Remmo
Generic Name
Remogliflozin Etabonate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| remmo 20 mg tablet | ৳ 10.00 | ৳ 150.00 |
Description
Overview of the medicine
Remogliflozin Etabonate is an oral antidiabetic drug used to improve glycemic control in adults with type 2 diabetes mellitus. It belongs to the SGLT2 inhibitor class, which helps to lower blood glucose levels by increasing glucose excretion in the urine.
Uses & Indications
Dosage
Adults
The recommended initial dose is 20 mg once daily, taken orally. The dose may be increased to 100 mg once daily based on individual patient response and tolerability.
Elderly
No specific dose adjustment is required based on age alone. However, renal function should be monitored regularly as elderly patients may have reduced renal function.
Renal_impairment
Not recommended for patients with severe renal impairment (eGFR < 30 mL/min/1.73m²), end-stage renal disease, or those on dialysis. For moderate renal impairment (eGFR 30-60 mL/min/1.73m²), caution is advised, and close monitoring is necessary.
How to Take
Remmo 20 mg Tablet should be taken orally, once daily, with or without food. It is recommended to take the tablet at approximately the same time each day.
Mechanism of Action
Remogliflozin Etabonate works by selectively inhibiting the Sodium-Glucose Co-transporter 2 (SGLT2) in the renal tubules. This inhibition reduces the reabsorption of glucose from the glomerular filtrate back into the blood, leading to increased urinary glucose excretion and a reduction in blood glucose levels.
Pharmacokinetics
Onset
Glycemic effects typically observed within hours of administration and are sustained over 24 hours with once-daily dosing.
Excretion
Excreted predominantly via urine (as metabolites) and a lesser extent via feces. Approximately 75-80% of the dose is recovered in urine and 10-20% in feces.
Half life
The terminal elimination half-life of remogliflozin is approximately 2-4 hours.
Absorption
Rapidly absorbed after oral administration. Remogliflozin etabonate is a pro-drug, rapidly hydrolyzed to the active compound remogliflozin. Peak plasma concentrations (Tmax) of remogliflozin are generally reached within 1-2 hours.
Metabolism
Remogliflozin is primarily metabolized by uridine diphosphate glucuronosyltransferase (UGT1A9) to inactive glucuronide conjugates.
Side Effects
Contraindications
- Known hypersensitivity to remogliflozin etabonate or any of its excipients.
- Patients with severe renal impairment, end-stage renal disease (ESRD), or on dialysis.
Drug Interactions
Digoxin
Remogliflozin may slightly increase the AUC and Cmax of digoxin, necessitating monitoring of digoxin levels.
Lithium
SGLT2 inhibitors may decrease serum lithium concentrations. Monitor serum lithium levels frequently.
Diuretics
Co-administration with diuretics may increase the risk of dehydration and hypotension.
Insulin and Insulin Secretagogues (e.g., Sulfonylureas)
May increase the risk of hypoglycemia when used in combination. A lower dose of insulin or sulfonylurea may be required.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In the event of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for remogliflozin etabonate. Removal of remogliflozin by dialysis has not been studied.
Pregnancy & Lactation
There are no adequate and well-controlled studies of Remogliflozin Etabonate in pregnant women. It is not recommended during pregnancy. It is also unknown whether remogliflozin is excreted in human milk, so caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Known hypersensitivity to remogliflozin etabonate or any of its excipients.
- Patients with severe renal impairment, end-stage renal disease (ESRD), or on dialysis.
Drug Interactions
Digoxin
Remogliflozin may slightly increase the AUC and Cmax of digoxin, necessitating monitoring of digoxin levels.
Lithium
SGLT2 inhibitors may decrease serum lithium concentrations. Monitor serum lithium levels frequently.
Diuretics
Co-administration with diuretics may increase the risk of dehydration and hypotension.
Insulin and Insulin Secretagogues (e.g., Sulfonylureas)
May increase the risk of hypoglycemia when used in combination. A lower dose of insulin or sulfonylurea may be required.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In the event of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for remogliflozin etabonate. Removal of remogliflozin by dialysis has not been studied.
Pregnancy & Lactation
There are no adequate and well-controlled studies of Remogliflozin Etabonate in pregnant women. It is not recommended during pregnancy. It is also unknown whether remogliflozin is excreted in human milk, so caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Generics available in specific regions
Clinical Trials
Remogliflozin has undergone clinical trials demonstrating its efficacy and safety in improving glycemic control in type 2 diabetes. Ongoing research may explore its cardiovascular and renal benefits further.
Lab Monitoring
- Renal function (eGFR) should be assessed prior to initiation and periodically thereafter.
- Blood glucose levels and HbA1c should be monitored regularly.
- Lipid profile may be monitored.
Doctor Notes
- Educate patients thoroughly on the importance of hydration and good perineal hygiene to mitigate the risk of urogenital infections.
- Regularly monitor renal function (eGFR) and adjust treatment if necessary.
- Counsel patients on the symptoms of diabetic ketoacidosis and instruct them to seek urgent medical attention if these symptoms develop, especially during acute illness or reduced caloric intake.
- Consider dose adjustments for concomitant use of insulin or sulfonylureas to minimize hypoglycemia risk.
Patient Guidelines
- Take Remmo 20 mg Tablet exactly as prescribed by your doctor.
- Monitor your blood sugar levels regularly as advised.
- Stay well-hydrated by drinking plenty of fluids to reduce the risk of dehydration and urinary tract infections.
- Seek immediate medical attention if you experience symptoms of a severe urinary tract infection, genital infection, or diabetic ketoacidosis (e.g., nausea, vomiting, abdominal pain, excessive thirst, rapid breathing).
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, 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
Remmo 20 mg Tablet alone is unlikely to affect the ability to drive or operate machinery. However, if used in combination with insulin or sulfonylureas, it may increase the risk of hypoglycemia, which could impair driving ability. Patients should be aware of their response to the medication before driving.
Lifestyle Advice
- Maintain a balanced diet and engage in regular physical activity as part of your diabetes management plan.
- Achieve and maintain a healthy body weight.
- Practice good personal hygiene, especially genital hygiene, to minimize the risk of infections.
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