VILDAGLIPTIN/METFORMIN CINFA 50 mg/850 mg FILM-COATED TABLETS

2. What you need to know before you take Vildagliptin/Metformin cinfa

Do not take Vildagliptin/Metformin cinfa

• if you are allergic to vildagliptin, metformin or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic to any of these ingredients, consult your doctor before taking Vildagliptin/Metformin cinfa.
• if you have uncontrolled diabetes with, for example, severe hyperglycemia (high blood sugar), nausea, vomiting, diarrhea, rapid weight loss, lactic acidosis (see “Risk of lactic acidosis” below) or ketoacidosis. Ketoacidosis is a disorder in which substances called “ketone bodies” accumulate in the blood, which can lead to a pre-diabetic coma. Symptoms include stomach pain, rapid and deep breathing, drowsiness or an unusual fruity odor in your breath.
• if you have recently had a heart attack or if you have heart failure or severe circulatory problems or breathing difficulties that may be a sign of heart problems.
• if you have a severe reduction in kidney function.
• if you have a severe infection or severe dehydration (massive loss of body water).
• if you are going to have a contrast radiology (a specific type of diagnostic test with X-rays and an injectable contrast medium). For more information, see the section “Warnings and precautions”.
• if you have liver problems.
• if you drink excessive alcohol (daily or only occasionally).
• if you are breastfeeding (see also “Pregnancy and breastfeeding”).

Warnings and precautions

Consult your doctor or pharmacist before starting to take Vildagliptin/Metformin cinfa.

Risk of lactic acidosis

Vildagliptin/metformin may cause a very rare but very serious side effect called lactic acidosis, especially if your kidneys do not work 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 disorder 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 to indicate how to proceed if:

• You know you have a genetic hereditary disease that affects mitochondria (the energy-producing components inside cells), such as MELAS syndrome (mitochondrial encephalomyopathy, myopathy, lactic acidosis, and stroke-like episodes) or maternally inherited diabetes and deafness (MIDD).
• You present any of the following symptoms after starting treatment with metformin: seizure, deterioration of cognitive abilities, difficulty with body movements, symptoms indicative of nerve damage (e.g., pain or numbness), migraine, and hearing loss.

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

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

The symptoms of lactic acidosis include:

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

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

Vildagliptin/metformin is not a substitute for insulin. Therefore, you should not take vildagliptin/metformin for the treatment of type 1 diabetes.

Consult your doctor, pharmacist, or nurse before starting to take vildagliptin/metformin if you have or have had a pancreatic disease.

Consult your doctor, pharmacist, or nurse before starting to take vildagliptin/metformin if you are taking a diabetic medicine known as a sulfonylurea. Your doctor may want to reduce your sulfonylurea dose when taken together with vildagliptin/metformin to avoid low blood sugar levels (hypoglycemia).

If you have previously taken vildagliptin but had to stop taking it due to liver disease, you should not take this medicine.

Skin lesions are common complications of diabetes. Follow your doctor's or nurse's recommendations for skin and foot care. Pay special attention to the appearance of blisters or ulcers while taking vildagliptin/metformin. If this occurs, you should consult your doctor immediately.

If you need to undergo major surgery, you should stop taking vildagliptin/metformin during the procedure and for a period after it. Your doctor will decide when you should stop taking vildagliptin/metformin and when to restart it.

Liver function tests should be performed before starting treatment with vildagliptin/metformin, at intervals of three months during the first year, and periodically thereafter. This is done to detect any signs of increased liver enzymes (transaminases) as soon as possible.

During treatment with vildagliptin/metformin, your doctor will check your kidney function at least once a year or more frequently if you are an elderly person and/or if your kidney function is worsening.

Your doctor will periodically check your blood and urine sugar levels.

Children and adolescents

The administration of vildagliptin/metformin is not recommended in children and adolescents under 18 years of age.

Other medicines and Vildagliptin/Metformin cinfa

Tell your doctor if you are taking, have recently taken, or might take any other medicines.

