Treviamet

Treviamet (manufactured by Getz Pharma) is a fixed-dose combination oral antihyperglycemic medication containing two synergistic active pharmaceutical ingredients: sitagliptin and metformin hydrochloride.

• Sitagliptin (DPP-4 Inhibitor): Works by inhibiting the dipeptidyl peptidase-4 (DPP-4) enzyme, extending the active life of endogenous incretin hormones (GLP-1 and GIP). This stimulates glucose-dependent insulin secretion from pancreatic beta cells while lowering glucagon secretion from alpha cells.

• Metformin Hydrochloride (Biguanide): Reduces hepatic gluconeogenesis, decreases intestinal glucose absorption, and increases peripheral insulin sensitivity in muscle and adipose tissue.

By addressing both impaired insulin release and peripheral insulin resistance, Treviamet provides comprehensive glycemic control for patients with type 2 diabetes without increasing the risk of hypoglycemia when used appropriately.

Primary Medical Indications

Treviamet is indicated for adult patients (aged 18 years and older) for the management of type 2 diabetes mellitus:

• Inadequate Glycemic Control: For patients whose blood glucose remains uncontrolled on metformin monotherapy or sitagliptin monotherapy alone.

• Combination Therapy Replacement: For patients already stabilized on dual therapy with separate sitagliptin and metformin tablets.

• Triple Combination Protocols: In combination with a sulfonylurea, SGLT2 inhibitor, or insulin when dual oral therapy fails to achieve target HbA1c levels.

Key Product Specifications & Dosing Forms

Critical Safety Guidelines & Precautions

• Boxed Warning for Lactic Acidosis: Metformin accumulation can cause lactic acidosis, a severe metabolic emergency. Major risk factors include significant renal impairment (eGFR less than 30 mL/min/1.73 $\text{m}^2$), acute cardiac failure, severe hepatic disease, and excessive alcohol consumption.

• Pancreatitis Warning: Acute pancreatitis has been reported in patients taking DPP-4 inhibitors like sitagliptin. Instruct patients to report persistent, severe abdominal pain radiating to the back immediately.

• Renal Function Monitoring: Renal function (eGFR) must be evaluated prior to initiating Treviamet and monitored regularly thereafter.

• Contraindications: Strictly contraindicated in patients with type 1 diabetes, diabetic ketoacidosis, severe renal failure, or hypersensitivity to sitagliptin or metformin.