Ardance-M 500 

Presentation: Ardance-M 500 Tablet, available in Bangladesh, is a combination tablet containing Empagliflozin 5 mg and Metformin Hydrochloride 500 mg .

Indications: Ardance-M is indicated in adults with type 2 diabetes mellitus as an adjunct to diet and exercise to improve glycemic control:  

• In patients insufficiently controlled on their maximally tolerated dose of metformin alone. 
• In combination with other medicinal products for the treatment of diabetes, in patients insufficiently controlled with metformin and these medicinal products. 
• In patients already being treated with the combination of empagliflozin and metformin as separate tablets. 
• Empagliflozin, a component of Ardance-M, is also indicated to reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and established cardiovascular disease.  

Dosage and Administration: The dosage should be individualized based on the patient's current regimen, effectiveness, and tolerability, without exceeding the maximum recommended daily dose of empagliflozin 25 mg and metformin 2000 mg. Ardance-M 500 is usually administered twice daily with meals to reduce the gastrointestinal side effects associated with metformin.

• For patients not currently treated with metformin, the recommended starting dose is one tablet of Ardance-M 5/500 mg twice daily, with gradual dose escalation.
• For patients switching from metformin monotherapy, the starting dose of Ardance-M should provide the same total daily dose of metformin as was previously taken, plus empagliflozin 5 mg twice daily.
• For patients switching from separate tablets of empagliflozin and metformin, Ardance-M should be initiated at the same total daily doses of each component. 
• Renal function should be assessed before initiating Ardance-M and periodically thereafter. Ardance-M is contraindicated in patients with an eGFR below 45 mL/min/1.73 m².  

Side Effects: Common side effects associated with empagliflozin include urinary tract infections and female genital mycotic infections. Common side effects associated with metformin include diarrhea, nausea, vomiting, flatulence, abdominal discomfort, indigestion, asthenia, and headache, especially at the start of treatment. Hypoglycemia may occur when Ardance-M is used in combination with insulin or sulfonylureas.

Precautions: Ardance-M is contraindicated in patients with severe renal impairment (eGFR < 45 mL/min/1.73 m²), acute or chronic metabolic acidosis (including diabetic ketoacidosis), or a history of serious hypersensitivity reaction to empagliflozin or metformin. It is not recommended for use in patients with type 1 diabetes mellitus. Caution should be exercised in patients with moderate renal impairment, heart failure, liver disease, and excessive alcohol intake due to the risk of lactic acidosis associated with metformin. Volume depletion should be corrected before initiating Ardance-M.

Storage: Store Ardance-M 500 tablets below 30°C, protected from light and moisture. Keep out of reach of children.

Important Note: This information is for general knowledge and informational purposes only, and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication. They can assess your individual medical condition and provide the most appropriate advice.