If you need to be administered an intravenous injection of a contrast medium containing iodine, for example, in the context of an X-ray or examination, you should stop taking vildagliptin/metformin before the injection or at the time of the injection. Your doctor will decide when you should stop taking vildagliptin/metformin and when to restart it.

You may need more frequent blood glucose and kidney function tests, or your doctor may need to adjust the dose of vildagliptin/metformin. It is especially important to mention the following:

• corticosteroids, generally used to treat inflammation
• beta-2 agonists, generally used to treat respiratory disorders
• other active substances used to treat diabetes
• 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)
• certain active substances that affect the thyroid
• certain active substances that affect the nervous system
• certain active substances used to treat angina pectoris (e.g., ranolazine)
• certain active substances used to treat HIV infection (e.g., dolutegravir)
• certain active substances used to treat a specific type of thyroid cancer (medullary thyroid cancer) (e.g., vandetanib)
• certain active substances used to treat stomach acid and peptic ulcers (e.g., cimetidine)

Taking Vildagliptin/Metformin cinfa with alcohol

Avoid excessive alcohol consumption while taking Vildagliptin/Metformin cinfa, as this may increase the risk of lactic acidosis (see section “Warnings and precautions”).

Pregnancy and breastfeeding

• If you are pregnant, think you may be pregnant, or are planning to become pregnant, consult your doctor before using this medicine. Your doctor will inform you about the potential risks of taking vildagliptin/metformin during pregnancy.
• Do not take vildagliptin/metformin if you are pregnant or breastfeeding (see also “Do not take Vildagliptin/Metformin cinfa”). Consult your doctor or pharmacist before using any medicine.

Driving and using machines

If you feel dizzy while taking Vildagliptin/Metformin cinfa, do not drive or operate tools or machines.

Treatment of diabetes with metformin as the only medicine (monotherapy) does not produce hypoglycemia (low blood sugar) and therefore does not affect the ability to drive or use machines. However, if you take metformin with other medicines to treat your diabetes, hypoglycemia (symptoms of low blood sugar such as fainting, confusion, increased sweating, vision changes, or difficulty concentrating) may occur, and you should be extremely cautious when driving and using hazardous machinery.

Due to the content of vildagliptin, your concentration and reaction ability may be affected due to symptoms caused by hypoglycemia or hyperglycemia, such as vision difficulties. This can be dangerous in situations where these skills are important (e.g., driving or using machines). Therefore, consult your doctor if it is recommended to drive or use machines.

3. How to take Vildagliptin/Metformin cinfa

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

The dose of vildagliptin/metformin that you should take varies depending on your condition. Your doctor will indicate exactly the dose of vildagliptin/metformin that you should take.

The recommended dose is one 50 mg/850 mg or 50 mg/1,000 mg tablet twice a day.

If you have reduced kidney function, your doctor may prescribe a lower dose. Your doctor may also prescribe a lower dose if you are taking a diabetes medicine known as a sulfonylurea.

Your doctor may prescribe this medicine alone or with certain medicines that lower your blood sugar levels.

Method of use of Vildagliptin/Metformin cinfa

• Swallow the tablets whole with a glass of water
• Take one tablet in the morning and the other in the evening with meals or after meals. Taking the tablet after meals will reduce the risk of digestive discomfort.

Follow your doctor's dietary advice. In particular, if you follow a diet for weight control in diabetics, continue with the diet while taking vildagliptin/metformin.

If you take more Vildagliptin/Metformin cinfa than you should

If you have taken too many vildagliptin/metformin tablets, or if someone else has taken your tablets, consult your doctor or pharmacist immediately.You may need medical attention. If you have to visit a doctor or go to the nearest hospital, take the package and this leaflet with you.

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

If you forget to take Vildagliptin/Metformin cinfa

If you forget to take a tablet, take it with your next meal, unless it is already time for your usual dose. Do not take a double dose to make up for forgotten doses.

If you stop taking Vildagliptin/Metformin cinfa

Continue taking this medicine while your doctor prescribes it to continue controlling your blood sugar. Do not stop taking vildagliptin/metformin unless your doctor tells you to.

