Glipita M 1000

Indications

Glipita is used as an adjunct to diet and exercise to enhance glycemic control in adults with type 2 diabetes mellitus. It is effective for both monotherapy and combination therapy with metformin. Note that Glipita is not suitable for type 1 diabetes or diabetic ketoacidosis and has not been studied in patients with a history of pancreatitis.

Pharmacology

Glipita combines two antihyperglycemic agents: Sitagliptin, a DPP-4 inhibitor, and Metformin HCl, a biguanide. Sitagliptin helps by prolonging the action of incretin hormones, which enhances insulin release and reduces glucagon levels. Metformin works by lowering hepatic glucose production, reducing intestinal glucose absorption, and increasing peripheral glucose uptake. This combination improves glycemic control through complementary mechanisms.

Dosage & Administration

Glipita should be taken twice daily with meals to minimize gastrointestinal side effects. For those new to metformin, the starting dose is 50 mg sitagliptin/500 mg metformin twice daily. If switching from metformin, adjust the dose to combine existing metformin doses with 50 mg sitagliptin twice daily. Extended-release formulations should be taken once daily with food, adjusting doses based on effectiveness and tolerability.

Interactions

Caution is advised when using Glipita with cationic drugs eliminated by renal tubular secretion. It may also affect the anticoagulant effect of phenprocoumon and reduce the hypoglycemic effect of levothyroxine.

Contraindications

Glipita is contraindicated in patients with renal dysfunction, metabolic acidosis, or a history of severe hypersensitivity reactions to its components.

Side Effects

Common side effects of Glipita include diarrhea, upper respiratory tract infections, and headache. When combined with sulfonylureas or insulin, hypoglycemia may occur.

Pregnancy & Lactation

Pregnancy Category B. Glipita should be used during pregnancy only if necessary. It is not known whether it is excreted in human milk, so caution is advised for nursing mothers.

Precautions & Warnings

Monitor for lactic acidosis, particularly in patients with conditions that may predispose them to this complication. Regular renal function assessments are recommended, and monitor for signs of pancreatitis. Adjust doses in the elderly and patients with renal impairment.

Overdose Effects

In case of an overdose, supportive measures should be employed. Sitagliptin is modestly dialyzable, and Metformin may require hemodialysis for overdose management.

Therapeutic Class

Combination Oral Hypoglycemic Preparations

Storage Conditions

Store below 25°C in a dry place, away from light. Keep out of reach of children and use only under a physician’s prescription.