— Product
VILDACROSS M TAB
METFORMIN + VILDAGLIPTIN
VILDACROSS M TAB is a tablet combining metformin with vildagliptin, for type 2 diabetes mellitus. It is used where metformin alone no longer achieves adequate glycaemic control, adding a DPP-4 inhibitor with a low risk of hypoglycaemia and no weight gain.
01
Benefits
- Two complementary mechanisms — metformin reduces hepatic glucose production and insulin resistance, vildagliptin enhances incretin-driven insulin release.
- Vildagliptin's glucose-dependent action means the combination carries a low hypoglycaemia risk compared with adding a sulphonylurea.
- Weight-neutral, an advantage over sulphonylurea and pioglitazone combinations.
- A single tablet replaces two, improving adherence in a lifelong condition.
- Well tolerated, and a reasonable second-line choice in the elderly where hypoglycaemia would be hazardous.
02
Side effects
Not everyone gets these. Most are mild and settle as the course finishes.
Common
- Nausea or abdominal discomfort
- Diarrhoea, particularly when starting
- Headache or dizziness
- Metallic taste
Less common
- Loss of appetite
- Peripheral oedema
- Raised liver enzymes on testing
- Vitamin B12 deficiency with long-term metformin use
Stop and get medical help if any of these occur
- Deep rapid breathing, severe weakness, muscle pain, vomiting and abdominal pain — this may be lactic acidosis
- Severe persistent abdominal pain radiating to the back — this may be acute pancreatitis
- Yellowing of the skin or eyes, dark urine, or persistent nausea and loss of appetite
- Severe or disabling joint pain
- Blistering skin lesions
- Numbness or tingling of the hands and feet developing over months
03
Precautions
- Metformin can cause lactic acidosis — rare but frequently fatal. Risk rises sharply in renal impairment, dehydration, sepsis, heart failure, liver disease and excess alcohol.
- Stop before any procedure using iodinated contrast media and before major surgery, restarting only once renal function is confirmed stable.
- Stop during any acute illness with dehydration, vomiting or diarrhoea — sick-day rules must be explained to every patient.
- Check liver function before starting and at intervals during the first year, because of the vildagliptin.
- DPP-4 inhibitors have been associated with acute pancreatitis; avoid in a history of pancreatitis and stop at once if severe abdominal pain occurs.
- Contraindicated in type 1 diabetes, diabetic ketoacidosis, significant renal impairment and hepatic impairment.
- Take with or after food and increase the dose gradually to reduce gastrointestinal effects; avoid excess alcohol.
- Contraindicated in pregnancy and breastfeeding; check vitamin B12 periodically on long-term use.