Glinta-Plus
Generic Name
glinta-plus-10-mg-tablet
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| glinta plus 10 mg tablet | ৳ 30.00 | ৳ 300.00 |
Description
Overview of the medicine
Glinta-Plus is a brand name typically referring to a fixed-dose combination of Vildagliptin and Metformin Hydrochloride, used to improve glycemic control in adults with type 2 diabetes mellitus. While the drug ID specifies '10 mg', common formulations usually contain Vildagliptin 50 mg combined with Metformin 500 mg, 850 mg, or 1000 mg. It works by complementary mechanisms to reduce blood glucose.
Uses & Indications
Dosage
Adults
The typical daily dose is Vildagliptin 50 mg/Metformin 500 mg, 50 mg/850 mg, or 50 mg/1000 mg twice daily, depending on individual patient's current Metformin dose and tolerability. As the '10 mg' in this specific ID is atypical for this combination, consult physician for exact dosage based on actual drug components.
Elderly
No dose adjustment is generally required for Vildagliptin based on age. For Metformin, dosage should be carefully titrated to identify the minimum effective dose, monitoring renal function regularly.
Renal_impairment
Contraindicated if eGFR <30 mL/min/1.73m². Dose adjustment may be necessary for eGFR 30-59 mL/min/1.73m² (e.g., maximum Metformin 1000 mg/day, Vildagliptin 50 mg once daily).
How to Take
Take orally, generally twice daily with meals to reduce gastrointestinal side effects associated with Metformin. Do not crush or chew the tablet.
Mechanism of Action
Vildagliptin (a DPP-4 inhibitor) prevents the degradation of incretin hormones (GLP-1 and GIP), enhancing their glucose-dependent stimulation of insulin release from beta cells and decreasing glucagon secretion from alpha cells. 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
Vildagliptin's DPP-4 inhibition is rapid, with effects on incretin hormones seen quickly. Metformin's glucose-lowering effects typically develop over days to weeks.
Excretion
Vildagliptin: Primarily renal (85%). Metformin: Primarily renal.
Half life
Vildagliptin: ~3 hours. Metformin: ~6.2 hours (plasma elimination), ~17.6 hours (blood).
Absorption
Vildagliptin is rapidly absorbed (Tmax 1-2 hours) with oral bioavailability of ~85%. Metformin's oral bioavailability is 50-60% (Tmax 2-3 hours). Food delays Vildagliptin Tmax slightly but does not affect AUC. For Metformin, food slightly decreases and delays absorption.
Metabolism
Vildagliptin: Primarily hydrolyzed by carboxylesterase 1 (85%) to an inactive metabolite. Metformin: Not metabolized; excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to Vildagliptin, Metformin, or any excipients.
- Renal impairment (eGFR <30 mL/min/1.73m²).
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis.
- Acute conditions with potential to alter renal function (e.g., 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
Increases the risk of lactic acidosis (Metformin).
ACE inhibitors, NSAIDs, ARBs
May increase risk of renal dysfunction with Metformin, increasing lactic acidosis risk.
Cationic drugs (e.g., Cimetidine, Amiloride)
May increase Metformin concentrations.
Glucocorticoids, sympathomimetics, diuretics, thyroid hormones
May decrease glycemic control.
Storage
Store below 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
Overdose of Vildagliptin typically results in mild, transient gastrointestinal disturbances. Metformin overdose can lead to lactic acidosis, which is a medical emergency requiring hospitalization, supportive measures, and hemodialysis for severe cases.
Pregnancy & Lactation
Not recommended during pregnancy or lactation. Metformin crosses the placenta and is excreted in breast milk. Vildagliptin has shown fetotoxic effects in animals. Consult a doctor for alternative treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date, varies by specific formulation and manufacturer.
Availability
Available in pharmacies worldwide
Approval Status
Approved by regulatory bodies for Type 2 Diabetes treatment
Patent Status
Patents may vary by region and formulation; generics available in many markets
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Vildagliptin and Metformin combination in improving glycemic control in type 2 diabetes.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating treatment and at least annually thereafter.
- Liver function tests (ALT, AST) should be performed before initiation and periodically during treatment.
- Vitamin B12 levels (long-term Metformin use can lead to deficiency).
- HbA1c to monitor glycemic control.
Doctor Notes
- Counsel patients on lifestyle modifications (diet, exercise) as cornerstone of diabetes management.
- Monitor renal function carefully, especially in elderly patients and those at risk for renal impairment.
- Educate patients on symptoms of hypoglycemia and lactic acidosis and when to seek immediate medical attention.
- Consider temporary discontinuation of Metformin in situations of acute illness, dehydration, or procedures involving iodinated contrast agents.
Patient Guidelines
- Take this medicine regularly as prescribed by your doctor.
- Do not stop taking it without consulting your doctor.
- Follow diet and exercise recommendations provided by your healthcare provider.
- Be aware of the symptoms of hypoglycemia (e.g., sweating, trembling, confusion) and know how to manage it.
- Report any unusual or severe side effects, especially symptoms of lactic acidosis (e.g., severe tiredness, muscle pain, breathing difficulties).
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine is unlikely to affect your ability to drive or operate machinery. However, if you experience symptoms like dizziness or hypoglycemia, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet low in sugar and refined carbohydrates.
- Engage in regular physical activity.
- Monitor blood glucose levels regularly as advised.
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