Glura M 100mg/1000mg Tablet XR: Complete Guide to Uses, Side Effects, and Safety
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Unusual muscle pain, difficulty breathing, or stomach discomfort with feeling cold or dizzy (possible lactic acidosis).
- Severe abdominal pain radiating to the back, with or without nausea and vomiting (possible pancreatitis).
- Swelling of the face, lips, tongue, or throat, or difficulty breathing (severe allergic reaction).
- Yellowing of the skin or eyes, dark urine, or severe fatigue (possible liver problem).
- Decreased urine output, swelling in the legs, or sudden weight gain (possible kidney problem).
- Symptoms of hypoglycemia: shakiness, sweating, confusion, rapid heartbeat, or blurred vision.
- Persistent nausea, vomiting, or diarrhea leading to dehydration.
If experiencing severe symptoms, call emergency services immediately.
What is istamet xr cp combipack used for?
This medicine is a combination of Sitagliptin and Metformin used to treat type 2 diabetes. It helps control blood sugar by increasing insulin release and reducing glucose production in the liver. It is taken orally once daily with a meal.
- Generic Name: Sitagliptin (100mg) + Metformin (1000mg)
- Manufacturer: Sun Pharmaceutical Industries Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 istamet xr cp combipack के बारे में (Hindi Summary)
उपयोग: यह दवा टाइप 2 डायबिटीज (मधुमेह) के इलाज के लिए इस्तेमाल की जाती है। इसमें सिटाग्लिप्टिन और मेटफॉर्मिन दो सक्रिय तत्व होते हैं जो मिलकर ब्लड शुगर को कंट्रोल करने में मदद करते हैं। यह दवा उन मरीजों के लिए है जिनका शुगर लेवल दवा और व्यायाम से भी कंट्रोल नहीं हो पाता। यह इंसुलिन के स्तर को बढ़ाती है और लिवर में शुगर बनने की प्रक्रिया को कम करती है। इसे डॉक्टर की सलाह के अनुसार ही लें।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में दस्त, जी मिचलाना, पेट खराब होना, सिरदर्द और ऊपरी श्वसन संक्रमण शामिल हैं। ये आमतौर पर हल्के होते हैं और कुछ समय में ठीक हो जाते हैं। गंभीर दुष्प्रभाव दुर्लभ हैं लेकिन इनमें लैक्टिक एसिडोसिस, पैन्क्रियाटाइटिस, गंभीर एलर्जी और किडनी की समस्या शामिल हो सकती है। अगर आपको मांसपेशियों में असामान्य दर्द, सांस लेने में कठिनाई, पेट में तेज दर्द, चक्कर आना या दिल की धड़कन अनियमित लगे तो तुरंत डॉक्टर से मिलें।
सुरक्षा सलाह: इस दवा को लेने से पहले अपने डॉक्टर को अपनी किडनी, लिवर, दिल की बीमारी और पैन्क्रियाटाइटिस के इतिहास के बारे में बताएं। अगर आपको गंभीर किडनी की समस्या है तो यह दवा न लें। शराब का सेवन न करें क्योंकि इससे लैक्टिक एसिडोसिस का खतरा बढ़ सकता है। दवा को डॉक्टर के बताए अनुसार ही लें, आमतौर पर दिन में एक बार भोजन के साथ। टैबलेट को चबाएं या तोड़ें नहीं, पूरा निगल लें। अगर आपको खुराक लेना भूल जाए तो याद आते ही ले लें, लेकिन अगर अगली खुराक का समय हो गया है तो छूटी हुई खुराक न लें। ब्लड शुगर, किडनी फंक्शन और विटामिन बी12 की नियमित जांच कराएं। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें।
💊 istamet xr cp combipack Uses & Benefits
[{"condition":"Type 2 Diabetes Mellitus","description":"Used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus who are not adequately controlled on metformin alone or who are already on a combination of sitagliptin and metformin.","evidence":"Well-established"}]
Off-label uses: []
Primary treatment for: Type 2 Diabetes Mellitus
Also treats: Obesity, Metabolic Syndrome, Polycystic Ovary Syndrome (PCOS) - off-label for metformin component
📋 Drug Information
| Generic Name(s) | Sitagliptin (100mg) + Metformin (1000mg) |
| Brand Name | istamet xr cp combipack |
| Manufacturer | Sun Pharmaceutical Industries Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | ANTI DIABETIC |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Keep away from moisture, heat, and direct sunlight. Do not refrigerate. Keep in the original container tightly closed. Keep out of reach of children. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. However, metformin is generally recommended as first-line therapy for type 2 diabetes by many guidelines, and DPP-4 inhibitors like sitagliptin are recommended as add-on therapy. |
