Medicine Information

Diampa-M

Name: Diampa-M
Brand: Diampa-M
Rating: 4.5 (117 reviews)

TabletDapagliflozin 5 mg & Metformin Hydrochloride 500 mgOral AntidiabeticATC: A10BD15

Generic Name

Dapagliflozin & Metformin Hydrochloride

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
diampa m 5 mg tablet	৳ 18.00	৳ 108.00

Description

Overview of the medicine

Diampa-M 5 mg Tablet is a combination oral antidiabetic medicine containing Dapagliflozin and Metformin Hydrochloride, used to improve glycemic control in adults with type 2 diabetes mellitus.

Uses & Indications

Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

To reduce the risk of cardiovascular death and hospitalization for heart failure in adults with type 2 diabetes mellitus and established cardiovascular disease or multiple cardiovascular risk factors.

To reduce the risk of kidney function decline, ESRD, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes mellitus and chronic kidney disease.

Dosage

Adults

Initial dose: 5 mg Dapagliflozin/500 mg Metformin once daily. May be titrated up to a maximum of 10 mg Dapagliflozin/2000 mg Metformin daily, taken twice daily.

Elderly

Dosage should be individualized based on renal function. Initiate with lower doses and titrate carefully.

Renal_impairment

Not recommended for initiation in patients with eGFR <45 mL/min/1.73 m². Discontinue if eGFR persistently falls below 30 mL/min/1.73 m². Metformin is contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²).

How to Take

Take orally, once or twice daily with meals to reduce gastrointestinal side effects of Metformin.

Mechanism of Action

Dapagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, which reduces renal glucose reabsorption and increases urinary glucose excretion. Metformin is a biguanide that decreases hepatic glucose production, decreases intestinal glucose absorption, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.

Pharmacokinetics

Onset

Within hours for both components.

Excretion

Dapagliflozin: primarily renal (75% urinary, 21% fecal). Metformin: renal excretion, primarily tubular secretion.

Half life

Dapagliflozin: approximately 12.9 hours. Metformin: approximately 6.2 hours.

Absorption

Dapagliflozin is rapidly absorbed with peak plasma concentrations occurring within 2 hours. Metformin has an absolute bioavailability of 50-60%, with peak plasma concentrations reached in 2.5 hours.

Metabolism

Dapagliflozin is metabolized mainly by UGT1A9 to an inactive metabolite. Metformin is excreted unchanged in the urine.

Side Effects

Contraindications

Severe renal impairment (eGFR <30 mL/min/1.73 m²), end-stage renal disease (ESRD), or dialysis.
Metabolic acidosis, including diabetic ketoacidosis, acute or chronic, with or without coma.
Hypersensitivity to dapagliflozin, metformin, or any component of the formulation.

Drug Interactions

Loop Diuretics

May increase risk of dehydration and hypotension with Dapagliflozin.

Contrast Agents

Temporarily discontinue Metformin at time of or prior to iodinated contrast imaging procedures.

Insulin and Insulin Secretagogues

Increased risk of hypoglycemia with Dapagliflozin & Metformin.

Topiramate, Zonisamide, Acetazolamide, or Carbonic Anhydrase Inhibitors

May increase risk of lactic acidosis with Metformin.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

In case of overdose, discontinue Diampa-M and initiate appropriate supportive treatment. Hemodialysis can be used to remove metformin.

Pregnancy & Lactation

Not recommended during the second and third trimesters of pregnancy due to potential fetal renal dysfunction. Metformin is excreted in breast milk; advise caution during lactation.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets30 tablets

Shelf Life

24 months

Availability

Pharmacies, Hospitals

Approval Status

FDA approved

Patent Status

Off-patent (Metformin), Patented (Dapagliflozin, but expiring)

Clinical Trials

Extensive clinical trials (e.g., DECLARE-TIMI 58 for cardiovascular outcomes of dapagliflozin, UKPDS for metformin) have demonstrated the efficacy and safety of dapagliflozin and metformin, both individually and in combination, in managing type 2 diabetes and associated cardiovascular/renal risks.

Lab Monitoring

Renal function (eGFR) prior to initiation and annually thereafter
Glycemic control (HbA1c, fasting plasma glucose)
Vitamin B12 levels (long-term Metformin use)

Doctor Notes

Emphasize patient education on hydration and signs of DKA/lactic acidosis.
Monitor renal function closely, especially in elderly or patients with comorbidities.
Consider Vitamin B12 supplementation for long-term Metformin users.

Patient Guidelines

Take with food to minimize stomach upset.
Stay hydrated to reduce the risk of dehydration.
Monitor blood glucose regularly as advised by your doctor.
Report any signs of serious side effects like lactic acidosis or DKA immediately.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.

Driving Precautions

Caution is advised if dizziness or hypoglycemia occurs, especially when used with insulin or sulfonylurea. Avoid driving or operating machinery if you experience these symptoms.