Sinjard-M
Generic Name
Empagliflozin and Metformin Hydrochloride
Manufacturer
Example Pharma Ltd. (Hypothetical, as actual manufacturer varies by region)
Country
USA (for originator drug, may vary for generic brands)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sinjard m 125 mg tablet | ৳ 30.00 | ৳ 210.00 |
Description
Overview of the medicine
Sinjard-M 12.5 mg/1000 mg tablet is a combination oral antidiabetic medicine containing Empagliflozin, an SGLT2 inhibitor, and Metformin Hydrochloride, a biguanide. It is used to improve glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise.
Uses & Indications
Dosage
Adults
Initial dose is typically Empagliflozin 5 mg / Metformin 500 mg or 1000 mg once daily, adjusted based on efficacy and tolerability. For this specific strength (12.5 mg/1000 mg), it's usually taken once or twice daily with meals. Max Empagliflozin 25 mg/day and Metformin 2000 mg/day.
Elderly
Careful dose titration is recommended due to potential age-related decline in renal function.
Renal_impairment
Not recommended for eGFR <30 mL/min/1.73m². Dose adjustment may be necessary for eGFR 30-60 mL/min/1.73m².
How to Take
Take orally with meals to reduce gastrointestinal side effects associated with Metformin. Swallow the tablet whole; do not crush, cut, or chew.
Mechanism of Action
Empagliflozin inhibits sodium-glucose co-transporter 2 (SGLT2) in the kidneys, reducing glucose reabsorption and increasing urinary glucose excretion. Metformin reduces hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Glycemic effect usually begins within hours of the first dose, with full effects seen over days to weeks.
Excretion
Empagliflozin: Approximately half of the dose is excreted unchanged in urine, and half in feces. Metformin: Primarily excreted unchanged in the urine.
Half life
Empagliflozin: Approximately 10-13 hours. Metformin: Approximately 4-9 hours.
Absorption
Empagliflozin is rapidly absorbed with peak plasma concentrations occurring within 1.5 hours. Metformin has an absolute bioavailability of 50-60%, with peak plasma concentrations reached in 2-3 hours for immediate release.
Metabolism
Empagliflozin is primarily metabolized via glucuronidation. Metformin is not metabolized and is excreted unchanged.
Side Effects
Contraindications
- •Hypersensitivity to empagliflozin, metformin, or any component of the formulation.
- •Severe renal impairment (eGFR <30 mL/min/1.73m²).
- •Metabolic acidosis, including diabetic ketoacidosis (DKA), with or without coma.
- •Acute or chronic metabolic acidosis, including lactic acidosis.
- •Acute conditions with potential for altered renal function (e.g., dehydration, severe infection, shock).
- •Acute or chronic disease that may cause tissue hypoxia (e.g., cardiac or respiratory failure, recent myocardial infarction, shock).
- •Hepatic impairment.
- •Alcohol abuse.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis.
Iodinated contrast agents
Temporarily discontinue Sinjard-M before or at the time of the procedure in patients with an eGFR between 30 and 60 mL/min/1.73m²; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast.
Diuretics (especially loop diuretics)
May increase the risk of dehydration and hypotension, potentially affecting renal function.
Corticosteroids, sympathomimetics, thiazides
May reduce the glycemic effect of Sinjard-M.
Insulin and insulin secretagogues (e.g., sulfonylureas)
Increased risk of hypoglycemia, may require lower doses of insulin or secretagogues.
Drugs that reduce metformin clearance (e.g., cimetidine, ranolazine, dolutegravir)
May increase metformin levels and risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose of Empagliflozin may lead to excessive diuresis and dehydration. Metformin overdose can lead to lactic acidosis, especially in patients with predisposing risk factors. Treatment involves supportive measures, correction of dehydration, and close monitoring. Hemodialysis can be used to remove Metformin.
Pregnancy & Lactation
Generally not recommended during pregnancy (Empagliflozin is Pregnancy Category C, Metformin is Category B). Avoid during the second and third trimesters. It is unknown if empagliflozin is excreted in human milk; Metformin is excreted into human milk. Therefore, it is not recommended during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Pharmacies and Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA for local versions)
Patent Status
Patent protected (for originator brand, generics may exist for components)
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Global Brand Names
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