hepexa m tablet - Metformin (500mg) + Ursodeoxycholic Acid/Ursodiol (150mg) medicine

This Medicine: Complete Guide to Uses, Side Effects, and Safety

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🏭 Eris Lifesciences Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 24, 2026
⚠️ Hepatotoxicity Risk 🤰 Pregnancy Category Not established from the available information. Consult your doctor if you are pregnant or planning pregnancy. 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Moderate to well-established for individual components; limited for the fixed-dose combination.
Reviewed by
SaathiMed Expert Panel | Sep 24, 2026

When to Call Your Doctor IMMEDIATELY

  • Rapid breathing or shortness of breath
  • Severe muscle pain or cramps
  • Extreme tiredness or weakness
  • Stomach pain with nausea and vomiting
  • Yellowing of skin or eyes (jaundice)
  • Decreased urine output
  • Signs of low blood sugar: shakiness, sweating, confusion, fast heartbeat

If experiencing severe symptoms, call emergency services immediately.

What is hepexa m tablet used for?

This medicine is a combination of Metformin and Ursodeoxycholic Acid used to treat type 2 diabetes in patients with liver conditions like fatty liver disease. It helps control blood sugar and supports liver health.

  • Generic Name: Metformin (500mg) + Ursodeoxycholic Acid/Ursodiol (150mg)
  • Manufacturer: Eris Lifesciences Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 hepexa m tablet के बारे में (Hindi Summary)

उपयोग: यह दवा मेटफॉर्मिन और अर्सोडीऑक्सीकोलिक एसिड का संयोजन है, जिसका उपयोग टाइप 2 डायबिटीज और लिवर की समस्याओं जैसे फैटी लिवर के इलाज के लिए किया जाता है। यह ब्लड शुगर को नियंत्रित करने और लिवर की रक्षा करने में मदद करती है।

साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, दस्त, पेट दर्द, और धातु जैसा स्वाद शामिल हैं। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन लैक्टिक एसिडोसिस या एलर्जी हो सकती है। कोई भी असामान्य लक्षण होने पर तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा को डॉक्टर के निर्देशानुसार ही लें। इसे भोजन के साथ लें ताकि पेट की परेशानी कम हो। शराब का सेवन बिल्कुल न करें। गुर्दे और लिवर की कार्यप्रणाली की नियमित जांच कराएं। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें।

💡 Did You Know? India has the highest number of USFDA-compliant plants outside the USA.

💊 hepexa m tablet Uses & Benefits

[{"condition":"Type 2 Diabetes Mellitus with Non-Alcoholic Fatty Liver Disease (NAFLD)","description":"This medicine helps control blood sugar levels while also improving liver function in patients with fatty liver disease.","evidence":"Well-established for metformin; ursodeoxycholic acid has supportive evidence in cholestatic liver conditions."},{"condition":"Type 2 Diabetes Mellitus with Cholestatic Liver Disease","description":"Used when diabetes coexists with conditions like primary biliary cholangitis or other cholestatic disorders.","evidence":"Ursodeoxycholic acid is well-established for cholestatic liver diseases; metformin manages diabetes."},{"condition":"Type 2 Diabetes Mellitus with Elevated Liver Enzymes","description":"May be prescribed when liver enzymes are persistently elevated, suggesting liver involvement.","evidence":"Limited to moderate evidence; clinical judgment required."}]

Off-label uses: [{"condition":"Non-alcoholic steatohepatitis (NASH)","description":"Ursodeoxycholic acid is sometimes used off-label to improve liver enzymes in NASH, though evidence is limited.","evidence":"Limited"},{"condition":"Gallstone dissolution","description":"Ursodeoxycholic acid can dissolve small cholesterol gallstones in selected patients, but this is not the primary use of this combination.","evidence":"Well-established for ursodeoxycholic acid alone"}]

Primary treatment for: Type 2 Diabetes Mellitus with liver dysfunction

Also treats: Non-Alcoholic Fatty Liver Disease (NAFLD), Cholestatic liver diseases (e.g., Primary Biliary Cholangitis), Elevated liver enzymes

