Jalra M 50/500mg Tablet

• If you are allergic to vildagliptin or metformin or other ingredients of Jalra-M 50mg/500mg tablet.
• If you have uncontrolled diabetes along with nausea, vomiting, diarrhoea, rapid weight loss, lactic acidosis (symptoms include stomach pain, fast or rapid breathing, sleepiness).
• If you are in a diabetic coma due to a sudden rise or drop in blood sugar level.
• If you are an alcoholic or consume alcohol in excess regularly.
• If you have a pre-existing medical condition like kidney or liver disorder, heart disease, type 1 diabetes, etc.
• If you have infection or dehydration.
• If you are undergoing surgery or stress.
• If you are breastfeeding.

• Nausea and vomiting
• Diarrhoea
• Abdominal pain
• Metallic taste in the mouth
• Dizziness
• Headache
• Tremor
• Low blood sugar when combined with a sulfonylurea or insulin
• Reduced vitamin B12 with long-term use

Other General Warnings

• You have kidney disease and must have your kidney function monitored.
• You have or develop abnormal liver blood tests, and must report jaundice or dark urine immediately.
• You are due to have a contrast scan or surgery, so this medicine must be paused.
• You develop vomiting, diarrhoea, fever or dehydration from any cause.
• You develop severe upper abdominal pain radiating to the back, which may indicate pancreatitis.
• You develop muscle pain, rapid breathing, extreme tiredness, or feel very cold, which may indicate lactic acidosis.
• You also take a sulfonylurea or insulin, which increases the risk of low blood sugar.
• You have heart failure, particularly if unstable.
• You develop blistering skin lesions, which have been reported with this class.

• Take Jalra M 50/500mg Tablet exactly as prescribed by your doctor.
• Swallow the tablet whole with a glass of water.
• Take it with or immediately after food, usually one tablet in the morning and one in the evening.
• Do not crush or chew the tablet.
• Attend all scheduled blood tests for liver and kidney function.
• Stop the medicine before any contrast scan or surgery, as instructed.

• Jalra M 50/500mg Tablet combines two medicines that lower blood sugar by entirely different mechanisms. Always take it with or immediately after food to reduce nausea and loose stools.
• Stomach symptoms usually settle within the first few weeks of treatment.
• Attend your liver blood tests; vildagliptin requires monitoring, especially in the first year.
• Report yellowing of the eyes or skin, dark urine, or persistent nausea without delay.
• Tell your doctor before any CT scan with contrast dye or any surgery, as this medicine must be paused.
• Seek emergency care for muscle pain with rapid breathing, extreme tiredness, or feeling very cold.
• Seek urgent care for severe upper abdominal pain radiating to the back.
• Have your kidney function checked before starting and at least once a year.
• Ask for a vitamin B12 test after several years of metformin use, or if you develop tingling in your hands and feet.
• Avoid binge drinking and never drink on an empty stomach.
• Keep up your diet and exercise plan, and attend your HbA1c tests every 3 to 6 months.

Overdose

Missed a Dose

• Jalra M 50/500mg Tablet lowers blood glucose by two separate routes. Metformin reduces the amount of glucose the liver makes and releases, slows its absorption from the gut, and increases the sensitivity of muscle and fat tissue to circulating insulin. It does not stimulate the pancreas, which is why it seldom causes low blood sugar on its own.
• Vildagliptin acts on the incretin system. When food is eaten, the gut releases GLP-1 and GIP, hormones that instruct the pancreas to release insulin and to reduce glucagon, the hormone that pushes glucose up. These incretins are broken down within minutes by the enzyme DPP-4.
• By inhibiting DPP-4, vildagliptin allows the incretins to persist and act for longer, improving the pancreas's insulin response to a meal and reducing inappropriate glucagon release. Because incretins are only released in response to eating, this effect is naturally self-limiting.
• Correcting excess glucose production on one side and a blunted insulin response on the other simultaneously addresses two of the central defects of type 2 diabetes.

Interactions with other drugs

Interactions with food items

• Take Jalra M 50/500mg Tablet with or immediately after food. This substantially reduces the nausea, metallic taste, and diarrhoea caused by the metformin component.
• Keep meals regular and consistent in carbohydrate content. Skipped meals are a frequent cause of low readings if you also take a sulfonylurea or insulin.
• Avoid binge drinking and never drink on an empty stomach, given the combined risk of lactic acidosis, liver strain, and delayed low blood sugar.
• Drink enough fluid, especially in hot weather or during illness with vomiting or diarrhoea, since dehydration is the commonest trigger for metformin-related complications.
• Include milk, curd, paneer, eggs, and fish for vitamin B12, as long-term metformin reduces its absorption.
• Build meals around whole grains, pulses, vegetables, and lean protein while limiting sugary drinks, sweets, refined flour, and fried food.