Bontiv
Generic Name
Teneligliptin 20 mg + Metformin Hydrochloride 750 mg (Extended Release)
Manufacturer
Eris Lifesciences
Country
India
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| bontiv 750 mg tablet | ৳ 12.00 | ৳ 48.00 |
Description
Overview of the medicine
Bontiv 750 mg Tablet is a combination medicine used to treat type 2 diabetes mellitus in adults. It helps to control high blood sugar levels by increasing insulin release, decreasing sugar production by the liver, and decreasing glucose absorption from the intestines. It should be used in conjunction with diet and exercise.
Uses & Indications
Dosage
Adults
The usual recommended dose is one tablet (Teneligliptin 20 mg + Metformin Hydrochloride 750 mg ER) orally once daily with the evening meal. Do not crush, chew, or break the tablet.
Elderly
No specific dose adjustment is required based on age alone, but renal function should be monitored closely as elderly patients are more likely to have decreased renal function.
Renal_impairment
Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²). Dose adjustments are needed for moderate renal impairment (eGFR 30-59 mL/min/1.73 m²). Consult a physician.
How to Take
Take orally, once daily with the evening meal. Swallow the tablet whole; do not crush, chew, or break it.
Mechanism of Action
Teneligliptin selectively inhibits the enzyme Dipeptidyl Peptidase-4 (DPP-4), leading to an increase in active incretin hormones (GLP-1 and GIP). These hormones enhance glucose-dependent insulin secretion and suppress glucagon secretion. Metformin, a biguanide, primarily reduces hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Glycemic effects observed within hours of first dose; full therapeutic effects seen after several days to weeks.
Excretion
Teneligliptin is excreted via both renal (approx. 30%) and hepatic pathways. Metformin is excreted primarily unchanged in the urine (approx. 90% within 24 hours).
Half life
Teneligliptin has an effective half-life of approximately 24 hours. Metformin has an elimination half-life of about 6.2 hours.
Absorption
Teneligliptin is rapidly absorbed with a peak plasma concentration (Tmax) of 1-2 hours. Metformin ER has a slower and more prolonged absorption, reaching Tmax in 4-8 hours.
Metabolism
Teneligliptin undergoes limited metabolism, primarily by CYP3A4 and flavin-containing monooxygenase (FMO1 and FMO3). Metformin is negligibly metabolized.
Side Effects
Contraindications
- Hypersensitivity to Teneligliptin, Metformin, or any excipients.
- Severe renal impairment (eGFR <30 mL/min/1.73 m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- Conditions such as dehydration, severe infection, shock, which may cause renal dysfunction.
- Acute or chronic disease which may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction).
Drug Interactions
Alcohol
Potentiates the effect of Metformin on lactate metabolism, increasing the risk of lactic acidosis.
Iodinated Contrast Media
Temporarily discontinue Metformin before or at the time of an iodinated contrast imaging procedure in patients with eGFR between 30 and 60 mL/min/1.73 m², those with a history of liver disease, alcoholism, or heart failure, or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the procedure; restart Metformin only if renal function is stable.
Carbonic Anhydrase Inhibitors (e.g., Topiramate, Acetazolamide)
May increase the risk of lactic acidosis.
Cationic Drugs (e.g., Cimetidine, Amiloride, Digoxin, Morphin, Procainamide, Quinidine, Quinine, Ranitidine, Triamterene, Trimethoprim, Vancomycin)
May increase Metformin accumulation by competing for renal tubular transport.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose of Metformin can lead to lactic acidosis, which is a medical emergency. Overdose of Teneligliptin alone is unlikely to cause severe effects. Management of overdose is primarily supportive, including general measures to remove unabsorbed drug from the GI tract and clinical monitoring. Hemodialysis is the most effective means of removing Metformin from blood.
Pregnancy & Lactation
Not recommended during pregnancy unless clearly necessary, as there are no adequate and well-controlled studies in pregnant women. Metformin is excreted in human milk; the effects of Teneligliptin on breastfed infants are unknown. Consult a physician to weigh benefits against risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Approved in many countries
Patent Status
Generic versions available
Clinical Trials
Various clinical trials have demonstrated the efficacy and safety of Teneligliptin and Metformin combination therapy in patients with type 2 diabetes, showing significant reductions in HbA1c and improved glycemic control.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating Bontiv 750 mg Tablet and at least annually thereafter. More frequent monitoring may be needed in patients at risk of renal impairment (e.g., elderly).
- HbA1c levels to assess long-term glycemic control.
- Blood glucose levels (fasting and post-prandial).
- Hematologic parameters (e.g., Vitamin B12 levels) in patients on long-term Metformin therapy.
Doctor Notes
- Assess renal function (eGFR) before initiating and regularly during treatment, especially in elderly patients or those at risk of renal impairment. Adjust dose or discontinue based on eGFR.
- Counsel patients on the risk of lactic acidosis, especially regarding alcohol intake and intercurrent illnesses.
- Monitor for symptoms of B12 deficiency with long-term Metformin use.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking this medicine without consulting your doctor, even if you feel better.
- Maintain a balanced diet and regular exercise as advised by your healthcare provider.
- Monitor your blood sugar levels regularly as instructed.
- Inform your doctor about all other medicines you are taking, including over-the-counter drugs and herbal supplements.
- Seek immediate medical attention if you experience symptoms of lactic acidosis (e.g., unusual muscle pain, difficulty breathing, unusual drowsiness, stomach pain).
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Bontiv 750 mg Tablet generally does not cause hypoglycemia when used alone, so it usually does not affect the ability to drive or operate machinery. However, if used in combination with other antidiabetic agents that can cause hypoglycemia (e.g., insulin, sulfonylureas), patients should be cautious about driving or operating machinery.
Lifestyle Advice
- Follow a diabetes-friendly diet low in refined sugars and saturated fats.
- Engage in regular physical activity, aiming for at least 30 minutes of moderate-intensity exercise most days of the week.
- Maintain a healthy weight.
- Limit alcohol consumption to reduce the risk of lactic acidosis.
- Quit smoking if you smoke.
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