📋 Drug Information

Generic Name(s)Metformin (500mg) + Ursodeoxycholic Acid/Ursodiol (150mg)
Brand Namehepexa m tablet
ManufacturerEris Lifesciences Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassGASTRO INTESTINAL
Action Class
Route of AdministrationOral
StorageStore at room temperature (15-30°C) in a dry place, away from direct sunlight and moisture. Keep in the original container.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Always take this medicine with meals to minimize stomach upset.
2
Monitor your blood sugar levels regularly and keep a log.
3
Get your kidney and liver function tested at least every 6 months.
4
Avoid alcohol completely while on this medicine.
5
Inform your doctor if you are scheduled for any surgery or contrast imaging.
6
Report any unusual muscle pain, breathing difficulty, or extreme fatigue immediately.
7
Do not stop this medicine without consulting your doctor, even if you feel better.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
High blood sugar
This medicine is commonly prescribed for this.
Likely Use
✅
Fatty liver
This medicine may be prescribed for this.
Likely Use
❌
Fever
This medicine is not a primary fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionMetformin is absorbed primarily from the small intestine. Ursodeoxycholic Acid is absorbed in the ileum and colon. Food may slightly delay absorption of metformin but does not significantly affect overall bioavailability.
DistributionMetformin distributes widely into body tissues and is not bound to plasma proteins. Ursodeoxycholic Acid is extensively bound to plasma proteins, mainly albumin, and is taken up by the liver.
Protein BindingMetformin: negligible protein binding. Ursodeoxycholic Acid: approximately 96-99% bound to plasma proteins.
MetabolismMetformin is not metabolized in humans and is excreted unchanged. Ursodeoxycholic Acid undergoes hepatic conjugation with glycine or taurine and is then metabolized by intestinal bacteria.
Half-LifeMetformin: approximately 6.2 hours in plasma and about 17.6 hours in whole blood. Ursodeoxycholic Acid: not well established from available information.
ExcretionMetformin is excreted unchanged in urine. Ursodeoxycholic Acid is excreted mainly in feces via bile, with a small amount in urine.
BioavailabilityMetformin: 50-60% under fasting conditions. Ursodeoxycholic Acid: approximately 60-80% absorbed, but bioavailability varies due to first-pass metabolism.
Onset of ActionMetformin: blood glucose lowering effect may take several days to weeks. Ursodeoxycholic Acid: improvement in liver enzymes may be seen within 2-4 weeks.
Peak Plasma TimeMetformin: 2-3 hours after oral dose. Ursodeoxycholic Acid: 1-3 hours after oral dose.
Duration of ActionMetformin: 24 hours with immediate-release formulation taken multiple times daily. Ursodeoxycholic Acid: effects last until next dose; steady state achieved after several doses.

How It Works

This medicine combines two active ingredients with distinct mechanisms. Metformin decreases hepatic glucose production, reduces intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Ursodeoxycholic Acid reduces the cholesterol saturation of bile, disperses cholesterol in bile, and protects hepatocytes from the toxic effects of hydrophobic bile acids. Together, they address both glycemic control and liver health.

Mechanism Steps

1
Metformin inhibits hepatic gluconeogenesis: Metformin reduces glucose production in the liver by inhibiting mitochondrial respiratory chain complex I, leading to decreased ATP and increased AMP levels, which activates AMPK.
2
Metformin improves insulin sensitivity: Activation of AMPK enhances insulin signaling and glucose uptake in skeletal muscle and adipose tissue.
3
Ursodeoxycholic Acid reduces bile cholesterol: Ursodeoxycholic Acid decreases cholesterol absorption and secretion into bile, lowering bile cholesterol saturation.
4
Ursodeoxycholic Acid protects hepatocytes: It replaces toxic bile acids in the bile acid pool, reducing detergent-like damage to cell membranes and preventing cholestatic liver injury.

💡 How to Take hepexa m tablet

Strength: Each tablet contains Metformin 500 mg and Ursodeoxycholic Acid 150 mg.

1Take this medicine exactly as prescribed by your doctor.
2Swallow the tablet whole with a glass of water.
3Take it with meals to reduce stomach upset.
4Do not crush, chew, or break the tablet unless advised.
5Maintain a consistent schedule for best results.

Dosage Information

Adult DosageThe usual adult dose is one tablet taken orally one to two times daily with meals, or as prescribed by your doctor. The exact dose and frequency depend on your blood sugar levels, liver function, and kidney function. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Do not self-adjust the dose.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may require lower doses due to reduced kidney function. Regular monitoring of renal function is essential. Dose must be individualized by a qualified clinician.
Renal ImpairmentMetformin is contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²). In mild to moderate renal impairment, dose reduction or discontinuation may be needed. Ursodeoxycholic acid does not require renal dose adjustment. Consult your doctor for personalized dosing.
Hepatic ImpairmentUse with caution in patients with severe liver disease. Ursodeoxycholic acid is generally safe, but metformin should be avoided in severe hepatic impairment due to risk of lactic acidosis. Dose must be individualized by a qualified clinician.
Maximum Daily DoseThe maximum recommended daily dose of metformin is 2000-2550 mg depending on formulation. Ursodeoxycholic acid maximum daily dose is typically 15 mg/kg/day. For this combination, do not exceed the dose prescribed by your doctor.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With meals
Take with food
Reduces stomach upset and improves tolerance.
Alcohol
Avoid
Increases risk of lactic acidosis and liver damage.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of hepexa m tablet

