Product Information:

TREVIAMET 50/500mg Tablets is a fixed-dose combination of two oral antidiabetic agents:

1. Sitagliptin Phosphate 50mg – a dipeptidyl peptidase-4 (DPP-4) inhibitor that enhances incretin hormones to stimulate insulin release and suppress glucagon
2. Metformin Hydrochloride 500mg – a biguanide that reduces hepatic glucose production and improves insulin sensitivity in peripheral tissues

This lower-strength combination is used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, particularly as a starting regimen or for patients requiring gentler titration.

Uses of (TREVIAMET 50/500MG TABLETS):

1. Initial combination therapy in adults with type 2 diabetes and HbA1c ≥7.5%
2. Patients inadequately controlled on metformin monotherapy or sitagliptin monotherapy
3. Those experiencing gastrointestinal intolerance with higher metformin doses
4. To reduce pill burden and improve medication adherence

Key Benefits of (TREVIAMET 50/500MG TABLETS):

1. Dual mechanism targets both fasting and postprandial blood glucose
2. Low risk of hypoglycemia when used alone
3. Weight-neutral—unlike sulfonylureas or insulin
4. Lower metformin dose (500mg) minimizes GI side effects during initiation
5. Once- or twice-daily dosing for convenience

How To Use (TREVIAMET 50/500MG TABLETS):

1. Take with meals to reduce stomach upset.
2. Typical starting dose: 1 tablet twice daily (morning and evening with food).
3. May be increased gradually based on glycemic response and tolerance.
4. Swallow whole with water—do not crush or chew.
5. Continue diet, exercise, and regular blood glucose monitoring.

When Not to Use (TREVIAMET 50/500MG 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 sitagliptin, metformin, or any excipients
5. History of pancreatitis (use DPP-4 inhibitors with caution)

⚠️ Discontinue temporarily: Before iodinated contrast imaging or major surgery.

Side Effects of (TREVIAMET 50/500MG TABLETS):

Common:

1. Nausea, diarrhea, abdominal discomfort (usually mild and transient due to lower metformin dose)
2. Headache, upper respiratory infection
3. Metallic taste

Less common:

1. Vitamin B12 deficiency (with long-term metformin use)
2. Joint pain (rare; may indicate serious reaction to sitagliptin)

Serious (rare):

1. Lactic acidosis (symptoms: muscle pain, weakness, slow heartbeat, trouble breathing)—medical emergency
2. Acute pancreatitis (persistent severe abdominal pain radiating to back)—stop immediately
3. Hypoglycemia (mainly if combined with insulin or sulfonylureas)
4. Seek emergency care if severe symptoms occur.

Dosage: (TREVIAMET 50/500MG TABLETS):

1. Adults: Typically 1–2 tablets twice daily with meals
2. Maximum daily dose: Sitagliptin 100mg + Metformin 2000mg
3. Renal function monitoring:
4. eGFR ≥45 mL/min: Safe to use
5. eGFR 30–44 mL/min: Avoid initiation; use only if benefits outweigh risks
6. eGFR <30 mL/min: Contraindicated

Who It’s For (TREVIAMET 50/500MG TABLETS):

1. Adults newly diagnosed with type 2 diabetes needing dual therapy
2. Elderly or frail patients requiring lower metformin doses
3. Those with GI sensitivity to standard metformin formulations

Warnings & Precautions:

1. Monitor renal function before starting and periodically thereafter
2. Check vitamin B12 levels annually during long-term therapy
3. Discontinue 48 hours before procedures involving iodinated contrast
4. Avoid excessive alcohol consumption (increases lactic acidosis risk)
5. Educate patients on symptoms of lactic acidosis and pancreatitis

Drug Interactions:

1. Iodinated contrast agents: Temporarily stop metformin to avoid lactic acidosis
2. Cimetidine, furosemide, nifedipine: May increase metformin levels
3. Insulin or sulfonylureas: May increase hypoglycemia risk
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.