Formet-V
Generic Name
Vildagliptin + Metformin Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| formet v 50 mg tablet | ৳ 22.00 | ৳ 220.00 |
Description
Overview of the medicine
Formet-V 50 mg tablet is a combination medication containing Vildagliptin and Metformin, used to improve glycemic control in adults with type 2 diabetes mellitus. Vildagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, and Metformin is a biguanide. This combination is typically used when diet, exercise, and either Vildagliptin or Metformin alone do not provide adequate glycemic control.
Uses & Indications
Dosage
Adults
The usual starting dose is one tablet containing Vildagliptin 50 mg + Metformin 500 mg, taken twice daily, with or after meals. The dose can be titrated based on efficacy and tolerability, up to a maximum of Vildagliptin 100 mg/day (e.g., 50 mg twice daily) and Metformin 2000 mg/day (e.g., 1000 mg twice daily).
Elderly
No specific dose adjustment is required based on age alone. However, renal function should be monitored, and dose adjustments made based on renal impairment status.
Renal_impairment
Contraindicated in severe renal impairment (eGFR <30 mL/min). Dose adjustment is necessary for moderate renal impairment (eGFR 30-59 mL/min), with reduced Metformin dose and careful monitoring.
How to Take
Take orally, generally twice daily, with or immediately after meals to reduce gastrointestinal side effects associated with Metformin. Swallow the tablet whole with water.
Mechanism of Action
Vildagliptin works by inhibiting the enzyme DPP-4, which leads to increased levels of active incretin hormones (GLP-1 and GIP). These hormones enhance glucose-dependent insulin secretion from pancreatic beta cells and reduce glucagon secretion from alpha cells. Metformin primarily works by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Vildagliptin: Rapid onset, within hours. Metformin: Glycemic effects develop gradually over several days to weeks.
Excretion
Vildagliptin: Approximately 85% excreted renally, with the remainder via feces. Metformin: Primarily excreted unchanged in the urine.
Half life
Vildagliptin: Approximately 3 hours. Metformin: Approximately 4-9 hours.
Absorption
Vildagliptin is rapidly absorbed with an absolute oral bioavailability of 85%. Metformin has an absolute oral bioavailability of 50-60%. Absorption of Metformin is incomplete and saturable.
Metabolism
Vildagliptin: Major pathway is hydrolysis, with minimal involvement of CYP450 enzymes. Metformin: Excreted unchanged; not metabolized by the liver.
Side Effects
Contraindications
- •Hypersensitivity to Vildagliptin or Metformin or any excipients.
- •Severe renal impairment (eGFR <30 mL/min/1.73 m²).
- •Acute or chronic metabolic acidosis, including diabetic ketoacidosis.
- •Acute conditions with potential for renal function impairment such as dehydration, severe infection, shock.
- •Acute or chronic disease which may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock).
- •Hepatic impairment.
- •Acute alcohol intoxication, alcoholism.
Drug Interactions
Alcohol
Potentiates Metformin's effect on lactate metabolism, increasing the risk of lactic acidosis.
Iodinated contrast agents
Risk of acute renal failure leading to lactic acidosis with Metformin; discontinue Metformin before or at the time of procedure and restart 48 hours after, provided renal function is stable.
Cationic drugs (e.g., Cimetidine, Furosemide, Amiloride, Digoxin, Morphine, Procainamide, Quinidine, Ranitidine, Triamterene, Trimethoprim, Vancomycin)
May increase Metformin concentrations by competing for renal tubular transport systems.
Glucocorticoids, sympathomimetics, diuretics, thyroid products, phenothiazines, estrogens, oral contraceptives, phenytoin, nicotinic acid, calcium channel blockers, isoniazid
May cause hyperglycemia, requiring blood glucose monitoring and potential Metformin dose adjustment.
Storage
Store in a cool, dry place below 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
Overdose of Metformin can lead to lactic acidosis, which requires immediate medical attention. Overdose of Vildagliptin may lead to mild, transient gastrointestinal symptoms. Management involves supportive measures and, for Metformin overdose, hemodialysis to remove Metformin.
Pregnancy & Lactation
Not recommended during pregnancy due to insufficient data and potential risks. Advise women to discontinue if pregnancy is planned or occurs. It is not known if Vildagliptin or Metformin is excreted in human milk; therefore, Formet-V is not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Approved in various countries for Type 2 Diabetes Mellitus
Patent Status
Generic versions available; original patents for components have expired in many regions.
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Global Brand Names
International brand names for this medicine
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