Inosita Plus XR 100mg+1000mg Tablet 7 ‘S

Description

Inosita Plus XR 100mg+1000mg Tablet 7 ‘S belongs to a class of drugs called “hypoglycemics” (anti-diabetics, biguanide/dipeptidyl peptidase-4 inhibitor) that are used in the treatment of type 2 diabetes (high blood sugar levels) as an adjunct to diet and exercise, in patients that are inadequately controlled by metformin alone or have been treated with the combination of sitagliptin and metformin as separate tablets. 

Type 2 diabetes, also known as non insulin-dependent diabetes, is a condition resulting from a combination of insulin resistance, i.e, body cells failing to respond properly to the insulin produced, inadequate insulin secretion, and excessive production of glucagon. Progression of the disease may lead to insulin deficiency. This causes hyperglycemia. (high blood sugar levels)

Inosita Plus XR 100mg+1000mg Tablet 7 ‘S is available in tablet form on prescription. Metformin is an anti diabetic medication (biguanide) that works by decreasing the amount of sugar released into the blood by the liver, delaying sugar absorption from the intestines and increasing the body’s responsiveness to insulin. Whereas, sitagliptin is an anti-diabetic medication (dipeptidyl peptidase-4 inhibitor) that works by increasing insulin (a natural substance required in breaking down sugar) production by the pancreas and the ability of the body to utilise it effectively. Besides this it also plays a role in decreasing hormones responsible for raising blood sugar levels

Dosage of Inosita Plus XR 100mg+1000mg Tablet 7 ‘S depends on age, severity of condition, patient’s response to medicine and their comorbidities.

The most common side effects of Inosita Plus XR 100mg+1000mg Tablet 7 ‘S are diarrhea, nausea, vomiting, upset stomach, headache, nasal congestion (stuffy nose) and sore throat.

Indications

Inosita Plus XR 100mg+1000mg Tablet 7 ‘S is prescribed to adults above 18 years of age.

It is used in the treatment of type 2 diabetes (high blood sugar levels): 

• In patients that are inadequately controlled by metformin alone or by metformin in combination with either a sulfonylurea or insulin, 

or 

• Have been treated with the combination of sitagliptin and metformin as separate tablets. 

 

How does Inosita Plus XR 100mg+1000mg Tablet 7 ‘S work?

Metformin is an anti diabetic medication (biguanide) that works by decreasing the amount of sugar released into the blood by the liver, delaying sugar absorption from the intestines and increasing the body’s responsiveness to insulin. Whereas, sitagliptin is an anti-diabetic medication (dipeptidyl peptidase-4 inhibitor) that works by increasing insulin (a natural substance required in breaking down sugar) production by the pancreas and the ability of the body to utilise it effectively. Besides this it also plays a role in decreasing hormones responsible for raising blood sugar level

 

How to use Inosita Plus XR 100mg+1000mg Tablet 7 ‘S?

It comes in tablet form that needs to be swallowed whole with a glass of water.

It is better to take Inosita Plus XR 100mg+1000mg Tablet 7 ‘S with meals to avoid side effects like an upset stomach.

 

Dosage 

Dosage needs to be personalized keeping in mind the patients current regime, effectiveness and tolerability towards the treatment.

IMMEDIATE RELEASE (initial dose) 

• For patients not taking metformin: sitagliptin 50 mg/metformin 500 mg, twice a day
• For patients taking metformin 1000 mg/day: sitagliptin 50 mg/ metformin 500 mg, twice a day
• For patients taking metformin 1700 or 2000 mg/day: sitagliptin 50 mg/ metformin 1000 mg, twice a day

EXTENDED RELEASE (initial dose)

• For patients not taking metformin: sitagliptin 100 mg/metformin 1000 mg, once a day
• For patients taking metformin 1000 mg/day: sitagliptin 100 mg/ metformin 1000 mg, once a day
• For patients taking metformin 1700 or 2000 mg/day: sitagliptin 100 mg/ metformin 2000 mg, once a day

To achieve optimal glycemic control, titrate the doses accordingly.

