Product Information:

TREVIAMET XR 100+1000mg Tablets is a once-daily extended-release (XR) fixed-dose combination of two oral antidiabetic agents:

1. Sitagliptin Phosphate 100mg – a dipeptidyl peptidase-4 (DPP-4) inhibitor that enhances incretin hormones to stimulate insulin secretion and suppress glucagon in a glucose-dependent manner
2. Metformin Hydrochloride Extended-Release 1000mg – a biguanide with prolonged action that reduces hepatic glucose production and improves insulin sensitivity

This formulation is designed for improved gastrointestinal tolerability and convenience of once-daily dosing, making it suitable for long-term management of type 2 diabetes.

Uses of (TREVIAMET XR 100+1000MG TABLETS):

1. Management of type 2 diabetes mellitus in adults
2. Patients inadequately controlled on metformin XR or sitagliptin monotherapy
3. As initial combination therapy in patients with HbA1c ≥9% where dual therapy is appropriate
4. To reduce pill burden and improve adherence with once-daily dosing

Key Benefits of (TREVIAMET XR 100+1000MG TABLETS):

1. Once-daily dosing improves compliance
2. Extended-release metformin significantly reduces gastrointestinal side effects (nausea, diarrhea)
3. Dual mechanism targets both fasting and postprandial hyperglycemia
4. Low risk of hypoglycemia when used without insulin or sulfonylureas
5. Weight-neutral—unlike insulin or sulfonylureas

How To Use (TREVIAMET XR 100+1000MG TABLETS):

1. Take once daily with the evening meal to further minimize GI side effects.
2. Swallow whole with water—do not crush, chew, or split (doing so destroys the extended-release mechanism).
3. Continue diet, exercise, and regular blood glucose monitoring.
4. Dose may be adjusted based on glycemic response and renal function.

When Not to Use (TREVIAMET XR 100+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 sitagliptin, metformin, or any excipients
5. History of pancreatitis (use DPP-4 inhibitors cautiously)

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

Side Effects of (TREVIAMET XR 100+1000MG TABLETS):

Common:

1. Mild abdominal discomfort, bloating, or diarrhea (less than immediate-release metformin)
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 XR 100+1000MG TABLETS):

1. Adults: One tablet once daily with evening meal
2. Maximum daily dose: Sitagliptin 100mg + Metformin XR 2000mg
3. Renal function guidance:
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 XR 100+1000MG TABLETS):

1. Adults with type 2 diabetes requiring dual therapy
2. Patients intolerant to immediate-release metformin due to GI side effects
3. Those seeking simplified, once-daily regimen for better long-term adherence

Warnings & Precautions:

1. Monitor renal function before starting and at least annually
2. Check vitamin B12 levels periodically during long-term therapy
3. Discontinue 48 hours before procedures involving iodinated contrast
4. Avoid excessive alcohol intake (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.