Metformina + Vildagliptina Zentiva K.S. (Metformin Hydrochloride, Vildagliptin)

Metformina + Vildagliptina is used in the management of type 2 diabetes mellitus, targeting hyperglycaemia.

• Type 2 diabetes mellitus: lowers fasting and post‑prandial glucose levels.
• Adjunct to diet and exercise: enhances overall glycaemic management when combined with lifestyle measures.
• Overweight patients with type 2 diabetes: contributes to improved insulin sensitivity and metabolic control.

• Metformin decreases hepatic gluconeogenesis and increases peripheral insulin sensitivity, while Vildagliptin selectively inhibits dipeptidyl peptidase‑4 (DPP‑4), prolonging the activity of endogenous incretin hormones (GLP‑1 and GIP) that stimulate glucose‑dependent insulin secretion and suppress glucagon release.

The combination may cause a range of adverse reactions, which are classified by frequency.

Common Side Effects

• Gastrointestinal upset: nausea, abdominal discomfort or diarrhoea.
• Metallic taste: transient alteration in taste perception.
• Headache: mild to moderate headache episodes.
• Hypoglycaemia (when combined with other glucose‑lowering agents): mild low blood sugar.

Serious or Rare Side Effects

• Lactic acidosis: rare but potentially fatal accumulation of lactate.
• Severe hypersensitivity reactions: including skin rash, angio‑edema or anaphylaxis.
• Pancreatitis: inflammation of the pancreas presenting with abdominal pain.

Before initiating therapy, several safety considerations should be evaluated.

• Renal function: assess eGFR and avoid use in severe renal impairment.
• Hepatic impairment: use with caution and monitor liver enzymes.
• Risk of lactic acidosis: contraindicated in conditions predisposing to hypoxia.
• Pregnancy and lactation: evaluate risk‑benefit ratio before prescribing.
• Drug interactions: review concomitant medications for potential interactions.
• Store at ambient temperature: keep in the original container, protect from moisture and heat.

Metformina + Vildagliptina can interact with other medicines, requiring attention to the following categories.

Major Interactions (Avoid)

• Insulin or sulfonylureas: increased risk of hypoglycaemia.
• Cimetidine: may raise metformin plasma concentrations.
• Iodinated contrast agents: can impair renal function and elevate metformin levels.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask symptoms of hypoglycaemia.
• Diuretics: can affect renal clearance of metformin.
• ACE inhibitors or ARBs: monitor renal function and electrolytes.