Sitagliptin + Metformin Hydrochloride

This tablet combines two medicines that lower blood sugar in different ways, so together they help control glucose in people with type 2 diabetes. The two ingredients are Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, and Metformin HCl, which belongs to the biguanide class.

Sitagliptin is believed to work in type 2 diabetes by slowing the inactivation of incretin hormones. These hormones include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The intestine releases them throughout the day, and their levels rise after a meal. The enzyme DPP-4 inactivates them quickly. They are part of an endogenous system that helps regulate glucose homeostasis in the body.

When blood glucose is normal or high, GLP-1 and GIP increase insulin synthesis and release from the pancreatic beta cells, through intracellular signalling pathways that involve cyclic AMP. GLP-1 also lowers glucagon secretion from the pancreatic alpha cells, which reduces glucose production in the liver. Because Sitagliptin increases and prolongs the levels of active incretins, it raises insulin release and lowers circulating glucagon, and it does this in a glucose-dependent way.

Metformin HCl works differently from the other classes of oral antihyperglycemic agents. It decreases hepatic glucose production, decreases glucose absorption from the intestine, and increases glucose uptake and utilization in the peripheral tissues.