| ICMR Guideline | Not established from the available information. However, ICMR guidelines for type 2 diabetes recommend metformin as first-line and DPP-4 inhibitors as add-on options. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two antidiabetic agents with complementary mechanisms of action. Sitagliptin inhibits the enzyme dipeptidyl peptidase-4 (DPP-4), which normally breaks down incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). By inhibiting DPP-4, sitagliptin increases the levels of these active incretins, leading to increased insulin secretion from pancreatic beta cells and decreased glucagon secretion from alpha cells, both in a glucose-dependent manner. Metformin decreases hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Together, they effectively lower blood glucose levels without causing significant hypoglycemia when used alone.
Mechanism Steps
💡 How to Take istamet xr cp combipack
Strength: Extended-release tablet containing Sitagliptin 100 mg and Metformin 1000 mg.
Dosage Information
| Adult Dosage | The usual adult dose is one tablet of Sitagliptin 100 mg and Metformin 1000 mg extended-release taken once daily with a meal. The dose may be adjusted based on your blood sugar levels and kidney function. For patients with kidney problems, a lower dose may be prescribed. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Do not exceed the recommended dose. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients may be more sensitive to the effects of this medicine, especially regarding kidney function. Dose should be adjusted based on renal function. Regular monitoring of kidney function is recommended. Start with a lower dose if renal impairment is present. |
| Renal Impairment | For patients with mild renal impairment (eGFR 60-89 mL/min/1.73 m²), no dose adjustment is needed. For moderate renal impairment (eGFR 45-59 mL/min/1.73 m²), the dose of sitagliptin should be reduced to 50 mg and metformin dose should be adjusted. For eGFR 30-44 mL/min/1.73 m², sitagliptin 50 mg and metformin 500 mg may be used. This medicine is contraindicated if eGFR is below 30 mL/min/1.73 m². Consult your doctor for personalized dosing. |
| Hepatic Impairment | No dose adjustment is recommended for mild to moderate hepatic impairment. However, metformin should be used with caution in patients with hepatic impairment due to the risk of lactic acidosis. This medicine is not recommended in patients with severe hepatic impairment. Consult your doctor. |
| Maximum Daily Dose | The maximum recommended daily dose is Sitagliptin 100 mg and Metformin 1000 mg once daily. Do not exceed this dose. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of istamet xr cp combipack
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Cationic drugs | Major | |
| Alcohol | Major | |
| Insulin or sulfonylureas | Major | |
| Diuretics | Moderate | |
| Corticosteroids | Moderate | |
| ACE inhibitors | Moderate | |
| Digoxin | Minor | |
| Insulin | Minor |
🚨 Major Interactions
- Cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin)
- Alcohol
- Insulin or sulfonylureas
⚡ Moderate Interactions
- Diuretics (e.g., furosemide, hydrochlorothiazide)
- Corticosteroids
- ACE inhibitors
🍷 Alcohol Interaction
Alcohol should be avoided or limited while taking this medicine. Alcohol increases the risk of lactic acidosis, a rare but serious complication of metformin. It can also cause hypoglycemia by impairing glucose production in the liver. If you choose to drink alcohol, do so in moderation and never on an empty stomach. Discuss safe limits with your doctor.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Severe renal impairment (eGFR
⚠️ Warnings & Precautions
["Lactic acidosis: Rare but serious. Risk increases with renal impairment, sepsis, dehydration, excessive alcohol use, hepatic impairment, and heart failure. Discontinue and seek immediate medical attention if suspected.","Pancreatitis: Acute pancreatitis has been reported. Monitor for signs and symptoms. Discontinue if suspected.","Hypoglycemia: May occur when used with insulin or sulfonylureas. Monitor blood glucose and adjust doses as needed.","Renal impairment: Dose adjustment required. Contraindicated in severe renal impairment.","Hepatic impairment: Use with caution due to risk of lactic acidosis.","Vitamin B12 deficiency: Metformin may reduce vitamin B12 levels. Monitor periodically.","Alcohol: Avoid excessive consumption due to risk of lactic acidosis.","Surgery: Discontinue temporarily before surgery and restart after renal function is stable.","Hypersensitivity reactions: Discontinue if allergic reactions occur."]
