Description: Torformin ST 1000 Tablets contains Sitagliptin, a potent and highly selective inhibitor of the enzyme DPP-4 and Metformin, a biguanide with antihyperglycaemic effects, lowering both basal and postprandial plasma glucose. Pharmaceutical Dosage Form: Tablet Route of Administration: Oral Composition: Each film coated tablet contains: Sitagliptin Phosphate Monohydrate IP equivalent to Sitagliptin 50 mg Metformin Hydrochloride IP 1000 mg Excipients q.s. Mechanism of Action: Sitagliptin by inhibiting the DPP-4 enzyme, increases the levels of two known active incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. When blood glucose concentrations are normal or elevated, GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells. GLP-1 also lowers glucagon secretion from pancreatic alpha cells, leading to reduced hepatic glucose production. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Indications: Torformin ST 1000 is indicated for the treatment of patients with type II diabetes mellitus when diet, exercise and single agent does not result in adequate glycemic control. Dosage: As directed by the physician. Storage: Store at a temperature not exceeding 30°C, protect from light & moisture. Presentation: 10 x 2 x 15 Side effects: The following adverse reactions may occur: Lactic Acidosis Taste Disturbance Loss of Appetite Hypoglycaemia Flatulence Nausea Vomiting Constipation Diarrhoea Abdominal Pain Peripheral Oedema Headache Dizziness Contraindications: Torformin ST 1000 is contraindicated in patients with: Known hypersensitivity to metformin or any of the components of this product. any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis) diabetic pre-coma Severe renal impairment Acute conditions with the potential to alter renal function such as: - dehydration, - severe infection, - shock Disease which may cause tissue hypoxia Decompensated Heart Failure Respiratory Failure Recent Myocardial Infarction Shock Hepatic insufficiency, acute alcohol intoxication, alcoholism Drug Interactions: Alcohol NSAIDs ACE Inhibitors Angiotensin II Receptor Antagonists Diuretics Verapamil Rifampicin Cimetidine, Ranolazine, Trimethoprime Isavuconazole, ketoconazole, itraconazole Vandetanib, Crizotinib, Olaparib ritonavir, Dolutegravir, clarithromycin Ciclosporin Digoxin