A fixed-dose combination (FDC) oral antidiabetic medication containing Metformin Hydrochloride (a biguanide) and Teneligliptin Hydrobromide Hydrate (a dipeptidyl peptidase-4 inhibitor). This combination provides complementary mechanisms of action to improve glycemic control in type 2 diabetes mellitus (T2DM) by reducing hepatic glucose production, improving insulin sensitivity, and enhancing glucose-dependent insulin secretion while suppressing glucagon secretion. It is a second-line or add-on therapy when monotherapy with metformin is insufficient.
Adult: One tablet (Metformin 500mg + Teneligliptin 20mg) once daily, preferably with the evening meal to improve gastrointestinal tolerance to metformin. Dose can be titrated based on glycemic control, up to a maximum of two tablets per day (Metformin 1000mg + Teneligliptin 40mg) in divided doses.
Note: Swallow the tablet whole with a glass of water. Take with or immediately after food to reduce gastrointestinal side effects from metformin. Do not crush or chew.
The combination works via two distinct and complementary pathways. Metformin decreases hepatic gluconeogenesis and glycogenolysis, reduces intestinal absorption of glucose, and improves peripheral glucose uptake and utilization by increasing insulin sensitivity. Teneligliptin inhibits the enzyme dipeptidyl peptidase-4 (DPP-4), which degrades the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). This inhibition increases and prolongs the activity of endogenous incretins, leading to glucose-dependent insulin secretion from pancreatic beta cells and suppression of glucagon secretion from alpha cells.
Pregnancy: Pregnancy Category C (US FDA). Not recommended during pregnancy. Insulin is the preferred drug for glycemic control in pregnant women with diabetes. Limited human data; use only if potential benefit justifies potential risk to fetus.
Driving: Usually no effect. However, patients should be cautioned about the risk of hypoglycemia (especially when combined with other drugs) or dizziness, which may impair ability to drive or operate machinery.
| Iodinated Contrast Media | Risk of contrast-induced nephropathy and subsequent metformin-associated lactic acidosis. | Major |
| Alcohol | Potentiates metformin's effect on lactate metabolism; increases risk of lactic acidosis and hypoglycemia. | Major |
| Cimetidine | Increases metformin plasma concentration by competing for renal tubular secretion. | Moderate |
| Corticosteroids, Diuretics, Sympathomimetics | May lead to hyperglycemia and loss of glycemic control. | Moderate |
| Sulfonylureas (e.g., Glimepiride) or Insulin | Increased risk of hypoglycemia. May require dose reduction of sulfonylurea/insulin. | Moderate |
| Strong CYP3A4 Inducers (e.g., Rifampicin, Carbamazepine, Phenytoin) | May decrease plasma concentration of teneligliptin, reducing efficacy. | Moderate |
| Digoxin | Metformin may increase digoxin bioavailability; monitor digoxin levels. | Minor |
Same composition (Metformin (500mg) + Teneligliptin (20mg)), different brands: