Prospect: Information for the Patient

Sitagliptin/Metformin Kern Pharma50 mg/850 mg Film-Coated Tablets

sitagliptin/metformin hydrochloride

Read this prospect carefully before starting to take this medicine, as it contains important information for you.

-Keep this prospect, as you may need to read it again.

-If you have any doubts, consult your doctor, pharmacist, or nurse.

-This medicine has been prescribed only for you, and you should not give it to other people, even if they have the same symptoms as you, as it may harm them.

-If you experience any adverse effects, consult your doctor, pharmacist, or nurse, even if they are not listed in this prospect. See section 4.

1.What is Sitagliptin/Metformin Kern Pharma and what is it used for

2.What you need to know before starting to take Sitagliptin/Metformin Kern Pharma

3.How to take Sitagliptin/Metformin Kern Pharma

4.Possible adverse effects

5.Storage of Sitagliptin/Metformin Kern Pharma

6.Contents of the pack and additional information

Sitagliptina/Metformina Kern Pharma contains two different medicines, called sitagliptin and metformin.

• Sitagliptin belongs to a class of medicines called DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors);
• Metformin belongs to a class of medicines called biguanides.

They work together to control blood sugar levels in adult patients with a form of diabetes called “type 2 diabetes mellitus”. This medicine helps to increase the levels of insulin produced after a meal and reduces the amount of sugar produced by the body.

Along with a diet and exercise, this medicine helps to lower your blood sugar level. This medicine can be used alone or with certain diabetes medicines (insulin, sulfonylureas or thiazolidinediones).

What is type 2 diabetes?

Type 2 diabetes is a disease in which your body does not produce enough insulin and the insulin that your body produces does not work as well as it should. Your body may also produce too much sugar. When this occurs, sugar (glucose) accumulates in the blood. This can lead to serious medical problems, such as heart diseases (cardiovascular), kidney diseases (renal), blindness, and amputations.

Do not takeSitagliptin/Metformin Kern Pharma:

• if you are allergic to sitagliptin, metformin, or any of the other ingredients of this medicine (listed in section 6);
• if you have severe kidney function reduction;
• if you have uncontrolled diabetes, for example, severe hyperglycemia (high blood sugar), nausea, vomiting, diarrhea, rapid weight loss, lactic acidosis (see "Risk of lactic acidosis" below). Lactic acidosis is a condition in which substances called "ketone bodies" accumulate in the blood, which can lead to diabetic precoma. Symptoms include stomach pain, rapid and deep breathing, drowsiness, or if your breath develops an unusual fruity odor;
• if you have a severe infection or are dehydrated;
• if you are going to have a radiography for which you will be injected with a contrast agent. You will need to stop taking this medicine at the time of the radiography and for 2 or more days after, as instructed by your doctor, depending on the functioning of your kidneys;
• if you have recently had a heart attack or have severe circulatory problems, such as "shock" or difficulty breathing;
• if you have liver problems (hepatic);
• if you drink excessive alcohol (either daily or occasionally);
• if you are breastfeeding.

Do not take this medicine if any of the above circumstances affect you and consult your doctor about other ways to control your diabetes. If you are unsure, consult your doctor, pharmacist, or nurse before starting to take this medicine.

Warnings and precautions

Cases of pancreatitis have been reported in patients treated with this medicine (see section 4).

If you notice blisters on your skin, it may be a sign of a disease called bullous pemphigoid. Your doctor may ask you to stop taking this medicine.

Risk of lactic acidosis

This medicine may cause a very rare but serious side effect called lactic acidosis, especially if your kidneys do not function properly. The risk of developing lactic acidosis is also increased with uncontrolled diabetes, severe infections, prolonged fasting, or alcohol consumption, dehydration (see more information below), liver problems, and any medical condition in which a part of the body has a reduced oxygen supply (such as acute and severe heart diseases).

If any of the above applies to you, consult your doctor for further instructions.

Consult your doctor immediately if:

• You know you have a genetic disease that affects the mitochondria (the components that produce energy inside cells), such as MELAS syndrome (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) or maternal diabetes and hearing loss (MIDD).

