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Type 2 diabetes mellitus (T2DM) in adults, to improve glycaemic control when diet and exercise are not enough; used when metformin alone is inadequate or as combination therapy as advised by physician.

Vildagliptin is a DPP-4 inhibitor that increases incretin hormones (GLP-1, GIP), leading to glucose-dependent increase in insulin release and reduced glucagon. Metformin reduces hepatic glucose production and improves insulin sensitivity, lowering blood glucose without causing significant hypoglycaemia when used alone.

Oral tablet. Take exactly as prescribed, usually with meals to reduce stomach upset. Swallow whole (especially if SR/ER); do not crush/chew. Typical use is once or twice daily depending on strength and glycaemic targets.

Nausea, vomiting, diarrhoea, abdominal discomfort, loss of appetite, headache, dizziness, upper respiratory tract infection, tremor (rare), hypoglycaemia (more likely with insulin/sulfonylureas)

Prescription-only antidiabetic. Metformin: risk of lactic acidosis (rare but serious), higher risk in severe kidney disease, dehydration, sepsis, hypoxia, heart failure, excessive alcohol use; assess eGFR before and during therapy; stop temporarily before iodinated contrast procedures and major surgery as advised. Vildagliptin: monitor liver function; discontinue if jaundice or marked LFT elevation; use caution in hepatic impairment. Not for type 1 diabetes or diabetic ketoacidosis. Monitor vitamin B12 with long-term metformin use. Use caution in elderly and in conditions causing dehydration.

Alcohol (increases lactic acidosis risk), iodinated contrast media, carbonic anhydrase inhibitors (e.g., topiramate, acetazolamide) increase acidosis risk, cimetidine may increase metformin levels, diuretics/ACE inhibitors/NSAIDs may affect kidney function, insulin or sulfonylureas increase hypoglycaemia risk, corticosteroids/thiazides/sympathomimetics may raise glucose, digoxin levels may be affected with vildagliptin in some cases (monitor).

Store below 25°C in a dry place, protected from light and moisture. Keep in original blister pack and out of reach of children.

Galvus Met 50/500, Jalra M 50/500, Zomelis Met 50/500, Vilda M 50/500, Vildamet 50/500