Emfogen M 12.5 mg+500 mg (Tablet)
Unit Price: ৳ 28.00 (2 x 10: ৳ 560.00)
Strip Price: ৳ 280.00
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
- In patients insufficiently controlled on their maximally tolerated dose of Metformin alone
- In combination with other medicinal products for the treatment of diabetes
- In patients 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
- Lowers renal threshold for glucose
- Increases urinary glucose excretion
- Metformin Hydrochloride is a biguanide type 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 by increasing peripheral glucose uptake and utilization
Dosage & Administration
- Individualized dosage based on effectiveness and tolerability
- Take the combination twice daily with meals
- Dose escalation should be gradual to reduce gastrointestinal side effects
- Maximum recommended daily dose of Metformin Hydrochloride is 2000 mg and Empagliflozin is 25 mg
- Extended-release formulations available with individualized starting dose based on the patient’s current drug regimen
- Renal impaired patient assessment before initiating
- Safety and effectiveness not established in pediatric patients under 18 years of age
Interaction
- Diuretics
- Insulin or Insulin Secretagogues
- Positive Urine Glucose Test
- Drugs that Reduce Metformin Clearance
- Carbonic Anhydrase Inhibitors
- Drugs Affecting Glycemic Control
- Alcohol
Contraindications
- Hypersensitivity to Empagliflozin and Metformin
- Acute metabolic acidosis
- Diabetic pre-coma
- Severe renal failure (GFR <30 ml/min)
- Conditions altering renal function
- Tissue hypoxia-related diseases
- 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
- Gastrointestinal symptoms
- Vaginal moniliasis
- Vulvovaginitis
- Balanitis and other genital infection
- Thirst
- Taste disturbance
- Pruritus
- Rash
- Increased urination
- Increased serum lipids
- Volume depletion
- Urticaria
- Dysuria
- Increased blood creatinine/Glomerular filtration rate
- Increased haematocrit
- Diabetic ketoacidosis
Pregnancy & Lactation
- Potential risk to fetus especially during second and third trimesters
- Not recommended during breastfeeding
Precautions & Warnings
- Lactic Acidosis
- Hypotension
- Ketoacidosis
- Acute kidney injury & impairment in renal function
- Urosepsis, Pyelonephritis, Fournier's gangrene & Genital mycotic infections
- Hypoglycemia
- Vitamin B12 Deficiency
- Increased LDL-C
- Macrovascular Outcomes
Overdose Effects
- No toxicity seen at high Empagliflozin doses in studies
- No hypoglycemia seen with Metformin at high doses
- Lactic acidosis is a medical emergency and must be treated in a hospital setting
- Most effective method to remove lactate and Metformin is haemodialysis
- No study on removal of Empagliflozin by haemodialysis
Therapeutic Class
- Combination Oral hypoglycemic preparations
Storage Conditions
- Keep below 30°C temperature
- Protected from light & moisture
- Keep out of the reach of children