If you have any doubts about the duration of treatment, consult your doctor.

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

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

You should stop taking vildagliptin/metformin and see your doctor immediately if you experience any of the following adverse effects:

• Lactic Acidosis(very rare: may affect up to 1 in 10,000 people):

vildagliptin/metformin may cause a very rare but very serious adverse effect called lactic acidosis (see section "Warnings and Precautions"). If this happens to you, you must stop takingvildagliptin/metforminand contact a doctor or the nearest hospital immediately, as lactic acidosis can lead to coma.

• Angioedema (rare: may affect up to 1 in 1,000 people): symptoms that include swollen face, tongue, or throat, difficulty swallowing, difficulty breathing, sudden appearance of rash or hives, which may be indicative of a reaction called "angioedema".
• Liver disease (hepatitis) (uncommon: may affect up to 1 in 100 people): symptoms that include yellowing of the skin and eyes, nausea, loss of appetite, or dark-colored urine, which may be indicative of liver disease (hepatitis).
• Pancreatitis (uncommon: may affect up to 1 in 100 people): symptoms that include severe and persistent abdominal pain (stomach area), which may radiate to your back, as well as nausea and vomiting.

Other Adverse Effects

Some patients have experienced the following adverse effects while taking vildagliptin/metformin:

• Frequent (may affect up to 1 in 10 people): sore throat, nasal congestion, fever, itchy rash, excessive sweating, joint pain, dizziness, headache, uncontrolled tremor, constipation, nausea (discomfort), vomiting, diarrhea, flatulence, heartburn, stomach pain, and abdominal pain.
• Uncommon (may affect up to 1 in 100 people): fatigue, weakness, metallic taste, low blood glucose levels, loss of appetite, swollen hands, ankles, or feet (edema), chills, pancreatitis, muscle pain.
• Very rare (may affect up to 1 in 10,000 people): signs of high lactic acid levels in the blood (known as lactic acidosis) such as drowsiness or dizziness, severe nausea and vomiting, abdominal pain, irregular heartbeat or rapid breathing; skin redness, itching; decreased vitamin B12 levels (pallor, fatigue, mental symptoms such as confusion or memory changes).

Since the marketing of this medicine, the following adverse effects have also been reported:

• Frequency not known (cannot be estimated from available data): localized skin peeling or blisters, inflammation of blood vessels (vasculitis) that can cause skin rashes or pinpoint, flat, red, and round spots under the skin surface or bruising.

Reporting Adverse Effects

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

5. Storage of Vildagliptin/Metformin cinfa

• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiration date stated on the packaging and blister after "CAD". The expiration date is the last day of the month indicated.
• Store in the original packaging (blister) to protect it from light and moisture.
• This medicine does not require any special storage temperature.
• Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and medicines you no longer need at the SIGRE Point in the pharmacy. Ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Vildagliptin/Metformin cinfa

• The active ingredients are vildagliptin and metformin hydrochloride.
• Each tablet contains 50 mg of vildagliptin and 850 mg of metformin hydrochloride.
• The other ingredients are: hydroxypropylcellulose, magnesium stearate, Opadry Y-1-7000 (hypromellose, titanium dioxide (E-171), and macrogol), and yellow iron oxide (E-172).

Appearance of the Product and Package Contents

Vildagliptin/Metformin cinfa 50 mg/850 mg are yellow, oblong, biconvex, uncoated tablets marked with "VM2" on one side (size: 19 x 10.15 mm).

Vildagliptin/Metformin cinfa 50 mg/850 mg is available in packages containing 60 tablets.

Aluminum/aluminum unit-dose blister.

Marketing Authorization Holder and Manufacturer

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

Date of Last Revision of this Leaflet: May 2025

Other Sources of Information:

Detailed information about this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS): http://www.aemps.gob.es

You can access detailed and updated information about this medicine by scanning the QR code included in the leaflet and packaging with your smartphone. You can also access this information at the following internet address:

https://cima.aemps.es/cima/dochtml/p/85621/P_85621.html

QR code to: https://cima.aemps.es/cima/dochtml/p/85621/P_85621.html