✅ Common Side Effects

Nausea (Common (up to 30%))
Take with food and drink plenty of water. If persistent, consult your doctor.
Diarrhea (Common (up to 20%))
Stay hydrated. If severe or persistent, contact your doctor.
Abdominal discomfort (Common (10-20%))
Take with meals. Usually improves over time.
Metallic taste (Uncommon (5-10%))
Usually temporary. Chewing sugar-free gum may help.

🚨 Serious Side Effects

Lactic acidosis (Rare (<0.1%))
Seek immediate medical attention if you experience rapid breathing, muscle pain, extreme tiredness, or stomach pain.
Severe hypoglycemia (Rare when used alone; higher if combined with insulin or sulfonylureas)
Check blood sugar immediately and consume fast-acting sugar if conscious. Seek emergency care if unconscious.
Allergic reaction (Rare (<0.1%))
Stop the medicine and seek immediate medical help if you notice rash, swelling, or difficulty breathing.

⚠️ Rare Side Effects

Megaloblastic anemia
Report unusual fatigue or paleness to your doctor.
Pancreatitis
Seek immediate care if you have severe upper abdominal pain radiating to the back.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Iodinated contrast media Major
Alcohol Major
Cimetidine Moderate
Furosemide Moderate
Corticosteroids Moderate
ACE inhibitors Moderate
Cholestyramine Minor
Antacids (Al/Mg) Minor

🚨 Major Interactions

  • Iodinated contrast media
  • Alcohol
  • Cationic drugs (e.g., cimetidine, ranitidine)

⚡ Moderate Interactions

  • Diuretics (e.g., furosemide)
  • Corticosteroids
  • ACE inhibitors

🍷 Alcohol Interaction

Alcohol should be completely avoided while taking this medicine. Alcohol increases the risk of lactic acidosis, a rare but serious complication of metformin, and can worsen liver damage. It may also cause hypoglycemia.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Severe renal impairment (eGFR

⚠️ Warnings & Precautions

["Lactic acidosis is a rare but serious complication; seek immediate medical help if you experience muscle pain, breathing difficulty, stomach pain, or extreme fatigue.","Regularly monitor kidney function; dose adjustment may be needed if kidney function declines.","Avoid alcohol completely while on this medicine.","Inform your doctor if you are scheduled for surgery or imaging with contrast dyes; you may need to temporarily stop this medicine.","Vitamin B12 deficiency may occur with long-term metformin use; periodic monitoring is advised.","Do not use this medicine for weight loss without medical supervision."]

🤱 Lactation Safety

Metformin is excreted in breast milk in small amounts. Ursodeoxycholic acid is likely safe but data are limited. Consult your doctor before breastfeeding.

💊 Overdose Management

Overdose may cause lactic acidosis, hypoglycemia, or liver toxicity. Seek immediate medical attention. Treatment is supportive and symptomatic. Hemodialysis may be considered for metformin overdose.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

Additional Safety Advice

General Safety

Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop taking it without medical advice. Always take it with meals to reduce stomach upset. Drink plenty of water throughout the day. Avoid alcohol completely while on this medicine, as it increases the risk of lactic acidosis and liver problems. Inform your doctor about all other medicines, supplements, or herbal products you are taking. If you have kidney or liver disease, your doctor may need to adjust the dose or monitor you more closely. Do not use this medicine if you are pregnant or breastfeeding without consulting your doctor. Keep this medicine out of reach of children.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at higher risk of kidney impairment and lactic acidosis. Regular monitoring of renal function is crucial. Dose adjustments may be necessary.

🤰 Pregnancy Planning (TTC)

If you are planning pregnancy, consult your doctor. This medicine is not routinely recommended during pregnancy. Your doctor may switch you to safer alternatives like insulin.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist about this medicine. It may need to be temporarily stopped before surgery due to risk of lactic acidosis, especially if contrast dyes or kidney-affecting drugs are used.

