditions
- keep below 30°C temperature
- protected from light & moisture
- keep out of the reach of children