🤱 Lactation Safety
Not established from the available information. Sitagliptin and metformin are excreted in human milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Consult your doctor.
💊 Overdose Management
Overdose of this medicine may cause lactic acidosis, hypoglycemia, or pancreatitis. If you suspect an overdose, seek emergency medical attention immediately. Treatment is supportive and symptomatic. Hemodialysis may be effective in removing metformin and sitagliptin from the blood. Monitor vital signs, blood glucose, renal function, and acid-base balance. There is no specific antidote.
⏰ 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 take two doses at the same time to make up for a missed dose.
Additional Safety Advice
Before taking this medicine, inform your doctor if you have kidney problems, liver disease, heart failure, or a history of pancreatitis or lactic acidosis. Do not take this medicine if you have severe kidney impairment, metabolic acidosis, or if you are allergic to any of its ingredients. Avoid excessive alcohol consumption while taking this medicine, as it increases the risk of lactic acidosis. Take this medicine exactly as prescribed by your doctor, usually once daily with a meal to reduce stomach upset. Do not crush, chew, or break the extended-release tablet; swallow it whole. If you miss a dose, take it as soon as you remember, but if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose. Your doctor may adjust your dose based on your kidney function and blood sugar levels. Regular monitoring of blood glucose, kidney function, and vitamin B12 levels is recommended. Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. This medicine may interact with other medications, so always provide a complete list of medicines you are taking. Store this medicine at room temperature away from moisture and heat. Keep out of reach of children.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients may be more sensitive to the effects of this medicine, especially regarding kidney function. Dose adjustment based on renal function is recommended. Regular monitoring of kidney function, blood sugar, and vitamin B12 levels is important. Elderly patients may also be at higher risk of lactic acidosis due to age-related decline in kidney function.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before taking this medicine. Insulin is generally the preferred treatment for diabetes during pregnancy. This medicine is not recommended during pregnancy unless clearly needed. Your doctor may switch you to a safer alternative.
🏥 Post-Surgery Considerations
This medicine may need to be temporarily discontinued before surgery due to the risk of lactic acidosis, especially if you will be fasting or undergoing procedures with contrast dyes. Your doctor will advise you on when to stop and when to restart. Monitor blood sugar closely during the perioperative period.
🦷 Dental Procedures
Inform your dentist that you are taking this medicine, especially if you are scheduled for a procedure that requires fasting or sedation. You may need to adjust your dose or timing to prevent hypoglycemia. Maintain good oral hygiene as diabetes can increase the risk of gum disease.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Exercise is highly beneficial for managing diabetes, but take precautions if you are on this medicine. Monitor your blood sugar before and after exercise, especially if you are also taking insulin or sulfonylureas, as the risk of hypoglycemia may increase. Stay hydrated and carry a fast-acting source of sugar in case of low blood sugar. If you experience dizziness, weakness, or confusion during exercise, stop and seek medical help.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause dizziness or hypoglycemia in some patients, which can affect your ability to drive or operate heavy machinery. Avoid driving if you experience these symptoms. Otherwise, most people can continue their normal work and daily activities while taking this medicine. Inform your employer about your condition and medication in case of emergencies.
