Sinjard-M
Generic Name
Empagliflozin and Metformin Hydrochloride
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sinjard m 5 mg tablet | ৳ 20.00 | ৳ 140.00 |
Description
Overview of the medicine
Sinjard-M 5 mg Tablet is a combination medicine containing Empagliflozin and Metformin Hydrochloride. It is used to lower blood sugar levels in adults with type 2 diabetes mellitus, especially when diet and exercise alone are not enough. It also helps reduce the risk of cardiovascular death and hospitalization for heart failure in certain patients with type 2 diabetes and established cardiovascular disease.
Uses & Indications
Dosage
Adults
The usual starting dose is Sinjard-M 5 mg/500 mg tablet once or twice daily with meals. Dosage may be adjusted based on efficacy and tolerability, up to a maximum of 25 mg Empagliflozin and 2000 mg Metformin daily.
Elderly
No specific dose adjustment is required based on age, but renal function should be monitored due to increased risk of renal impairment in elderly patients.
Renal_impairment
Not recommended for patients with eGFR <30 mL/min/1.73 m². Dose adjustment required for eGFR 30-60 mL/min/1.73 m².
How to Take
Take Sinjard-M tablet orally with meals to reduce gastrointestinal side effects associated with metformin. Swallow the tablet whole with water.
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, a biguanide, decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Pharmacokinetics
Onset
Onset of glucose-lowering effect within hours.
Excretion
Empagliflozin: Excreted via urine and feces. Metformin: Excreted unchanged in the urine.
Half life
Empagliflozin: Approximately 13 hours. Metformin: Approximately 6.5 hours (plasma), up to 17.6 hours (blood).
Absorption
Empagliflozin: Rapidly absorbed, peak plasma concentrations reached approximately 1.5 hours post-dose. Metformin: Slowly and incompletely absorbed, peak plasma concentrations reached approximately 2.5 hours post-dose.
Metabolism
Empagliflozin: Primarily metabolized via glucuronidation by UGT1A3, UGT1A8, UGT1A9, UGT2B7, and UGT2B15. Metformin: Not metabolized in the liver.
Side Effects
Contraindications
- •Hypersensitivity to empagliflozin, metformin, or any component of the formulation.
- •Severe renal impairment (eGFR <30 mL/min/1.73 m²).
- •Metabolic acidosis, including diabetic ketoacidosis, with or without coma.
Drug Interactions
Alcohol
Increases the risk of lactic acidosis associated with metformin.
Cimetidine
Increases peak metformin plasma and whole blood concentrations and AUC. Reduce metformin dose if co-administered.
Iodinated Contrast Media
May cause acute kidney injury. Discontinue Sinjard-M at the time of, or prior to, an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73 m²; in patients with a history of liver disease, alcoholism or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure, and restart Sinjard-M if renal function is stable.
Diuretics (e.g., Thiazide and loop diuretics)
May increase the risk of dehydration and hypotension, especially in elderly patients.
Insulin and Insulin Secretagogues (e.g., Sulfonylureas)
Increased risk of hypoglycemia when used concomitantly. Dosage adjustment of insulin or sulfonylurea may be necessary.
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, discontinue Sinjard-M and initiate appropriate symptomatic and supportive treatment as dictated by the patient’s clinical status. Empagliflozin is minimally dialyzable. Metformin is dialyzable. Lactic acidosis management may be required for metformin overdose.
Pregnancy & Lactation
Not recommended during the second and third trimesters of pregnancy due to potential adverse renal effects in the fetus from empagliflozin. Metformin is generally considered safer, but the combination is best avoided. Not recommended during breastfeeding as it is unknown if empagliflozin or metformin is excreted in human milk, and potential risks to the infant cannot be excluded.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Available in pharmacies and hospitals
Approval Status
Approved (DGDA, Bangladesh)
Patent Status
Patent protected (for combination)
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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