GENERIC NAME MECHANISM OF INDICATION/ DOSAGE ADVERSE REACTION CONTRAINDICATION

ACTION
SITAGLIPTIN General: In patients Type 2 DM as initial Hypoglycemia, dyspepsia, Renal disease or renal
PHOSPHATE + with type 2 diabetes, therapy to improve flatulence, nausea, vomiting, dysfunction, e.g., as suggested
Metformin administration of single glycemic control when diarrhea, abdominal pain, loss of by serum creatinine levels
oral doses of sitagliptin diet & exercise alone do appetite, metallic taste, upper 1.5 mg/dL [males], 1.4
leads to inhibition of not provide adequate resp tract infection, headache, mg/dL [females] or abnormal
DPP-4 enzyme activity glycemic control. Type cough, fungal skin infection, creatinine clearance which
for a 24-hour period, 2 DM as adjunct to diet peripheral edema & pruritus. may also result from
resulting in a 2- to 3- & exercise to improve Worsening renal function. conditions such as
fold increase in glycemic control in Constipation. Pancreatitis. cardiovascular collapse
circulating levels of patients cannot be (shock), acute myocardial
active GLP-1 and GIP, controlled w/ metformin infarction,
increased plasma or sitagliptin alone or in andsepticemia [see WARNINGS
levels of insulin and C- patients already being AND PRECAUTIONS].
peptide, decreased treated w/ combination Acute or chronic metabolic
glucagon of sitagliptin & acidosis, including diabetic
concentrations, metformin. Type 2 DM ketoacidosis, with or without
reduced fasting as an adjunct to diet & coma.
glucose, and reduced exercise to improve History of a serious
glucose excursion glycemic control in hypersensitivity reaction to
following an oral combination w/ insulin; JANUMET or sitagliptin (one of
glucose load or a meal. sitagliptin & metformin. the components of JANUMET),
In Phase III clinical As part of triple such
studies of 18- and 24- combination therapy w/ as anaphylaxis orangioedema.
week duration, a sulfonylurea or w/ a
treatment with PPAR agonist (ie
sitagliptin 100 mg daily thiazolidinediones) as
in patients with type 2 an adjunct to diet &
diabetes significantly exercise in patients w/
improved beta cell type 2 DM inadequately
function, as assessed controlled w/ any 2 of 3
by several markers, agents: Metformin,
including HOMA- sitagliptin or a
(Homeostasis Model sulfonylurea alone or a
Assessment-), PPAR agonist alone.
 proinsulin to insulin
ratio, and measures of
beta cell
responsiveness from
the frequently-sampled
meal tolerance test. In
Phase II studies,
sitagliptin 50 mg twice
daily provided similar
glycemic efficacy
compared to sitagliptin
100 mg once daily.

METFORMIN Description: Metformin Type 2 DM. Anorexia, nausea, vomiting, Renal impairment represents
is a biguanide w/ diarrhoea, abdominal pain, taste a contraindication to metformi
antihyperglycaemic disturbance, hepatitis. Rarely, n usage due to the increased
effects, lowering both decreased vit B12 absorption, risk of lactic acidosis (a form o
basal and postprandial erythema, pruritus and urticaria. metabolic acidosis due to the
plasma glucose. It inadequate clearance of lactic
decreases hepatic acid from the blood)
glucose production by
inhibiting
gluconeogenesis and
glycogenolysis; delays
intestinal absorption of
glucose; and enhances
insulin sensitivity by
increasing peripheral
glucose uptake and
utilisation.

CLOPIDOGREL Description: Clopidogre Adult : PO Prophylaxis Haematoma, epistaxis, diarrhoea, Clopidogrel tablets
l selectively inhibits of thromboembolic dyspepsia, abdominal pain, are contraindicated in patients
adenosine diphosphate disorders 75 mg once bruising, bleeding at puncture with active pathological
(ADP) from binding to daily. Acute coronary site. Rarely, Stevens-Johnson bleeding such as peptic ulcer
its platelet syndromeST-elevation syndrome, erythema multiforme, or intracranial hemorrhage.
 P2Y12 receptor and MI: In combination w/ serum sickness, interstitial
subsequent activation aspirin: 75 mg once pneumonitis, lichen planus,
of glycoprotein daily. Loading dose: 300 myalgia.
GPIIb/IIIa complex thus mg for patients <75 yr. Potentially Fatal: Intracranial
reducing platelet Continue treatment for bleeding, GI and retroperitoneal
aggregation. at least 4 wk. Unstable haemorrhage, blood dyscrasias,
angina, non-ST- thrombotic thrombocytopenic
elevation MI: In purpura.
combination w/ aspirin:
Initial: 300 mg loading
dose, followed by 75
mg once daily for up to
12 mth.

ATORVASTATIN Description: Atorvastati Adult : PO Mixed Headache, flatulence, Contraindications

n competitively inhibits dyslipidaemia; constipation, dyspepsia, nausea, Active liver disease:
HMG-CoA reductase, Heterozygous familial diarrhoea, vomiting, anorexia. cholestasis, hepatic
the enzyme that hypercholesterolaemia; Pain in extremity, musculoskeletal encephalopathy, hepatitis, and
catalyses the Nonfamilial and pharyngolaryngeal; jaundice.
conversion of HMG-CoA hypercholesterolaemia I myopathy, muscle spasms,
Unexplained elevations
to mevalonate. This nitial: 10 or 20 mg once myalgia, arthralgia,
in AST or ALT levels.
results in the induction daily, may be adjusted nasopharyngitis, insomnia, UTI.
of the LDL receptors at 4-wk interval. May Increased serum Pregnancy: Atorvastatin
and stimulation of LDL initiate 40 mg once aminotransferase, glycosylated may cause fetal harm by
catabolism, leading to daily in patients who haemoglobin and fasting serum affecting serum cholesterol
lowered LDL- require >45% reduction glucose levels. and triglyceride levels, which
cholesterol levels. in LDL-cholesterol. Max: Potentially Fatal: Severe are essential for fetal
80 mg/day. rhabdomyolysis w/ acute renal development.
failure. Hepatitis, pancreatitis.
Rarely, Stevens-Johnson
syndrome, anaphylaxis, toxic
epidermal necrolysis.