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VOGLOYD M
Composition Voglibose 0.3 / 0.2mg + Metformin 500 mg SR bilayer tablet
Indication Diabetes mellitus
Mechanism of Action

Voglibose: has general properties similar to acarbose and selectively inhibits α-glucosidase in the enteric canal, delaying the digestion and absorption of carbohydrate, thereby suppressing sharp increase in post-prandial plasma glucose.

Metformin: is a biguanide w/ antihyperglycaemic effects, lowering both basal and postprandial plasma glucose. It decreases hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis; delays intestinal absorption of glucose; and enhances insulin sensitivity by increasing peripheral glucose uptake and utilisation.

Pharmacokinetic's

Voglibose:

Absorption: voglibose is poorly absorbed after oral administration. However, systematic adverse effects have been observed.

Metabolism: the metabolism of voglibose in liver is negligible.

Excretion: The renal excretion is negligible and plasma concentations after oral dose have been undetectable.

Metformin:

Absorption: Slowly and incompletely absorbed from the GI tract. Absolute bioavailability: Approx 50-60% (fasting); reduced if taken w/ food. Time to peak plasma concentration: 2-3 hr (immediate-release); 4-8 hr (extended-release).

Distribution: It crosses the placenta and distributed in breast milk (small amounts). Volume of distribution: 654 ± 358 L. Plasma protein binding: Negligible.

Metabolism: Not metabolised.

Excretion: Via urine (90% as unchanged drug). Elimination half-life: Approx 2-6 hr.

Side effects

Voglibose: Flatulence; abdominal distension; diarrhoea; pain; skin reactions; hypoglycemia; increased LFT.

Potentially Fatal: Hepatotoxicity.

Metformin: Anorexia, nausea, vomiting, diarrhoea, abdominal pain, taste disturbance, hepatitis. Rarely, decreased vit B12 absorption, erythema, pruritus and urticaria.

Potentially Fatal: Lactic acidosis.

Precaution

Voglibose: History of laparotomy or ileus. Roemheld's syndrome, stenosis, severe hepatic or renal impairment. Child 18 yr; elderly. Monitor LFT. Treat hypoglycaemic episodes with glucose (not with sucrose).

Metformin: Patient w/ CHF requiring drug therapy, cardiac or resp failure, recent MI, shock. Patient exposed to stress-related states (e.g. Fever, trauma, infection, surgery). Hepatic impairment. Elderly. Pregnancy and lactation. Monitoring Parameters Monitor renal function regularly.

Haematologic parameters (e.g. Hb, hematocrit, erythrocyte indices) should be evaluated prior to initiation of therapy and at least annually during treatment.

Dosage

Adult: 200-300 mcg Thrice a day.

Elderly: Initiate at lower doses.