Emjard-M-XR
Generic Name
Empagliflozin 25 mg and Metformin Hydrochloride Extended-Release Tablet
Manufacturer
Local Pharmaceutical Co.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| emjard m xr 25 mg tablet | ৳ 50.00 | ৳ 200.00 |
Description
Overview of the medicine
Emjard-M-XR is a combination oral antidiabetic medicine containing Empagliflozin and Metformin HCl extended-release. It is used to improve glycemic control in adults with Type 2 Diabetes Mellitus, along with diet and exercise. Empagliflozin also helps reduce the risk of cardiovascular death in adults with Type 2 Diabetes Mellitus and established cardiovascular disease.
Uses & Indications
Dosage
Adults
The usual starting dose is Empagliflozin 5 mg / Metformin HCl XR 500 mg or 1000 mg once daily, with the morning meal. The dose can be titrated based on efficacy and tolerability, up to a maximum of Empagliflozin 25 mg / Metformin HCl XR 2000 mg daily.
Elderly
Careful monitoring of renal function is recommended. Dose adjustments may be necessary based on renal function.
Renal_impairment
Not recommended for patients with eGFR < 30 mL/min/1.73m². Dose adjustments needed for eGFR 30-60 mL/min/1.73m².
How to Take
Take orally, once daily, with the morning meal. Swallow the tablet whole. Do not crush, cut, or chew the tablet.
Mechanism of Action
Empagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor that reduces renal glucose reabsorption, leading to increased urinary glucose excretion. Metformin is a biguanide that decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Glycemic effect usually within hours.
Excretion
Empagliflozin: Excreted renally (approx. 50%) and hepatically/biliary. Metformin: Excreted renally unchanged.
Half life
Empagliflozin: Approximately 12.4 hours. Metformin XR: Approximately 17 hours.
Absorption
Empagliflozin: Rapidly absorbed with peak plasma concentrations (Tmax) around 1.5 hours. Metformin XR: Slower absorption with Tmax around 7 hours.
Metabolism
Empagliflozin: Primarily metabolized by glucuronidation. Metformin: Not metabolized; excreted unchanged.
Side Effects
Contraindications
- •Severe renal impairment (eGFR < 30 mL/min/1.73m²), end-stage renal disease, or dialysis.
- •Metabolic acidosis, including diabetic ketoacidosis, with or without coma.
- •Hypersensitivity to empagliflozin, metformin, or any component of the formulation.
Drug Interactions
Lithium
SGLT2 inhibitors may decrease serum lithium concentrations, requiring monitoring.
Contrast agents (iodinated)
Temporarily discontinue metformin at the time of or prior to an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73m², patients with a history of liver disease, alcoholism, or heart failure, or patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure and restart metformin if renal function is stable.
Diuretics (e.g., loop or thiazide diuretics)
May increase the risk of dehydration and hypotension with empagliflozin.
Insulin or insulin secretagogues (e.g., sulfonylureas)
May increase the risk of hypoglycemia when used with empagliflozin. A lower dose of insulin or sulfonylurea may be required.
Carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide)
May increase the risk of lactic acidosis.
Drugs that affect renal function or metformin disposition (e.g., NSAIDs, ACE inhibitors, ARBs)
May increase the 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, supportive treatment should be initiated. Empagliflozin: Limited data, but increased urinary glucose excretion is expected. Metformin: Lactic acidosis may occur. Hemodialysis can be useful for removing metformin.
Pregnancy & Lactation
Not recommended during the second and third trimesters of pregnancy due to potential adverse renal developmental effects. It is also not recommended during lactation, as metformin is excreted in human milk, and it is unknown if empagliflozin is excreted.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Patent-protected for original formulation, generic versions may exist.
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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