Voglibose + Metformin

Voglibose+ Metformin is an Anti-diabetic Agent belonging to the pharmacological class of Alpha-Glucosidase inhibitors and biguanides.

Voglibose+ Metformin has been approved to treat type 2 diabetes in adults when diet and exercise alone do not provide adequate glycemic control.

Voglibose is absorbed in the gastrointestinal system, primarily eliminated in the urine, and does not significantly undergo metabolism. In the small intestine, metformin is absorbed, undergoes little metabolic processing, and is eliminated unaltered in the urine. These two drugs increase glucose synthesis and use in the liver while blocking glucose absorption in the gastrointestinal tract.

The common side effects of Voglibose+ Metformin are taste changes, nausea, vomiting, diarrhoea, stomach pain and bloating.

Voglibose+ Metformin is available as a tablet for convenient administration.

Voglibose+ Metformin is available in India, the United States, Canada, the United Kingdom, Japan, France and Australia.

Voglibose+ Metformin is an Anti-diabetic Agent belonging to the pharmacological class of Alpha-Glucosidase inhibitors and biguanides.

Voglibose: A synthetic substance called Voglibose, an alpha-glucosidase inhibitor, has strong and long-lasting therapeutic effects against diseases of the sensory, motor, and autonomic nerve systems brought on by diabetes mellitus. Alpha-glucosidase inhibitors are oral anti-diabetic medications used to treat type 2 diabetes mellitus. They function by stopping the breakdown of complex carbohydrates, such as starch. Usually, simple sugars, or monosaccharides, are formed from complex carbohydrates and can be absorbed by the colon. As a result, alpha-glucosidase inhibitors lessen the effect that complex carbohydrates have on blood glucose.

Metformin: Metformin decreases hepatic glucose production, reduces glucose absorption in the intestine and improves insulin sensitivity (increases peripheral glucose uptake and utilization).

Synergistic Benefits: Metformin and Voglibose combination provide synergistic effects on type 2 diabetes management. Voglibose effectively decreases blood sugar spikes after meals by delaying the gut's processing and absorption of carbohydrates. Inversely, metformin mainly works by improving peripheral tissue insulin sensitivity and reducing the amount of glucose produced in the liver. Together, these medications offer an effective method of managing diabetes and also help with weight management (metformin may provide a little amount of weight loss) and blood sugar control and may even benefit the cardiovascular system by lowering the risk of heart-related problems. The combination also reduces the possibility of hypoglycemia, which can be harmful when using some other antidiabetic drugs.

Data Onset of action of Voglibose+ Metformin typically occurs within 1 to 2 hours after administration.

Data duration of action of Voglibose+ Metformin effects generally within 4 to 6 hours after administration.

The Data of Tmax (time to peak concentration) of Voglibose+ Metformin generally reached within 1-2 hours after oral administration.

The Data of Cmax of Voglibose+ Metformin is achieved within 1-2 hours following administration.

Voglibose+ Metformin is available in oral tablets.

Tablets: To be swallowed whole with water/liquid. Do not chew, crush or break it.

As the physician recommends, take the medication orally three times daily before meals or generally with a meal.

Voglibose: Voglibose is an alpha-glucosidase inhibitor used for lowering postprandial blood glucose levels in people with diabetes mellitus.

Metformin: Metformin improves glucose tolerance by lowering basal and postprandial plasma glucose. It exerts its effect by decreasing hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis, delaying intestinal glucose absorption, and increasing insulin sensitivity by increasing peripheral glucose uptake and utilization.

Type 2 diabetes is treated with metformin + Voglibose. Voglibose and metformin are combined in it. Voglibose prevents intestinal enzymes from breaking down complex sugars into simple sugars like glucose. It postpones the absorption of glucose. The spike in blood glucose levels that occurs right after meals is stopped by this treatment.In contrast, metformin exhibits the non-pancreatic action to lower blood sugar levels without boosting insulin production. Its ability to enhance the effects of insulin has given it the name "insulin sensitizer." Because it doesn't lower blood sugar, it is regarded as a particular anti-diabetic medication. In most circumstances, metformin is not associated with weight gain.

