Emfogen M XR 25 mg+1000 mg (Tablet (Extended Release))
Unit Price: ৳ 45.00 (2 x 6: ৳ 540.00)
Strip Price: ৳ 270.00
Medicine Details
| Category | Details |
|---|---|
| Generic | Empagliflozin metformin hydrochloride |
| Company | General pharmaceuticals ltd |
| Also available as |
Indications
- Treatment of adults with type 2 diabetes mellitus as an adjunct to diet and exercise
- Insufficiently controlled on maximally tolerated dose of Metformin alone
- In combination with other medicinal products for diabetes treatment
- 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)
- Reduces renal reabsorption of filtered glucose and lowers the renal threshold for glucose
- Metformin Hydrochloride is a biguanide type oral antihyperglycemic drug
- Lowers basal and postprandial plasma glucose without producing hypoglycemia
Dosage & Administration
- Should be individualized based on effectiveness and tolerability
- Take this combination twice daily with meals
- Gradual dose escalation to reduce gastrointestinal side effects
- Extended-release formulations available
- Adjust dosing based on effectiveness and tolerability
- Assess renal function before initiating this combination
Interaction
- Co-administration of Empagliflozin with diuretics increases urine volume and frequency of voids
- Risk for hypoglycemia with insulin or insulin secretagogues
- Monitoring glycemic control with urine glucose tests is not recommended
- Drugs that reduce Metformin clearance may increase the accumulation of Metformin
- Carbonic Anhydrase Inhibitors may increase risk of lactic acidosis
- Alcohol can potentiate the effect of Metformin on lactate metabolism
Contraindications
- Hypersensitivity to Empagliflozin and Metformin
- Acute metabolic acidosis (e.g., lactic acidosis, diabetic ketoacidosis)
- Severe renal failure (GFR <30 ml/min)
- Conditions such as dehydration, severe infection, shock
- Diseases causing tissue hypoxia (e.g., decompensated heart failure, respiratory failure)
Side Effects
- Most common adverse reactions associated with Empagliflozin and Metformin
- Common adverse reactions with Metformin: diarrhea, nausea/vomiting, flatulence, abdominal discomfort
- Important adverse reactions: hypoglycemia, genital infections, urinary tract infection, thirst, taste disturbance
- Rare adverse reaction: diabetic ketoacidosis
Pregnancy & Lactation
- Potential risk to fetus, especially during second and third trimesters
- Not recommended during breastfeeding
Precautions & Warnings
- Lactic Acidosis is a potential risk
- Assess and correct volume status before initiating therapy
- Assess patients with signs and symptoms of metabolic acidosis for ketoacidosis
- Consider temporarily discontinuing in settings of reduced oral intake or fluid losses
- Increased risk for urinary tract infections and genital mycotic infections
- Consider lowering the dose of insulin secretagogue or insulin to reduce the risk of hypoglycemia
Overdose Effects
- Single doses of up to 800 mg Empagliflozin in healthy volunteers did not show toxicity
- Hypoglycemia not seen with Metformin doses of up to 85 g, although lactic acidosis has occurred in such circumstances
- Lactic acidosis is a medical emergency and must be treated in hospital
- Haemodialysis is the most effective method to remove lactate and Metformin
Therapeutic Class
- Combination Oral hypoglycemic preparations
Storage Conditions
- Keep below 30°C temperature
- Protected from light & moisture
- Keep out of the reach of children