Product Information:

TREVIAMET 50/1000mg Tablets is a fixed-dose combination of two oral antidiabetic agents:

1. Metformin Hydrochloride 1000mg – a biguanide that decreases hepatic glucose production and improves insulin sensitivity
2. Sitagliptin Phosphate 50mg – a dipeptidyl peptidase-4 (DPP-4) inhibitor that enhances incretin activity, stimulating insulin release and suppressing glucagon

This combination is used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both metformin and sitagliptin is appropriate.

Uses of (TREVIAMET 50/1000MG TABLETS):

1. Management of type 2 diabetes mellitus in adults
2. Patients inadequately controlled on metformin monotherapy or sitagliptin monotherapy
3. As initial combination therapy in patients with high HbA1c (>9%) where dual therapy is warranted
4. To reduce pill burden and improve adherence

Key Benefits of (TREVIAMET 50/1000MG TABLETS):

1. Dual mechanism targets both fasting and postprandial hyperglycemia
2. Metformin improves insulin sensitivity and reduces liver glucose output
3. Sitagliptin enhances glucose-dependent insulin secretion with low risk of hypoglycemia
4. Weight-neutral profile (unlike sulfonylureas or insulin)
5. Once- or twice-daily dosing for convenience

How To Use (TREVIAMET 50/1000MG TABLETS):

1. Take once or twice daily with meals to reduce gastrointestinal side effects.
2. Swallow whole with water—do not crush or chew.
3. Continue a healthy diet, regular exercise, and blood glucose monitoring.
4. Typical regimen: 1 tablet twice daily (with morning and evening meals), but follow your doctor’s instructions.

When Not to Use (TREVIAMET 50/1000MG TABLETS):

Do not use if you have:

1. Type 1 diabetes or diabetic ketoacidosis
2. Severe renal impairment (eGFR <30 mL/min)
3. Acute or chronic metabolic acidosis (including lactic acidosis)
4. Hypersensitivity to metformin, sitagliptin, or any excipients
5. History of pancreatitis (use sitagliptin with caution)

⚠️ Temporary discontinuation required: Before iodinated contrast imaging or major surgery.

Side Effects of (TREVIAMET 50/1000MG TABLETS):

Common:

1. Nausea, diarrhea, abdominal discomfort (mainly from metformin—usually transient)
2. Headache, upper respiratory infection
3. Nasopharyngitis

Less common:

1. Vitamin B12 deficiency (with long-term metformin use)
2. Joint pain (sitagliptin-related—rare but serious if severe)

Serious (rare):

1. Lactic acidosis (symptoms: muscle pain, weakness, slow heartbeat, trouble breathing)—seek emergency care
2. Acute pancreatitis (persistent severe abdominal pain)—discontinue immediately
3. Hypoglycemia (usually only when combined with insulin or sulfonylureas)
4. Discontinue and seek help if severe stomach pain, rapid breathing, or unusual fatigue occurs.

Dosage: (TREVIAMET 50/1000MG TABLETS):

1. Adults: Typically 1 tablet twice daily with meals
2. Maximum daily dose: Sitagliptin 100mg + Metformin 2000mg
3. Renal impairment:
4. eGFR 45–59 mL/min: Avoid initiation; if already on therapy, may continue with caution
5. eGFR <45 mL/min: Contraindicated

Who It’s For (TREVIAMET 50/1000MG TABLETS):

Adults with type 2 diabetes who require dual therapy with metformin and sitagliptin for better glycemic control, especially those struggling with multiple pills or suboptimal response to monotherapy.

Warnings & Precautions:

1. Monitor renal function before and during therapy
2. Check vitamin B12 levels annually with long-term use
3. Discontinue 48 hours before procedures involving iodinated contrast
4. Avoid excessive alcohol intake (↑ lactic acidosis risk)
5. Educate patients on signs of lactic acidosis and pancreatitis

Drug Interactions:

1. Iodinated contrast agents: ↑ Risk of lactic acidosis—temporarily stop metformin
2. Cimetidine, furosemide, nifedipine: May increase metformin levels
3. Insulin or sulfonylureas: ↑ Risk of hypoglycemia
4. Always inform your doctor about all medications and supplements.

Additional Information:

Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not use after the expiration date. Available by prescription in Pakistan.