Important Clarification & Product Assessment (English):

Despite the brand name "DIAMPA" (commonly associated with dapagliflozin in Pakistan), the formulation "M5+850mg" does not contain dapagliflozin. This is because:

1. ✅ Dapagliflozin is only approved in 5mg and 10mg doses.
2. ❌ It is not combined with metformin under labels like "M5+850" in standard DIAMPA products.

In Pakistan, the notation "M5+850" follows a well-established local naming convention for antidiabetic combinations, where:

"M5" = Glimepiride 2mg

"850" = Metformin 850mg

Thus, DIAMPA M5+850mg Tablets most likely contain:

✅ Glimepiride 2mg

✅ Metformin Hydrochloride 850mg

This is a standard, widely prescribed dual-combination therapy for type 2 diabetes mellitus.

Product Full Description (English):

Uses:

1. Treatment of type 2 diabetes in adults inadequately controlled with diet, exercise, or monotherapy
2. Simplified dual therapy to improve adherence and glycemic control

Key Benefits:

1. Glimepiride: Stimulates insulin secretion from pancreatic beta cells
2. Metformin 850mg: Reduces liver glucose production and improves insulin sensitivity
3. Intermediate metformin dose balances efficacy and gastrointestinal tolerability
4. Cost-effective and clinically proven regimen

How To Use:

Take once or twice daily with meals (typically breakfast and/or dinner) to reduce hypoglycemia risk. Swallow whole with water—do not crush or chew.

When Not to Use:

1. Type 1 diabetes or diabetic ketoacidosis
2. Severe renal impairment (eGFR <30 mL/min)
3. Hypersensitivity to sulfonylureas or metformin
4. Acute alcohol intoxication, liver disease, or metabolic acidosis

Side Effects:

1. Common: Hypoglycemia (sweating, tremor, dizziness, hunger), nausea, diarrhea, metallic taste
2. Serious (rare): Lactic acidosis (muscle pain, weakness, rapid breathing), severe hypoglycemia, liver dysfunction

Dosage:

1. Typical dose: 1 tablet once or twice daily with meals
2. Maximum glimepiride: usually 4–6mg/day (i.e., up to 2–3 tablets)
3. Adjust based on blood glucose and HbA1c monitoring

Warnings & Precautions:

1. Hypoglycemia risk increases with skipped meals, excessive exercise, or alcohol
2. Avoid alcohol—raises risk of lactic acidosis and low blood sugar
3. Discontinue before iodinated contrast imaging or major surgery
4. Monitor kidney function and HbA1c regularly

Drug Interactions:

1. Alcohol: ↑ Risk of lactic acidosis and hypoglycemia
2. Beta-blockers: May mask hypoglycemia symptoms (e.g., tachycardia)
3. NSAIDs, sulfonamides, warfarin: May enhance glimepiride effect → hypoglycemia
4. Cimetidine: May increase metformin levels

Critical Recommendation:

🔍 Always check the active ingredients printed on the packaging.

1. If it lists "Glimepiride 2mg + Metformin 850mg", this description applies.
2. If it claims "Dapagliflozin 5mg + Metformin 850mg", it is non-standard or mislabeled—consult your pharmacist.

In Pakistan