Metformindosage

Take ZITUVIMET XR orally once daily with a meal. Patients taking two ZITUVIMET XR tablets should take the tablets together. Individualize the dosage of ZITUVIMET XR on the basis of the patient's current regimen, effectiveness, and tolerability. The maximum recommended daily dose is 100 mg of sitagliptin and 2,000 mg of metformin HCl extended-release. The recommended starting dose in patients not currently treated with metformin is 100 mg sitagliptin and 1,000 mg metformin HCl once daily, with gradual dose escalation recommended to reduce gastrointestinal side effects associated with metformin. The starting dose in patients already treated with metformin should provide sitagliptin dosed as 100 mg and the dose of metformin already being taken once daily. For patients taking metformin HCl 850 mg twice daily or 1,000 mg twice daily, the recommended starting dose of ZITUVIMET XR is two 50 mg sitagliptin and 1,000 mg metformin HCl extended-release tablets once daily. Maintain the same total daily dose of sitagliptin and metformin when changing between sitagliptin and metformin immediate-release or sitagliptin and metformin extended-release and ZITUVIMET XR. Prior to initiation, assess renal function with estimated glomerular filtration rate (eGFR) Do not use in patients with eGFR below 30 mL/min/1.73 m 2. ZITUVIMET XR is not recommended in patients with eGFR between 30 to 45 mL/min/1.73 m 2. Limit dose of sitagliptin to 50 mg once daily if eGFR falls below 45 mL/min/1.73 m 2. ZITUVIMET XR may need to be discontinued at time of, or prior to, iodinated contrast imaging procedures.

2.1 Recommended

Dosage and Administration Take ZITUVIMET XR orally once daily with a meal. Patients taking two ZITUVIMET XR tablets should take the two tablets together once daily. Individualize the dosage of ZITUVIMET XR on the basis of the patient's current regimen, effectiveness, and tolerability. The maximum recommended daily dose is 100 mg of sitagliptin and 2,000 mg of metformin hydrochloride (HCl) extended-release. The recommended starting dose in patients not currently treated with metformin is 100 mg sitagliptin and 1,000 mg metformin HCl extended-release once daily, with gradual dose escalation recommended to reduce gastrointestinal side effects associated with metformin. The starting dose in patients already treated with metformin should provide 100 mg sitagliptin and the previously prescribed dose of metformin. For patients taking metformin HCl immediate-release 850 mg twice daily or 1,000 mg twice daily, the recommended starting dose of ZITUVIMET XR is two 50 mg sitagliptin and 1,000 mg metformin HCl extended-release tablets taken together once daily. Maintain the same total daily dose of sitagliptin and metformin when changing between sitagliptin and metformin HCl immediate-release or sitagliptin and metformin extended-release and ZITUVIMET XR. Do not split, crush or chew ZITUVIMET XR tablets.

2.2 Recommendations for

Use in Renal Impairment Assess renal function prior to initiation of ZITUVIMET XR and periodically thereafter. ZITUVIMET XR is contraindicated in patients with an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m 2. Initiation of ZITUVIMET XR in patients with an eGFR between 30 and 45 mL/min/1.73 m 2 is not recommended. In patients taking ZITUVIMET XR whose eGFR later falls below 45 mL/min/1.73 m 2, assess the benefit risk of continuing therapy and limit dose of the sitagliptin component to 50 mg once daily.

2.3 Discontinuation for

Iodinated Contrast Imaging Procedures Discontinue ZITUVIMET XR at the time of, or prior to, an iodinated contrast imaging procedure in patients with an eGFR between 30 and 60 mL/min/1.73 m 2; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure; restart ZITUVIMET XR if renal function is stable.