Metformindosage

Take sitagliptin and metformin hydrochloride extended-release tablets orally once daily with a meal. Patients taking two sitagliptin and metformin hydrochloride extended-release tablets should take the tablets together. Individualize the dosage of sitagliptin and metformin hydrochloride extended-release tablets on the basis of the patient’s current regimen, effectiveness, and tolerability. The maximum recommended daily dose is 100 mg of sitagliptin and 2000 mg of metformin hydrochloride extended-release. The recommended starting dose in patients not currently treated with metformin is 100 mg sitagliptin and 1000 mg metformin hydrochloride once daily, with gradual dose escalation recommended to reduce the gastrointestinal effects due to metformin. The starting dose in patients already treated with metformin should provide sitagliptin dosed as 100 mg and the dose of metformin already being taken once daily. For patients taking metformin hydrochloride 850 mg twice daily or 1000 mg twice daily, the recommended starting dose of sitagliptin and metformin hydrochloride extended-release tablets is two 50 mg sitagliptin and 1000 mg metformin hydrochloride extended-release tablets once daily. Maintain the same total daily dose of sitagliptin and metformin when changing between JANUMET and sitagliptin and metformin hydrochloride extended-release tablets. Prior to initiation, assess renal function with estimated glomerularz filtration rate (eGFR) Do not use in patients with eGFR below 30 mL/min/1.73 m 2. Discontinue if eGFR later falls below 30 mL/min/1.73 m 2. Initiation is not recommended in patients with eGFR between 30 – 45 mL/min/1.73 m 2. Assess risk/benefit of continuing if eGFR falls below 45 mL/min/1.73 m 2. Limit dose of sitagliptin to 50 mg once daily if eGFR falls below 45 mL/min/1.73 m 2. Sitagliptin and metformin hydrochloride extended-release tablets may need to be discontinued at time of, or prior to, iodinated contrast imaging procedures.

2.1 Recommended

Dosing Take sitagliptin and metformin hydrochloride extended-release tablets orally once daily with a meal. Patients taking two sitagliptin and metformin hydrochloride extended-release tablets should take the two tablets together once daily. Individualize the dosage of sitagliptin and metformin hydrochloride extended-release tablets on the basis of the patient’s current regimen, effectiveness, and tolerability. The maximum recommended daily dose is 100 mg of sitagliptin and 2000 mg of metformin hydrochloride (HCl) extended-release. The recommended starting dose in patients not currently treated with metformin is 100 mg sitagliptin and 1000 mg metformin hydrochloride extended-release once daily, with gradual dose escalation recommended to reduce gastrointestinal side effects associated with metformin. The starting dose in patients already treated with metformin should provide 100 mg sitagliptin and the previously prescribed dose of metformin. For patients taking metformin hydrochloride immediate-release 850 mg twice daily or 1000 mg twice daily, the recommended starting dose of sitagliptin and metformin hydrochloride extended-release tablets is two 50 mg sitagliptin and 1000 mg metformin hydrochloride extended-release tablets taken together once daily. Maintain the same total daily dose of sitagliptin and metformin when changing between JANUMET and sitagliptin and metformin hydrochloride extended-release tablets. Do not split, crush or chew sitagliptin and metformin hydrochloride extended-release tablets.

2.2 Recommendations for

Use in Renal Impairment Assess renal function prior to initiation of sitagliptin and metformin hydrochloride extended-release tablets and periodically thereafter. Sitagliptin and metformin hydrochloride extended-release tablets are contraindicated in patients with an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m 2. Discontinue sitagliptin and metformin hydrochloride extended-release tablets if the patient’s eGFR later falls below 30 mL/min/1.73 m 2. Initiation of sitagliptin and metformin hydrochloride extended-release tablets in patients with an eGFR between 30 and 45 mL/min/1.73 m 2 is not recommended. In patients taking sitagliptin and metformin hydrochloride extended-release tablets whose eGFR later falls below 45 mL/min/1.73 m 2, assess the benefit risk of continuing therapy and limit dose of the sitagliptin component to 50 mg once daily.

2.3 Discontinuation for

Iodinated Contrast Imaging Procedures Discontinue sitagliptin and metformin hydrochloride extended-release tablets 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 m 2; 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; restart sitagliptin and metformin hydrochloride extended-release tablets if renal function is stable.