Elzanor Tablets 5/500mg

Medicine Name: Elzanor Tablets 5/500mg

Elzanor 5 mg / 500 mg
Requires Prescription
Yes
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Generics
Empagliflozin 5 mg + Metformin Hydrochloride 500 mg (fixed-dose combination)
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Used For
Type 2 Diabetes Mellitus – to improve blood sugar control alongside diet and exercise 
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How It Works
•    Empagliflozin: Inhibits SGLT2 in the kidneys, blocking glucose reabsorption and increasing urinary glucose excretion.
•    Metformin: Suppresses hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity 
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Usage And Safety

Dosage
•    Typically one tablet daily with meals, often with breakfast.
•    Empagliflozin: usually starts at 5 mg daily, max 10 mg/day.
•    Metformin: commonly 500 mg twice daily, up to 2,500 mg/day depending on response 
Side Effects
•    Most common: genital yeast infections (females), urinary tract infections, increased urination, gastrointestinal upset (nausea, diarrhea, flatulence), headache, weakness 
•    Serious but rare: lactic acidosis (metformin), hypotension or dehydration (empagliflozin), euglycemic diabetic ketoacidosis, Fournier’s gangrene 
Drug Interactions
•    Diuretics (enhanced dehydration risk)
•    Agents causing electrolyte imbalance or altering renal function
•    Drugs that interfere with renal tests like 1,5 AG assay
•    Certain anti-retrovirals, anticonvulsants, corticosteroids, thyroid products, estrogens, nicotinic acid, phenytoin, calcium channel blockers, and nifedipine 
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Indication
Recommended as an adjunct to diet and exercise in adults with type 2 diabetes mellitus who are inadequately controlled on metformin or empagliflozin alone, or already on both as separate therapies
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Contraindications (When Not to Use)
•    Type 1 diabetes mellitus, diabetic ketoacidosis
•    Severe renal impairment or ESRD
•    Known hypersensitivity to empagliflozin, metformin, or any excipients
•    Conditions predisposing to lactic acidosis (e.g. severe hepatic impairment) 
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Precautions
•    Assess volume status to avoid dehydration/hypotension
•    Monitor kidney function before and during treatment
•    Alcohol intake should be limited due to risk of lactic acidosis
•    Instruct patients to maintain proper hydration and monitor for signs of infection or low blood pressure 
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Warnings
1.    Lactic acidosis: Metformin-associated risk, especially in renal impairment or dehydration. Discontinue if symptoms such as unexplained malaise, respiratory distress, or severe abdominal pain appear.
2.    Hypotension/dehydration: Especially in elderly, renal-impaired or those on diuretics
3.    Diabetic Ketoacidosis / Fournier’s gangrene: Though rare, watch for unexplained nausea, abdominal pain, breathlessness, genital pain/swelling 
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Additional Information
•    Pregnancy/Breastfeeding: Not generally recommended; consult healthcare provider
•    Storage: Store at room temperature, away from direct light and heat