• MAXIMUM daily doses: Sitagliptin 100 mg; Metformin 2000 mg

If you are switching from immediate release to extended release, make sure to maintain the same daily dose of Inosita Plus XR 100mg+1000mg Tablet 7 ‘S.

To reduce the risk of hypoglycemia (low blood sugar), dose adjustment of insulin secretagogue (e.g., sulfonylurea) or insulin may be necessary when initiating therapy using Inosita Plus XR 100mg+1000mg Tablet 7 ‘S. 

 

Pregnancy use and lactation

If you are pregnant, think you may be pregnant or are planning to have a baby, please consult your doctor before using Inosita Plus XR 100mg+1000mg Tablet 7 ‘S. If you are breastfeeding, please consult your doctor before taking Inosita Plus XR 100mg+1000mg Tablet 7 ‘S as it is contraindicated.

 

Contraindications

Please inform your doctor if you have a history of any before using Inosita Plus XR 100mg+1000mg Tablet 7 ‘S:

Metformin: 

• Diabetic ketoacidosis (abnormally fast breakdown of fat into blood acids called ketones) or precoma 
• Renal (kidney) impairment – acute conditions predisposing to renal impairment (e.g dehydration, severe infection, shock)
• Hepatic (liver) impairment
• Alcohol intoxication
• Cardiac or respiratory failure – recent MI (myocardial infarction)
• Administration of iodinated contrast materials 
• Discontinue for 48 hours before and after surgery

Sitagliptin: 

• Diabetic ketoacidosis (abnormally fast breakdown of fat into blood acids called ketones)
• Renal (kidney) impairment 
• Any problem in the pancreas (pancreatitis – inflammation of the pancreas) 
• Presence of gallstones or high levels of triglycerides (type of fat)
• Type 1 diabetes mellitus (condition in which your body does not produce insulin) 

Inosita Plus XR 100mg+1000mg Tablet 7 ‘S is contraindicated if you are allergic to any of its constituents.

 

Precautions

Please tell your doctor about any of the following conditions while using Inosita Plus XR 100mg+1000mg Tablet 7 ‘S:

• Elderly 
• Assess risk factors for lactic acidosis (excessive lactic acid accumulation in the blood) 
• Monitor renal function at least annually , 2-4 times a year in elderly and in patients with serum creatinine levels at ULN (upper limit of normal)
• If there is renal (kidney) impairment, measure kidney function before resuming therapy
• Severe breathing problems (such as obstructive lung disease, asthma)
• History of gallstones (stones in the gallbladder)
• History of heart failure 
• History of pancreatitis (inflammation of the pancreas)
• Discontinue for 48 hours before and after surgery
• Allergic reaction to product
• Pregnant, trying to get pregnant or breastfeeding

 

Interaction with other medications

Certain medications could interact with Inosita Plus XR 100mg+1000mg Tablet 7 ‘S, hence, in that case your doctor might alter your dosage and make sure to monitor blood sugar levels more closely.

Please inform your doctor about the use of the following before taking Inosita Plus XR 100mg+1000mg Tablet 7 ‘S:

Metformin: 

• Alcohol
• Iodinated contrast agents
• Diuretics
• Corticosteroids
• ACE inhibitors
• Sympathomimetics
• NSAIDs
• Other hypoglycemics 
• inhibitors of OCT2 (organic cation transporter-2) e.g cimetidine (H2 receptor blocker), dolutegravir (antiretroviral/HIV integrase inhibitor), ranolazine (sodium channel blocker), trimethoprim (anti folate antibiotic).

Sitagliptin: 

• Digoxin (medicine for heart conditions, including heart failure)
• Insulin or any other anti-diabetic medicine
• Ketoconazole or itraconazole (medicines for fungal infections)
• Ritonavir (medicine used in treating HIV/AIDS
• Clarithromycin (antibiotic for treating pneumonia and ear infections)

Make sure to inform your doctor that you are taking Inosita Plus XR 100mg+1000mg Tablet 7 ‘S before you start or stop any other medicine.

