ZITAMET-20/1000

# Teneligliptin 20 mg + Metformin Hydrochloride 1000 mg ## SHORT DESCRIPTION Teneligliptin 20 mg + Metformin Hydrochloride 1000 mg is an **oral antidiabetic combination medicine** used to help control blood glucose levels in adults with **Type 2 diabetes mellitus**. Teneligliptin is a DPP-4 inhibitor that helps increase glucose-dependent insulin release, while metformin reduces glucose production by the liver and improves the body's sensitivity to insulin. Together, they can provide complementary blood sugar control when diet and exercise alone are not sufficient. ## KEY BENEFITS * Helps control blood glucose levels in Type 2 diabetes * Supports better post-meal and overall blood sugar control * Helps reduce excessive glucose production by the liver * Improves the body's response to insulin * Teneligliptin provides glucose-dependent enhancement of insulin secretion * May help achieve blood sugar targets when a single medicine is insufficient * Generally has a low risk of hypoglycemia when used alone ## USES / INDICATIONS Teneligliptin + Metformin may be prescribed for: * **Type 2 diabetes mellitus** * Inadequately controlled blood glucose despite diet and exercise * Patients requiring combination therapy for better glycemic control * Patients already taking teneligliptin and metformin who need a convenient combination formulation This medicine is **not intended to treat Type 1 diabetes or diabetic ketoacidosis**. ## HOW IT WORKS ### Teneligliptin Teneligliptin is a **DPP-4 (dipeptidyl peptidase-4) inhibitor**. It prevents the breakdown of incretin hormones such as GLP-1 and GIP. This helps: * Increase insulin release when blood glucose is elevated * Reduce glucagon release * Reduce excessive glucose production * Improve blood glucose control after meals and between meals ### Metformin Metformin is a **biguanide antidiabetic medicine**. It primarily: * Reduces glucose production by the liver * Improves insulin sensitivity * Helps the body use glucose more effectively * Reduces intestinal glucose absorption to a lesser extent ### Combination Effect The two medicines work through different mechanisms, providing complementary effects on blood glucose control. ## DOSAGE & ADMINISTRATION * Take Teneligliptin 20 mg + Metformin Hydrochloride 1000 mg exactly as prescribed. * Take the medicine **with or after food** to reduce stomach-related side effects from metformin. * Swallow the tablet with water. * Take it at approximately the same time each day. * Do not crush or split the tablet unless your specific product allows this. * The exact dosing schedule depends on the formulation, previous diabetes medicines, blood glucose levels, kidney function, and individual treatment needs. ### Important A **1000 mg metformin strength may be available in immediate-release or extended-release formulations**, and the administration instructions can differ. Follow the specific product label and your doctor's instructions. ### Missed Dose Take the missed dose when remembered unless it is nearly time for the next dose. Do not take two doses together to compensate for a missed dose. ## SIDE EFFECTS ### Common Side Effects * Nausea * Diarrhea * Stomach discomfort * Abdominal pain * Loss of appetite * Indigestion * Headache * Dizziness * Mild upper respiratory symptoms Gastrointestinal side effects are particularly common when starting metformin and may improve as the body adjusts. ### Serious Side Effects Seek medical attention if you experience: * Severe or persistent abdominal pain * Severe weakness * Difficulty breathing * Unusual sleepiness or confusion * Severe vomiting or dehydration * Signs of an allergic reaction * Severe or persistent joint pain * Blistering or severe skin reactions ### Rare but Serious: Lactic Acidosis Metformin can rarely cause **lactic acidosis**, a serious medical condition. The risk is higher in people with significant kidney impairment, severe dehydration, certain serious illnesses, or excessive alcohol consumption. Seek urgent medical attention for severe weakness, unusual muscle pain, difficulty breathing, extreme sleepiness, abdominal discomfort, or feeling unusually cold. ## PRECAUTIONS & WARNINGS Tell your doctor before taking this medicine if you have: * Kidney disease * Liver disease * Heart failure or significant heart disease * A history of pancreatitis * Excessive alcohol consumption * Severe dehydration * A history of vitamin B12 deficiency * A planned surgery * A scheduled contrast-dye imaging procedure ### Kidney Function Metformin is eliminated through the kidneys. Kidney function should be assessed before and periodically during treatment. Teneligliptin may also require consideration of kidney function depending on the patient's clinical condition and the prescribing information for the specific product. ### Lactic Acidosis Although rare, metformin-associated lactic acidosis can be life-threatening. The risk increases with significant renal impairment, severe dehydration, hypoxia, and certain acute illnesses. ### Vitamin B12 Deficiency Long-term metformin treatment can reduce vitamin B12 absorption. Periodic monitoring may be appropriate, particularly in people with anemia, neuropathy, or other risk factors. ### Pancreatitis DPP-4 inhibitors have been associated with reports of acute pancreatitis. Contact your doctor if you develop persistent, severe abdominal pain, especially if it radiates to the back. ### Hypoglycemia Teneligliptin and metformin generally have a low risk of causing hypoglycemia when used alone. However, the risk can increase when combined with **insulin or sulfonylureas**. ### Alcohol Excessive alcohol intake can increase the risk of metformin-associated lactic acidosis and may affect blood glucose control. Avoid excessive alcohol consumption. ### Contrast Imaging Metformin may need to be temporarily stopped around certain procedures involving **iodinated contrast media**, depending on kidney function and the type of imaging procedure. Follow your healthcare professional's instructions. ## DRUG INTERACTIONS Teneligliptin + Metformin may interact with: * **Insulin and sulfonylureas** — may increase the risk of hypoglycemia. * **Iodinated contrast media** — may require temporary interruption of metformin in certain circumstances. * **Alcohol** — excessive intake can increase the risk of lactic acidosis. * **Cimetidine and