• You experience any of the following symptoms after starting treatment with metformin: convulsions, cognitive impairment, difficulty with motor movements, symptoms indicative of nerve damage (e.g., pain or numbness), migraine, and hearing loss.

Stop taking sitagliptin/metformin for a short period if you have a condition that may be associated with dehydration(significant loss of body fluids), such as intense vomiting, diarrhea, fever, exposure to heat, or if you drink less fluid than normal. Consult your doctor for further instructions.

Stop taking sitagliptin/metformin and contact a doctor or the nearest hospital immediately if you experience any of the symptoms that cause lactic acidosis, as this condition can lead to coma.

The symptoms of lactic acidosis include:

• vomiting;
• stomach pain (abdominal pain);
• muscle cramps;
• general feeling of discomfort, with intense fatigue;
• difficulty breathing;
• reduced body temperature and heart rate.

Lactic acidosis is a medical emergency and should be treated in a hospital.

Consult your doctor or pharmacist before starting to take this medicine:

• if you have or have had pancreatitis;
• if you have or have had gallstones, alcohol addiction, or have very high levels of triglycerides (a type of fat) in your blood. These medical conditions may increase your risk of developing pancreatitis (see section 4);
• if you have type 1 diabetes. This disease is also known as insulin-dependent diabetes;
• if you have or have had an allergic reaction to sitagliptin, metformin, or this medicine (see section 4);
• if you are taking a sulfonilurea or insulin, other diabetes medications, as you may experience low blood sugar (hypoglycemia). Your doctor may consider reducing the dose of the sulfonilurea or insulin you are taking.

If you need to undergo major surgery, stop taking this medicine while the procedure is being performed and for a period of time after. Your doctor will decide when to interrupt treatment with this medicine and when to restart it.

If you are unsure whether you are affected by any of the above circumstances, consult your doctor or pharmacist before starting to take this medicine.

During treatment with this medicine, your doctor will check your kidney function at least once a year or more frequently if you are an older person and/or if your kidney function is deteriorating.

Children and adolescents

Children and adolescents under 18 years old should not use this medicine. It is not effective in children and adolescents aged 10 to 17 years. The safety and efficacy of this medicine in children under 10 years old are unknown.

Other medicines and Sitagliptin/Metformin Kern Pharma

If you need to be administered an injection of a contrast agent containing iodine, such as in the context of a radiography or examination, stop taking this medicine before the injection or at the time of the injection. Your doctor will decide when to interrupt treatment with this medicine and when to restart it.

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medicine. You may need more frequent blood glucose and kidney function tests, or your doctor may need to adjust the dose of this medicine. It is especially important to mention the following:

• medicines (taken orally, inhaled, or injected) used to treat inflammatory diseases, such as asthma and arthritis (corticosteroids);
• medicines that increase urine production (diuretics);
• medicines used to treat pain and inflammation (NSAIDs and COX-2 inhibitors, such as ibuprofen and celecoxib);
• certain medicines used to treat high blood pressure (ACE inhibitors and angiotensin II receptor antagonists);
• specific medicines used to treat asthma (β-adrenergic agonists);
• contrast agents containing iodine or medicines containing alcohol;
• certain medicines used to treat stomach problems, such as cimetidine;
• ranolazine, a medicine used to treat angina pectoris;
• dolutegravir, an antiretroviral medicine used to treat HIV infection;
• vandetanib, a medicine used to treat a specific type of thyroid cancer (medullary thyroid cancer);
• digoxin (to treat irregular heartbeat and other heart problems). You may need to check your digoxin blood level if you are taking this medicine.

Taking Sitagliptin/Metformin Kern Pharma with alcohol

Avoid excessive alcohol consumption while taking this medicine, as this may increase the risk of lactic acidosis (see section "Warnings and precautions").

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, consult your doctor or pharmacist before using this medicine. Do not take this medicine during pregnancy or while breastfeeding. See section 2, Do not take Sitagliptin/Metformin Kern Pharma

Driving and operating machinery

The influence of this medicine on the ability to drive and operate machinery is negligible or insignificant. However, cases of dizziness and somnolence have been reported during treatment with sitagliptin, which may affect your ability to drive and operate machinery.

Taking this medicine with sulfonilureas or insulin may cause hypoglycemia, which may affect your ability to drive and operate machinery or work without a secure support.

Sitagliptin/Metformin Kern Pharma contains sodium

This medicine contains less than 23 mg of sodium (1 mmol) per tablet, i.e., it is essentially "sodium-free".

Follow exactly the administration instructions of this medication as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again.

• Take a tablet:
• twice a day orally.
• with food to reduce the likelihood of feeling stomach discomfort.
• Your doctor may need to increase the dose to control blood sugar levels.
• If you have reduced renal function, your doctor may prescribe a lower dose.

You must continue with the diet recommended by your doctor during treatment with this medication and be careful to distribute carbohydrate intake evenly throughout the day.

It is unlikely that treatment with this medication alone will cause an abnormal drop in blood sugar (hypoglycemia). A drop in blood sugar may occur when this medication is taken with a medication containing sulfonylurea or with insulin, so it is likely that your doctor will consider reducing the dose of your sulfonylurea or insulin.

The groove should not be used to break the tablet.

If you take more Sitagliptina/Metformina Kern Pharma than you should

If you take more than the prescribed dose of this medication, contact your doctor immediately. Go to the hospital if you have symptoms of lactic acidosis such as feeling cold or unwell, intense nausea or vomiting, stomach pain, unexplained weight loss, muscle cramps, or agitated breathing (see "Warnings and precautions").

In case of overdose or accidental ingestion, consult your doctor or pharmacist or call the Toxicological Information Service, phone: 91 562 04 20, indicating the medication and the amount ingested.

If you forget to take Sitagliptina/Metformina Kern Pharma

If you forget to take a dose, take it as soon as you remember. If you do not remember until the time of your next dose, skip the missed dose and continue with your regular treatment. Do not take a double dose of this medication.

If you interrupt treatment with Sitagliptina/Metformina Kern Pharma

Continue taking this medication as long as your doctor tells you to, to help you control your blood sugar level. Do not stop taking this medication without first consulting your doctor. If you interrupt treatment with this medication, your blood sugar level may increase again.

If you have any other questions about the use of this medication, ask your doctor or pharmacist.

Like all medicines, this medicine can cause side effects, although not everyone will experience them.

STOP taking this medicine and see your doctor immediately if you notice any of the following serious side effects:

• Intense and persistent abdominal pain (stomach area) that can reach the back with or without nausea and vomiting, as these can be signs of pancreatitis (inflammation of the pancreas).

This medicine can cause a very rare but serious side effect (can affect up to 1 in 10,000 people), called lactic acidosis (see "Warnings and precautions"). If this happens to you,you should stop taking this medicine and contact a doctor or the nearest hospital immediately, as lactic acidosis can lead to coma.

If you have a severe allergic reaction (frequency unknown), including skin rash, urticaria, blisters on the skin/skin peeling and swelling of the face, lips, tongue, and throat that can cause difficulty breathing or swallowing, stop taking this medicine and consult your doctor immediately. Your doctor will prescribe a medicine to treat the allergic reaction and change the medicine for diabetes treatment.

Some patients taking metformin have experienced the following side effects after starting treatment with sitagliptin:

Frequent(can affect up to 1 in 10 people): low blood sugar, nausea, gas, vomiting

Infrequent(can affect up to 1 in 100 people): stomach pain, diarrhea, constipation, drowsiness

Some patients have experienced diarrhea, nausea, gas, constipation, stomach pain, or vomiting when starting treatment with the combination of sitagliptin and metformin (frequency classified as frequent).