🦷 Dental Procedures

Inform your dentist about this medicine. No specific precautions are usually needed, but maintain good oral hygiene and monitor blood sugar.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to improve blood sugar control and liver health.
🥗
Engage in regular physical activity, such as brisk walking or swimming, for at least 30 minutes most days.
😴
Eat a balanced diet rich in fiber, lean proteins, and healthy fats.
💧
Limit sugary drinks and processed foods.
🧘
Get adequate sleep and manage stress through relaxation techniques.
🌞
Avoid smoking and limit alcohol consumption.

🏋️ Exercise Considerations

Exercise is beneficial, but monitor your blood sugar before and after exercise, especially if you are on other diabetes medications. Carry a fast-acting sugar source in case of hypoglycemia. Stay hydrated.

🥗 Diet Recommendations

Include plenty of vegetables, whole grains, and lean proteins.
Choose healthy fats like olive oil, nuts, and fatty fish.
Limit refined carbohydrates and sugary beverages.
Eat small, frequent meals to help control blood sugar.
Stay well hydrated with water.

💼 Impact on Daily Work & Life

This medicine may cause dizziness or low blood sugar in some people, which can affect driving or operating machinery. Avoid these activities if you feel unwell. Otherwise, it should not significantly impact your daily work life.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. If you experience serious side effects or your doctor advises discontinuation due to improved condition or other reasons, follow their guidance. Stopping suddenly can cause blood sugar to rise.

📅 Long-Term Use Effects

Long-term use of this medicine requires regular monitoring of kidney function, liver function, and vitamin B12 levels. Metformin may cause vitamin B12 deficiency over time. Ursodeoxycholic acid is generally safe for long-term use. Periodic review with your doctor is essential to adjust the dose and detect any complications early.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Lifestyle modifications

Diet and exercise are cornerstone treatments for diabetes and fatty liver disease.

Evidence: Well-established
Other antidiabetic medications

Your doctor may prescribe alternative medications if this combination is not suitable.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No specific vaccine interactions are known. However, keep your vaccinations up to date, especially for influenza and pneumonia, as diabetes can increase risk of infections.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

Carry this medicine in its original packaging with a copy of your prescription. If traveling across time zones, adjust your dosing schedule gradually in consultation with your doctor. Store at room temperature and protect from moisture. Declare it to customs if required. Always carry enough supply for your entire trip.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 52-year-old man with type 2 diabetes and fatty liver disease
He was prescribed this medicine after his liver enzymes were found elevated. Within 3 months, his blood sugar levels improved and liver enzymes normalized. He emphasized taking the tablet with meals and avoiding alcohol.
💡 Lesson: Consistent use with meals and lifestyle changes can lead to significant improvement in both diabetes and liver health.
👤 A 60-year-old woman with diabetes and primary biliary cholangitis
She started this medicine and noticed reduced itching and fatigue within a month. Her doctor monitored her kidney function regularly. She experienced mild diarrhea initially, which resolved after a few weeks.
💡 Lesson: Regular monitoring and patience with initial side effects are key to successful treatment.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: Metformin starts lowering blood sugar within a few days, but full effect may take 1-2 weeks. Ursodeoxycholic acid may improve liver enzymes within 2-4 weeks.

Q: Can I take this medicine if I have kidney disease?

A: It depends on the severity. This medicine is contraindicated in severe kidney disease. Your doctor will monitor your kidney function and adjust the dose.

Q: What should I do if I miss a dose?

A: Take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🛑 Myths vs. Facts

  • Myth: This medicine can cure diabetes permanently.
    Fact: This medicine helps manage blood sugar levels but does not cure diabetes. Lifestyle changes and ongoing medication are usually needed.
  • Myth: This medicine is safe for everyone with diabetes.
    Fact: It is not safe for people with severe kidney or liver disease, or those who drink alcohol heavily.
  • Myth: You can stop this medicine once your sugar levels are normal.
    Fact: Stopping without medical advice can cause blood sugar to rise again. Always consult your doctor before stopping.

🔄 Alternative Options

Generic Alternatives

  • Metformin 500 mg + Ursodeoxycholic Acid 150 mg tablet (generic)

📊 Comparison with Similar Medicines

[{"medicine":"This medicine","composition":"Metformin 500 mg + Ursodeoxycholic Acid 150 mg","primary_use":"Type 2 diabetes with liver dysfunction","key_feature":"Dual action: glycemic control + liver support"},{"medicine":"Metformin alone","composition":"Metformin 500 mg","primary_use":"Type 2 diabetes","key_feature":"Only glycemic control"},{"medicine":"Ursodeoxycholic Acid alone","composition":"Ursodeoxycholic Acid 150 mg","primary_use":"Liver diseases","key_feature":"Only liver support"}]

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