 

Adverse effects

Like most medicines, Inosita Plus XR 100mg+1000mg Tablet 7 ‘S has some side effects which include:

COMMON:

• Nausea
• Vomiting 
• Diarrhea
• Stomach pain
• Loss of appetite
• Dizziness 
• Headache 
• Nasal congestion (stuffy nose)
• Hypoglycemia (low blood glucose level)
• Metallic taste

SERIOUS:

Metformin:

• Lactic acidosis (excess lactic acid in the blood)
• Abnormal liver function tests (hepatitis) 
• Skin rash or itching (skin disease) 
• Reduced B12 absorptions

Sitagliptin:

• Hypoglycemia (low blood sugar) manifested as dizziness, weakness, drowsiness, headache and sweating
• Bullous pemphigoid 
• Hypersensitivity (allergic) reactions including anaphylaxis indicated by itching, difficulty breathing, swelling of your throat or tongue, hives, or difficulty swallowing and stevens – johnsons syndrome.
• Pancreatitis (signs such as persistent nausea/vomiting, loss of appetite, severe stomach/abdominal/back pain).
• Heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).
• Kidney problems (such as change in amount of urine)
• Monotherapy: Osteoarthritis (characterised by joint pain) and upper respiratory tract infections 
• GI disturbances with metformin
• Flatulence and peripheral edema with pioglitazone 
• Influenza with insulin 
• Nasopharyngitis (inflammation of throat and nasal passages)

 

How to cope with some of the adverse effects

• Nausea (feeling sick) – Take Inosita Plus XR 100mg+1000mg Tablet 7 ‘S with meals and avoid having spicy food

• Headaches – Take a painkiller, rest and keep yourself hydrated at all times. Avoid drinking alcohol

• Vomiting and Diarrhoea – Keep yourself hydrated by having lots of fluids and still if the problem persists, consult your doctor before taking any medication for vomiting and diarrhoea.

• Stomach ache – Try to rest as much as possible and have smaller and more frequent meals. Using a heat pack or hot water bottle over the area in pain might help in giving some relief. If the pain still persists and is severe, speak to your doctor.

• Loss of appetite – Have smaller meals than usual at times that you would normally eat.

• Dizziness – Try and rest until you feel better and refrain from driving or using any tools or machinery

• Metallic taste in the mouth – Have something that would change the taste of your mouth for example, sugar-free gum

• Hypoglycemia – Carry fast acting carbohydrates (like sweets and juice) to prevent your body from going into a state of hypoglycemia (low blood sugar)

Inform your doctor immediately if you experience any of the serious side effects.

 

Key facts about Inosita Plus XR 100mg+1000mg Tablet 7 ‘S

• Inosita Plus XR 100mg+1000mg Tablet 7 ‘S is used for the treatment of type 2 diabetes mellitus (condition resulting in elevated levels of sugar in the blood) in patients that are inadequately controlled by metformin alone or have been treated with the combination of sitagliptin and metformin as separate tablets. 
• It is prescribed to adults above 18 years of age.
• When using Inosita Plus XR 100mg+1000mg Tablet 7 ‘S with other medicines it can cause hypoglycemia, (low blood sugar) hence, carry something sweet in case that happens.
• Unlike some other anti diabetics, chances of weight gain are very low
• Inform your doctor about your treatment if you are to undergo surgery.
• Matter of concern arises when you experience deep or rapid breathing, persistent nausea, vomiting, and stomach pain, as Inosita Plus XR 100mg+1000mg Tablet 7 ‘S may cause a rare but serious condition called lactic acidosis.
• It is important for your doctor to monitor your blood sugar levels regularly, along with repeated kidney and liver function tests to prevent you from any complications

FAQs

 

1. WHAT EXACTLY DOES Inosita Plus XR 100mg+1000mg Tablet 7 ‘S DO?

It is used in the treatment of type 2 diabetes (high blood sugar levels) in patients that are inadequately controlled by metformin alone or have been treated with the combination of sitagliptin and metformin as separate tablets.

2. HOW LONG DOES IT TAKE FOR Inosita Plus XR 100mg+1000mg Tablet 7 ‘S TO START WORKING?

Inosita Plus XR 100mg+1000mg Tablet 7 ‘S starts working in a couple of weeks, however, optimum result is usually achieved in a few  weeks. It is essential to take it consistently to stabilise your blood sugar levels

3. HOW LONG WILL I HAVE TO TAKE Inosita Plus XR 100mg+1000mg Tablet 7 ‘S FOR?

Inosita Plus XR 100mg+1000mg Tablet 7 ‘S is usually prescribed for long term use, possibly life long. Your dosage and time period is decided by your doctor after knowing the severity of your condition.

4. CAN I STOP TAKING Inosita Plus XR 100mg+1000mg Tablet 7 ‘S?

This medicine largely controls your blood sugar levels, but does not cure your condition. Hence, do not just stop taking the medicine without consulting your doctor, otherwise your condition could possibly get worse.

5. WHAT IF Inosita Plus XR 100mg+1000mg Tablet 7 ‘S STOPS WORKING?

If it stops working, then your doctor will either give it to you with a combination of other medicines or recommend a different treatment to you by switching it with other anti-diabetics.

6. WILL Inosita Plus XR 100mg+1000mg Tablet 7 ‘S AFFECT MY KIDNEYS?

It does not affect those with normal kidney function and hence, is safe to use for them. However, if you have a history of kidney disease, inform your doctor as you might need to alter your daily dose.

7. DOES Inosita Plus XR 100mg+1000mg Tablet 7 ‘S CAUSE WEIGHT GAIN?

It does not cause weight gain like other anti diabetics.

8. CAN Inosita Plus XR 100mg+1000mg Tablet 7 ‘S CAUSE NAUSEA AND VOMITING?

Yes, it can. In case of vomiting, make sure to keep yourself hydrated. However, if it persists then inform your doctor and look out for signs like less frequent urination, dark coloured, strong smelling urine.

9. WHAT IF I TAKE TOO MUCH OF Inosita Plus XR 100mg+1000mg Tablet 7 ‘S?

An overdose of Inosita Plus XR 100mg+1000mg Tablet 7 ‘S alone usually does not cause hypoglycemia (low blood sugar) indicated by feeling hungry, trembling or shaking, sweating, feeling confused and having problems concentrating. However, it could occur if a good diet is not maintained. Contact your doctor immediately if you experience any of these signs or experience stomach pain, nausea/vomiting and dizziness.

10. WHAT IF I FORGET TO TAKE Inosita Plus XR 100mg+1000mg Tablet 7 ‘S?

Incase you miss a dose, take your next dose on time and do not try making up for the missed dose by doubling it up. If it helps to remind you, set an alarm so you do not miss any dose.

11. CAN I DRINK ALCOHOL WHILE TAKING Inosita Plus XR 100mg+1000mg Tablet 7 ‘S?

Avoid drinking alcohol while you are on Inosita Plus XR 100mg+1000mg Tablet 7 ‘S as it can interfere with your treatment causing low blood sugar levels especially in aged patients and on occasions where you have skipped a meal.

12. CAN I TAKE Inosita Plus XR 100mg+1000mg Tablet 7 ‘S BEFORE SURGERY ?

Inform your doctor that you are using Inosita Plus XR 100mg+1000mg Tablet 7 ‘S before surgery as he/she might ask you to stop taking the medicine before your operation.

13. CAN I DRIVE OR RIDE A BIKE AFTER TAKING Inosita Plus XR 100mg+1000mg Tablet 7 ‘S?

Inosita Plus XR 100mg+1000mg Tablet 7 ‘S alone might not affect your ability to drive or ride a bike, but when given in combination with other medicines, it could result in low blood sugar levels resulting in loss of concentration vision impairment (your eyesight is affected). To be on the safe side, always carry fast acting carbohydrates (like sweets and juice) to prevent your body from going into a state of hypoglycemia (low blood sugar)

14. HOW SHOULD Inosita Plus XR 100mg+1000mg Tablet 7 ‘S BE STORED?

Keep this medicine tightly closed in the container or the pack it came in. Store it at room temperature, away from excess heat and moisture. Make sure it is not consumed by pets, children and other people. Dispose of the unused medicine.