TREVIAMET 50/1000MG TABS 35S

What Is TREVIAMET 50/1000?

Treviamet 50/1000 is a fixed-dose combination tablet bringing two well-established diabetes medicines together in a single convenient tablet: Sitagliptin (a DPP-4 inhibitor that enhances your body's own insulin response after meals by protecting naturally occurring incretin hormones) and Metformin (which reduces the amount of glucose your liver releases and improves your cells' sensitivity to insulin).

Rather than relying on a single approach, combining both medicines targets blood sugar from two different directions at once, providing better overall control than either medicine alone. The larger 35-tablet pack (versus the 30-tablet packs of similar products) provides a convenient monthly-plus supply that reduces how often patients need to refill their prescription.

What Is It Used For?

Treviamet 50/1000 is for adults with Type 2 Diabetes whose blood sugar is not adequately controlled by Metformin alone, or who are already taking Sitagliptin and Metformin as separate tablets and would benefit from simplifying to a single combination pill.

Metformin reduces background blood sugar throughout the day, while Sitagliptin specifically targets the spikes in blood sugar that happen after meals, together lowering HbA1c (your average 3-month blood sugar reading) more effectively.

An important advantage of Treviamet 50/1000 combination is that it carries a very low risk of causing hypoglycaemia (dangerously low blood sugar) on its own, unlike sulphonylureas or insulin. In Kenya, where the burden of Type 2 Diabetes continues to rise alongside urbanisation and dietary changes, combination therapies like Treviamet help simplify treatment regimens and improve long-term adherence.

Usual Dose

1 tablet twice daily with meals. Always take with food to reduce stomach side effects from Metformin.

With Food

Always take with a meal, this is essential to reduce the nausea and stomach discomfort that Metformin can cause.

Swallow Whole

Swallow whole with water, do not crush or split the tablet.

Contrast Dye Procedures

Stop Treviamet before any procedure using iodinated contrast dye (e.g. CT scan with contrast) and restart only 48 hours after, once kidney function is confirmed normal.

Missed Dose

Take as soon as remembered with food. If nearly time for the next dose, skip it. Never double up.

Monitoring

Regular HbA1c, kidney function (eGFR), and liver function tests are recommended throughout treatment.

Common Side Effects

·       Nausea, stomach upset, or diarrhoea (Metformin, usually settles in 2–4 weeks with food)

·       Headache

·       Upper respiratory tract infection, runny nose, sore throat (Sitagliptin class effect)

·       Metallic taste (Metformin)

Uncommon Side Effects

·       Mild hypoglycaemia (when combined with sulphonylureas or insulin)

·       Dizziness

·       Constipation

·       Joint pain (arthralgia, rare DPP-4 inhibitor class effect)

Serious Side Effects, Seek Immediate Medical Attention

·       Lactic acidosis, rare but serious Metformin complication, mainly in renal impairment, dehydration, or contrast dye procedures

·       Pancreatitis, rare Sitagliptin class effect; report severe, persistent abdominal pain immediately

·       Severe allergic reactions including angioedema and anaphylaxis (rare)

·       Severe arthralgia (joint pain), uncommon but can be debilitating; discontinue if severe

·       LACTIC ACIDOSIS: A rare but potentially fatal complication of Metformin, most likely in patients with renal impairment, liver disease, dehydration, or alcohol excess. Symptoms: unusual muscle pain, breathing difficulty, abdominal pain, extreme cold feeling. Seek emergency care immediately.

·       CONTRAST DYE: Always inform the radiologist you are on Metformin before any scan involving contrast dye. Metformin must be withheld before the procedure.

·       PANCREATITIS: If you develop severe, persistent abdominal pain, particularly radiating to the back, stop Treviamet and seek urgent medical attention.

·       RENAL MONITORING: Check eGFR at baseline and periodically, Metformin accumulates in renal impairment.

·       B12 DEPLETION: Long-term Metformin use reduces Vitamin B12 absorption, annual B12 monitoring recommended; supplement if low.

·       HYPOGLYCAEMIA: Higher risk when combined with sulphonylureas or insulin, know the signs: shakiness, sweating, confusion.

Alcohol: Increases lactic acidosis risk with Metformin, limit intake.

Iodinated contrast media: Withhold Metformin 48 hours before and after.

Sulphonylureas / Insulin: Increased hypoglycaemia risk, consider dose reduction.

Cationic drugs (cimetidine, trimethoprim, vancomycin): Compete for renal tubular secretion of Metformin, increase Metformin levels.

Diuretics and NSAIDs: Can impair renal function, increases Metformin and lactic acidosis risk.

·       Store below 25°C in a cool, dry place.

·       Protect from moisture and direct sunlight.

·       Keep in original packaging.

·       Keep out of reach of children.

Treviamet 50/1000 is a prescription-only medicine (POM) in Kenya. Available at Pharmily with a valid prescription from a physician or diabetologist.

Treviamet 50/1000 is a Janumet-equivalent generic (Sitagliptin 50mg + Metformin 1000mg) in a 35-tablet pack, the extra 5 tablets accommodate a 35-day supply at twice-daily dosing rather than the usual 30-day supply, reducing refill frequency. All clinical counselling points are identical to Glipita M 50/1000: contrast dye interaction, lactic acidosis awareness, B12 monitoring, renal function, and pancreatitis vigilance.

The 35-tablet pack means patients on twice-daily dosing will need approximately 2 packs for a 35-day supply, clarify this at dispensing to avoid confusion with 30-day packs. Screen for concurrent medications that increase Metformin levels (trimethoprim, commonly used in Kenya for UTI).

Counsel on the symptomatic differences between DKA (less likely on DPP4i + Metformin, no SGLT2i here) and hypoglycaemia, relevant when sulphonylureas or insulin are co-prescribed.

Why must I always take Treviamet with food?

A: The Metformin in Treviamet can cause nausea, stomach cramps, and diarrhoea if taken on an empty stomach. Taking it with a meal greatly reduces these side effects and makes the medicine much easier to tolerate.

Will Treviamet 50/1000 cause low blood sugar?

A: On its own, Treviamet rarely causes hypoglycaemia. The risk increases significantly if you also take sulphonylureas (like glibenclamide) or insulin, your doctor may reduce those doses. Know the signs of low blood sugar: shakiness, sweating, hunger, and confusion.

17–18 days supply at twice-daily dosing, or a 35-day supply at once-daily dosing.

Can long-term use of Treviamet affect my Vitamin B12 levels?

A: Yes, Metformin in Treviamet reduces B12 absorption over time. Your doctor should check your B12 levels annually. If low, a B12 supplement (such as Nervoplex or Cachnerve) will be recommended.