Xylitol–Sorbitol Chewable

Mechanism

Metformin: Decreases hepatic gluconeogenesis, enhances peripheral glucose uptake, and reduces intestinal glucose absorption.
Voglibose: Inhibits intestinal alpha-glucosidase enzymes, delaying carbohydrate breakdown and absorption, thereby reducing postprandial hyperglycemia.

Pharmacokinetics

• Absorption: Metformin absorbed mainly in the small intestine; Voglibose acts locally in the gut with minimal systemic absorption.
• Distribution: Metformin widely distributed; Voglibose negligible systemic distribution.
• Metabolism: Metformin not metabolized significantly; Voglibose minimally metabolized.
• Elimination: Metformin excreted unchanged in urine; Voglibose excreted in feces.
• Half-life: Metformin ~6 hrs; Voglibose negligible systemic half-life.

Side Effects

• Gastrointestinal discomfort
• Flatulence (Voglibose)
• Nausea
• Diarrhea
• Rare: Lactic acidosis (Metformin)

Contraindication

• Hypersensitivity to Metformin or Voglibose
• Severe renal impairment
• Hepatic dysfunction
• Pregnancy and lactation (use with caution)

Interaction

• Alcohol (increases risk of lactic acidosis with Metformin)
• Other antidiabetic agents (additive effect)
• Cationic drugs (may compete with Metformin for renal tubular secretion)

Warning and Precautions

• Use under medical supervision only
• Monitor renal function before and during therapy
• Discontinue if lactic acidosis is suspected
• Advise patients to avoid excessive alcohol intake

Dosage

As directed by the Physician.