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Vildagliptin/metformin is indicated in the treatment of type-2 diabetes mellitus: [4] [6] [7] it is indicated in the treatment of adults who are unable to achieve sufficient glycaemic control at their maximally tolerated dose of oral metformin alone or who are already treated with the combination of vildagliptin and metformin as separate tablets.
Metformin has an oral bioavailability of 50–60% under fasting conditions, and is absorbed slowly. [9] [131] Peak plasma concentrations (C max) are reached within 1–3 hours of taking immediate-release metformin and 4–8 hours with extended-release formulations.
Further, metformin comes in the form of immediate-release tablets, extended-release tablets, and as a liquid. Each type of metformin has different requirements in terms of when and how to take it:
There are several types of insulin that are commonly used in medical practice, with varying times of onset and duration of action. [32] - Rapid acting (i.e. insulin lispro) with onset in 15 minutes and duration of about 4 hrs. - Short acting (i.e. regular insulin) with onset in 30 minutes and duration of about 6 hrs.
The duration of action should be determined during dose-ranging study, as it will allow definition of the dosage schedule. Because it is hard to measure reliable pharmacodynamic parameter, it is difficult to determine the duration of action during early clinical trials.
Insulins are typically characterized by the rate at which they are metabolized by the body, yielding different peak times and durations of action. [4] Faster-acting insulins peak quickly and are subsequently metabolized, while longer-acting insulins tend to have extended peak times and remain active in the body for more significant periods. [5]
The duration of action of a drug is the length of time that particular drug is effective. [5] Duration of action is a function of several parameters including plasma half-life, the time to equilibrate between plasma and target compartments, and the off rate of the drug from its biological target. [6]
To reduce the risk of developing ketoacidosis (a serious condition where the body produces high levels of blood acids called ketones) after surgery, the FDA has approved changes to the prescribing information for SGLT2 inhibitor diabetes medications, recommending they be temporarily stopped before scheduled surgery.