🛑 When to Stop This Medicine
Do not stop taking this medicine without consulting your doctor. If you experience serious side effects such as lactic acidosis, pancreatitis, or severe allergic reactions, your doctor may advise you to stop. If you are scheduled for surgery or a contrast imaging procedure, you may need to temporarily stop this medicine. Always follow your doctor's guidance.
📅 Long-Term Use Effects
Long-term use of this medicine may lead to vitamin B12 deficiency due to metformin, which can cause anemia and neuropathy. Regular monitoring of vitamin B12 levels is recommended. Kidney function should be monitored periodically, as metformin is excreted by the kidneys. There is also a rare risk of lactic acidosis with long-term metformin use, especially in patients with kidney or liver impairment. Sitagliptin may rarely cause pancreatitis or severe joint pain. Overall, the benefits of long-term use in managing type 2 diabetes generally outweigh the risks when monitored appropriately.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Diet and exercise are the cornerstone of diabetes management and can complement or reduce the need for medication.
Evidence: Well-establishedSulfonylureas, SGLT2 inhibitors, or GLP-1 receptor agonists may be considered based on individual needs.
Evidence: Well-establishedMay be required if oral agents fail to control blood sugar adequately.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
There are no specific vaccine interactions with this medicine. However, patients with diabetes are at higher risk of infections, so ensure you are up to date with recommended vaccinations, including influenza, pneumococcal, and hepatitis B vaccines. Consult your doctor for personalized advice.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C).
❌ DON'T
Do not refrigerate unless specified.
✅ DO
Keep in the original container tightly closed.
❌ DON'T
Do not transfer to unmarked containers.
✅ DO
Keep away from direct sunlight and moisture.
❌ DON'T
Do not store in the bathroom cabinet.
✅ DO
Keep out of reach of children.
❌ DON'T
Do not use after the expiry date.
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid loss or temperature extremes. If crossing time zones, consult your doctor about adjusting the timing of your dose. Store at room temperature and avoid exposure to heat or moisture. Check customs regulations for carrying prescription medicines in your destination country. Always carry enough supply for your entire trip and a little extra in case of delays.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine starts lowering blood sugar within a few days, but the full effect on HbA1c may take 2-3 months. Continue taking it as prescribed and monitor your blood sugar regularly.
A: Yes, but only under your doctor's supervision. It may be combined with insulin or sulfonylureas, but this increases the risk of hypoglycemia. Your doctor may adjust doses accordingly.
A: Mild side effects like nausea or diarrhea often resolve on their own. If they persist or you experience serious symptoms like severe abdominal pain, difficulty breathing, or swelling, seek medical attention immediately.
A: No, do not stop without consulting your doctor. Diabetes is a chronic condition, and stopping medication can lead to uncontrolled blood sugar and complications.
A: This medicine is safe for patients with normal kidney function. However, dose adjustment is needed for mild to moderate kidney impairment, and it is contraindicated in severe kidney impairment. Regular monitoring of kidney function is important.
🤔 Common Patient Concerns
🛑 Myths vs. Facts
- Myth: This medicine can cure diabetes.
Fact: This medicine helps manage blood sugar levels but does not cure diabetes. Lifestyle modifications and ongoing treatment are essential. - Myth: This medicine causes weight gain.
Fact: Metformin is weight-neutral or may cause slight weight loss. Sitagliptin is also weight-neutral. This combination is unlikely to cause weight gain. - Myth: You can stop taking this medicine once your sugar levels are normal.
Fact: Diabetes is a chronic condition. Stopping medication without consulting your doctor can lead to uncontrolled blood sugar and complications. - Myth: This medicine can be taken without food.
Fact: It is best taken with a meal to reduce stomach upset and improve tolerability.
🔄 Alternative Options
Generic Alternatives
- Sitagliptin + Metformin extended-release tablets (various manufacturers)
Brand Alternatives
- Janumet XR
- Zita-Met
- Istamet XR
- Sitagliptin Metformin ER