other medicines affecting renal elimination** — may alter metformin exposure. * Certain medicines that affect kidney function. * Corticosteroids — may increase blood glucose levels. * Diuretics — may affect glucose control and kidney function. * Certain thyroid medicines and other medicines may affect blood glucose control. Always inform your doctor about prescription medicines, over-the-counter medicines, vitamins, and herbal supplements you take. ## STORAGE INFORMATION * Store according to the manufacturer's instructions. * Keep the tablets in their original packaging. * Store at room temperature unless otherwise specified. * Protect from excessive heat, moisture, and direct sunlight. * Keep out of the reach of children. * Do not use after the expiry date. * Do not use tablets if the packaging is damaged. ## PRESCRIPTION STATUS **Prescription Medicine** Teneligliptin 20 mg + Metformin Hydrochloride 1000 mg should be used under the supervision of a qualified healthcare professional. Prescription requirements may vary by country. ## GENUINE MEDICINE ASSURANCE When purchasing Teneligliptin 20 mg + Metformin Hydrochloride 1000 mg: * Purchase from a licensed and reputable pharmacy. * Check that the packaging is sealed and intact. * Verify the medicine name, strength, dosage form, and manufacturer. * Check the batch number and expiry date. * Ensure appropriate storage conditions have been maintained. * Avoid products with damaged, altered, or suspicious packaging. * Purchase from an authorized pharmaceutical supplier. * Consult a pharmacist if you have concerns about product authenticity. ## FAQ — FREQUENTLY ASKED QUESTIONS ### What is Teneligliptin 20 mg + Metformin 1000 mg used for? It is an oral antidiabetic combination used to help control **blood glucose in adults with Type 2 diabetes mellitus** when diet, exercise, or single-drug treatment does not provide adequate control. ### Is Teneligliptin + Metformin used for Type 1 diabetes? No. This combination is generally used for **Type 2 diabetes** and is not a substitute for insulin in people with Type 1 diabetes. ### What is Teneligliptin? Teneligliptin is a **DPP-4 inhibitor** that helps improve glucose-dependent insulin secretion and reduce glucagon levels. ### What is Metformin? Metformin is a biguanide medicine that primarily reduces glucose production by the liver and improves insulin sensitivity. ### Can Teneligliptin and Metformin be taken together? Yes. The two medicines have complementary mechanisms and are commonly prescribed together for Type 2 diabetes when clinically appropriate. ### Does Teneligliptin + Metformin cure diabetes? No. It helps **control blood glucose**, but Type 2 diabetes generally requires ongoing management involving medication, diet, physical activity, weight management, and regular medical monitoring. ### Does this medicine lower blood sugar immediately? The medicines begin working after administration, but optimal blood glucose control generally develops with continued treatment. Individual responses vary. ### Can Teneligliptin + Metformin cause low blood sugar? The combination has a relatively low risk of hypoglycemia when used alone. The risk increases when it is combined with insulin or medicines such as sulfonylureas. ### Should Teneligliptin + Metformin be taken with food? Metformin is generally better tolerated when taken **with or after meals**. Follow the instructions for your specific formulation. ### Can Teneligliptin + Metformin cause diarrhea? Yes. Diarrhea, nausea, abdominal discomfort, and other gastrointestinal symptoms can occur, particularly when starting metformin. ### Can Metformin cause vitamin B12 deficiency? Yes. Long-term metformin use can reduce vitamin B12 absorption. Your healthcare professional may recommend periodic monitoring when appropriate. ### Can this medicine be used in kidney disease? Kidney function is important when using metformin. Depending on the degree of kidney impairment, metformin may require dose adjustment or may not be appropriate. ### Can I drink alcohol while taking this medicine? Avoid excessive alcohol consumption. Alcohol can increase the risk of **metformin-associated lactic acidosis** and can interfere with blood glucose control. ### Can Teneligliptin cause pancreatitis? Pancreatitis has been reported with DPP-4 inhibitors, although it is uncommon. Seek medical attention for persistent severe abdominal pain, especially if it radiates to the back. ### Can this medicine cause weight gain? Metformin is generally weight-neutral or may be associated with modest weight loss. Teneligliptin is generally considered weight-neutral, although individual responses can vary. ### Can I stop taking Teneligliptin + Metformin when my blood sugar improves? Do not stop the medicine without consulting your doctor. Improved glucose levels may indicate that the treatment is working. ### What should I do if I miss a dose? Take it when remembered unless it is nearly time for the next dose. Do not take a double dose to make up for a missed dose. ### Can Teneligliptin + Metformin be taken during pregnancy? If you are pregnant, planning pregnancy, or breastfeeding, consult your doctor before using this medicine. Diabetes treatment may need to be changed during pregnancy. ### Can this medicine be used while breastfeeding? Consult your healthcare professional before taking this combination while breastfeeding. The suitability of treatment depends on your individual circumstances and the specific formulation. ### What happens if I take too much Metformin? A significant metformin overdose can cause serious complications, including lactic acidosis. Seek urgent medical attention if you have taken more than prescribed. ### Is Teneligliptin + Metformin available without a prescription? It is generally considered a **prescription medicine** and should be taken under medical supervision. ## MEDICAL DISCLAIMER This information is provided for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Teneligliptin 20 mg + Metformin Hydrochloride 1000 mg should be used only as prescribed by a qualified healthcare professional. Kidney function, blood glucose levels, other medicines, and the exact metformin formulation should be considered before treatment. Seek urgent medical attention for symptoms suggestive of lactic acidosis, severe allergic reactions, or severe persistent abdominal pain.