Voglibose +Metformin is approved for use in the following clinical indications:

Orally: Voglibose+ Metformin is available as a tablet that can be taken orally.It is advised to progressively raise the metformin dose at the beginning of treatment to reduce gastrointestinal adverse effects. Take the drug along with food. Avoid breaking, crushing, dissolving, or chewing extended-release pills; instead, swallow them whole. When metformin extended-release pills are partially dissolved in the stool, as has happened with some of them, a healthcare professional should assess glycemic control. The tablet strength determines the precise dosage. Do not double the next dose if missed; instead, take it as soon as possible.

The dosage and duration of treatment should be as per the treating physician's clinical judgment.

Voglibose+ Metformin has various strengths, such as 0.3mg+500mg or 0.2mg+500mg.

Voglibose+ Metformin is available in the form of Oral tablets.

A single tablet, given two or three times a day, during or after meals, is the typical starting dose for the fixed-dose combination of Voglibose 0.2/0.3 mg and metformin hydrochloride 500 mg. Blood glucose levels should be used to modify the dosage after ten to fifteen days. The gastrointestinal tolerance of a dosage increase could be improved gradually. Metformin's highest suggested dosage is 3 g daily, administered in three separate doses. Limit the daily dosage of metformin to 2500 mg and Voglibose to 0.9 mg.

If switching from another oral antidiabetic is the strategy, stop taking the other medication and start taking metformin at the previously mentioned dosage.

Voglibose+ Metformin should be used in treating type 2 diabetes mellitus, along with appropriate dietary restrictions.

Voglibose+ Metformin is usually taken with meals to reduce the risk of gastrointestinal side effects. Excessive alcohol consumption should be avoided as it can potentiate the risk of lactic acidosis, a rare but severe side effect associated with Metformin.

While taking this combination, it is advised to stay hydrated, consume a rich-balanced diet low in saturated fats and cholesterol—and drink plenty of vegetables, whole grains, fruits, and lean proteins in meals.

The dietary restriction should be individualized as per patient requirements.

Voglibose+ Metformin may be contraindicated in the following conditions:-

The adverse reactions related to Voglibose+ Metformin can be categorized as:-

The clinically relevant drug interactions of Voglibose and metformin are briefly summarized here:

The most common side effects of Voglibose+ Metformin include:

Abdomen ache

Breathing difficulties

Nausea

Vomiting

Stomach pain

Rash on the skin

Bloating

Changes in taste

Diarrhoea

Dizziness

Flatulence (intestinal wind/gas)

Voglibose+ Metformin should be prudent in the following group of special populations.

Pregnancy Category C: Use with caution if the benefits outweigh the risks.

There are currently no relevant epidemiological data available. Because there are no reported adverse effects of the medication on pregnancy, fetal or embryonic development, parturition, or postnatal development, it should only be administered to pregnant or potentially pregnant women when the potential benefits outweigh the risks. This is supported by research on animals. To reduce the risk of fetal abnormalities linked to abnormal blood glucose levels, insulin should be used to keep blood glucose levels as close to normal as possible when the patient wishes to get pregnant and throughout the pregnancy. Metformin should not be used to treat diabetes.

Lactating rats excrete metformin into their milk. Since there is a lack of comparable data for humans, the benefits of continuing the compound in the mother should be considered when deciding whether to stop nursing or stop taking metformin.

Research conducted on rats has indicated that Voglibose has a suppressive effect on the increase in body weight of newborns. This effect is likely attributed to the suppression of milk production in mother animals, which results from the suppression of carbohydrate absorption. As such, it is preferable to avoid giving women Voglibose when they are nursing. Nursing should be avoided when administration cannot be avoided.

As per FDA, safety and effectiveness in the pediatric population have yet to be established.

Given that older individuals typically exhibit a physiological hypofunction, it is preferable to proceed with caution and begin the administration of the medication at low doses (e.g., 0.1 mg at a time). In addition, for the disease, this medication should be closely monitored and carefully provided. The initial onset of gastrointestinal symptoms and blood sugar levels should also be closely monitored.

Kidney Impairment (Mild to Severe): Not recommended; Regular assessment of renal function is necessary.

Mild-to-moderate: No dosage modification is required.

Severe: This has not been researched and is not advised.

The physician should be vigilant about the knowledge pertaining to the identification and treatment of overdosage of Voglibose+ Metformin.

Overconsumption of Voglibose+ Metformin could lead to

severe hypoglycemia (very low blood sugar), gastrointestinal disturbances, and lactic acidosis, with manifestations like nausea, vomiting, and abdominal pain.