Some patients have experienced the following side effects when taking this medicine with a sulfonylurea such as glimepiride:

Very frequent(can affect more than 1 in 10 people): low blood sugar

Frequent: constipation

Some patients presented the following side effects while taking this medicine in combination with pioglitazone:

Frequent: swelling of hands or feet

Some patients presented the following side effects while taking this medicine in combination with insulin:

Very frequent: low blood sugar

Infrequent: dry mouth, headache

Some patients have experienced the following side effects during clinical studies while taking sitagliptin alone (one of the medicines contained in Sitagliptina/Metformina Kern Pharma) or during use after approval of this medicine or sitagliptin alone or with other diabetes medicines:

Frequent: low blood sugar, headache, upper respiratory tract infection, congestion or nasal mucus, and throat pain, arthritis, arm or leg pain

Infrequent: dizziness, constipation, itching

Rare (can affect up to 1 in 1,000 people): reduction in platelet count

Unknown frequency: kidney problems (which sometimes require dialysis), vomiting, joint pain, muscle pain, back pain, interstitial lung disease, bullous pemphigoid (a type of blister on the skin)

Some patients have experienced the following side effects after taking metformin alone:

Very frequent: nausea, vomiting, diarrhea, stomach pain, and loss of appetite. These symptoms can appear when you start taking metformin and usually disappear

Frequent: metallic taste

Very rare: reduction of vitamin B12 levels, hepatitis (liver problem), urticaria, skin redness (rash) or itching

Reporting of side effects

If you experience any type of side effect, consult your doctor, pharmacist, or nurse, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Pharmacovigilance of Medicines for Human Use:https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.

Keep this medication out of the sight and reach of children.

Do not use this medication after the expiration date that appears on the blister pack and on the packaging after CAD. The expiration date is the last day of the month indicated.

Store below 30°C.

Medicines should not be disposed of through drains or in the trash. Dispose of the packaging and unused medicines at your local SIGRE collection point at your usual pharmacy. If in doubt, ask your pharmacist how to dispose of unused packaging and medicines. By doing so, you will help protect the environment.

Composition of Sitagliptin/Metformin Kern Pharma

• The active principles are sitagliptin and metformin. Each film-coated tablet contains sitagliptin hydrochloride monohydrate equivalent to 50 mg of sitagliptin and 850 mg of metformin hydrochloride.

• The other components are: In the tablet core: povidone K 29/32 (E1201), microcrystalline cellulose (E460), crospovidone Kollidon and sodium stearyl fumarate. Additionally, the film coating contains: polyvinyl alcohol (E1203), titanium dioxide (E171), macrogol/PEG (E1521), talc (E553b), yellow iron oxide (E172), red iron oxide (E172) and black iron oxide (E172).

Appearance of the product and contents of the package

Sitagliptin/Metformin Kern Pharma50 mg/850 mg are pink, oval, oblong film-coated tablets with a notch on one face and the inscription "SA" on the other.

Tablet diameter: 19.5 ± 0.5 mm

It is presented in PVC-PVDC/Aluminum blisters, in packs of 14, 28, 50, 56, 112, 168, 196 film-coated tablets.

Only some pack sizes may be marketed.

Marketing authorization holder

Kern Pharma, S.L.

Venus, 72 - Pol. Ind.Colón II

08228 Terrassa - Barcelona

Spain

Responsible for manufacturing

SAG MANUFACTURING S.L.U

Carretera Nacional I, Km 36

San Agustin de Guadalix 28750

Spain

O

GALENICUM HEALTH, S.L.U.

Sant Gabriel, 50

08950 - Esplugues de Llobregat (Barcelona)

Spain

This medicine is authorized in the member states of the European Economic Area with the following names:

Spain:Sitagliptin/Metformin Kern Pharma 50 mg/850 mg film-coated tablets EFG

Sitagliptin/Metformin Kern Pharma 50 mg/1000 mg film-coated tablets EFG

Malta:Sitagliptine/Metformine Kern Pharma 50 mg/850 mg film-coated tablets

Sitagliptine/Metformine Kern Pharma 50 mg/1000 film-coated tablets

Portugal:Metformina + Sitagliptina Pharmakern

Last revision date of this leaflet: March 2025

The detailed and updated information of this medicine is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/.