There is no specific antidote for Voglibose+ Metformin overdose, emphasizing the need for immediate medical attention. Suspected overdose warrants discontinuation of the medications. In recent overdose cases, gastric lavage or activated charcoal can limit further absorption. Supportive care addresses symptoms through fluids, electrolyte correction, and antiemetics for nausea and vomiting. Severe hypoglycemia necessitates close monitoring until stabilization.

In cases of severe metformin-induced lactic acidosis, hemodialysis may be an option to remove excess metformin and correct acidosis. Timely intervention and medical supervision are imperative to manage Voglibose+ Metformin overdose effectively and mitigate potential complications.

Voglibose: Alpha-glucosidase inhibitors are saccharides that function as competitive inhibitors of the alpha-glucosidase enzymes in the small intestine's brush border, which are necessary for digesting carbohydrates. In the small intestine, oligosaccharides, trisaccharides, and disaccharides are hydrolyzed to glucose and other monosaccharides by the membrane-bound intestinal alpha-glucosidases. Acarbose inhibits membrane-bound alpha-glucosidases and also suppresses pancreatic alpha-amylase. In the small intestine lumen, complex starches are hydrolyzed to oligosaccharides by pancreatic alpha-amylase. Compromising these enzyme systems slows down the rate at which complex carbohydrates are metabolized. Because the carbs are not converted into glucose molecules, less glucose is absorbed. The short-term impact of these medication regimens on diabetes patients is a decline in blood glucose levels; the long-term effect is a slight decrease in haemoglobin A1c levels.

Metformin: Metformin is an antihyperglycemic medication that lowers basal and postprandial plasma glucose levels in people with type 2 diabetes, improving their glucose tolerance. Its pharmacologic modes of action are distinct from those of other oral antihyperglycemic medication groups. Metformin increases peripheral glucose uptake and utilization, which lowers intestinal glucose absorption, reduces hepatic glucose synthesis, and enhances insulin sensitivity. Metformin, unlike sulfonylureas, does not result in hyperinsulinemia or hypoglycemia in either type 2 diabetes patients or healthy persons. Metformin medication does not alter insulin secretion, although it may reduce the plasma insulin response throughout the day and insulin levels while fasting.

Voglibose: <2% (as active drug) and approx 35% (as metabolites) are absorbed from the gastrointestinal tract.

Metformin: Slowly and incompletely absorbed from the gastrointestinal tract. Food slightly delays and decreases the extent of absorption. Absolute bioavailability: 50-60%. Time to peak plasma concentration: 2-3 hours (immediate-release); 7 hours, range: 4-8 hours (extended-release).

Bioavailability: 50-60% (Metformin [fasted])

Voglibose: Time to peak plasma concentration: Approx 1 hour (active drug).

Metformin: Concentrates in the liver, kidney and gastrointestinal tract. It crosses the placenta and then enters breast milk (small amounts). Volume of distribution: 654 ± 358 L.

Protein-bound: Negligible (Metformin)

Voglibose: Exclusively metabolized in the gastrointestinal tract mainly by intestinal bacteria and digestive enzymes into at least 13 metabolites, including sulfate, methyl, and glucuronide conjugates as the primary metabolites.

Metformin: Excreted unchanged in the urine and did not undergo specific hepatic metabolism (no metabolites have been found in humans) or biliary excretion.

Voglibose: Via urine (approx 34% as inactive metabolites; <2% as unchanged drug and active metabolites); faeces (approx 51% as unabsorbed drug). Elimination half-life: Approx 2 hours.

Metformin: With a plasma elimination half-life of roughly 6.2 hours, 90% of the absorbed medication is excreted via the renal pathway during the first 24 hours following oral administration. The elimination half-life of blood is roughly 17.6 hours, indicating that the erythrocyte bulk could constitute a distribution compartment.

Blood Sugar Control: Metformin and Voglibose are combined to control blood sugar levels effectively. Voglibose reduces post-meal glucose increases by inhibiting the digestion of complex carbohydrates in the intestines, which delays absorption. Metformin improves insulin sensitivity and reduces the synthesis of glucose in the liver, which enhances overall glycemic management.

Weight management: Patients with diabetes who may experience weight gain while taking other drugs will benefit most from this combination's neutral or even weight-reducing effects.

Decreased Hypoglycemia Risk: Compared to certain other diabetic drugs, Voglibose and metformin are less likely to induce hypoglycemia, thereby rendering them safer for a large number of people, especially those who are prone to hypoglycemia episodes.