Composition
Tribose M3:
Each tablet contains Voglibose 0.3mg and Metformin 500mg.
Tribose M:
Each tablet contains Voglibose 0.2mg and Metformin 500mg.

Product Description
Voglibose is an alpha-glucosidase inhibitor, it is an oral anti-diabetic drugs used for diabetes mellitus type 2. Alpha-glucosidase inhibitors are act as competitive inhibitors of enzymes needed to digest carbohydrates: specifically alpha-glucosidase enzymes in the brush border of the small intestines. The membrane-bound intestinal alpha-glucosidases hydrolyze oligosaccharides, trisaccharides, and disaccharides to glucose and other monosaccharides in the small intestine. that prevents the digestion of complex carbohydrates (such as starch). Complex carbohydrates are normally converted into simple sugars (monosaccharides) which can be absorbed through the intestine. Hence, alpha-glucosidase inhibitors reduce the impact of complex carbohydrates on blood sugar and decreases the post prandial hyperglycemia in diabetes.
Metformin is the oral anti hyperglycemic drug used in the management of type2 diabetes. It is the class of biguanides. Metformin improves glucose tolerance in patients with type 2 diabetes, Metformin lowers both basal and postprandial blood glucose. Metformin decreases hepatic glucose production, decrease intestinal absorption of glucose and improves peripheral glucose uptake and utilization.

Pharmacokinetics
Voglibose is slowly and poorly absorbed, and is rapidly excreted. Little metabolism occurs.
Voglibose competitively and reversibly inhibits the alpha–glucosidase enzymes; glucoamylase, sucrase, etc.
Metformin has an absolute oral bioavailability of 40 to 60%, and gastrointestinal absorption is apparently complete within 6 hours of ingestion. Metformin is rapidly distributed following absorption and does not bind to plasma proteins. No metabolites or conjugates of metformin have been identified. The absence of liver metabolism clearly differentiates the pharmacokinetics of metformin from that of other biguanides, such as phenformin. Metformin undergoes renal excretion and has a mean plasma elimination half-life after oral administration of between 4.0 and 8.7 hours. This elimination is prolonged in patients with renal impairment and correlates with creatinine clearance.

Indications
In the management of Post prandial Hyperglycemia in Diabetes.

Adverse Effects
Nausea, Vomiting, GI Disturbance like Increased flatulence, abdominal fullness,
intestinal obstruction-like symptom.

ContraIndication
Severe ketosis, diabetic coma or pre-coma, severe infection, before or after operation, or with severe trauma.

Special Precautions
History of laparotomy or ileus, chronic intestinal disease accompanied by disturbance in digestion & absorption, aggravating symptoms due to increased generation of intestinal gas, serious hepatic or renal disorders. Concomitant use with other antidiabetic drugs may result in hypoglycemia. Delays digestion & absorption of disaccharides. Elderly. Pregnancy, lactation.

Drug Interactions
Insulin, sulfonylamides, sulfonylureas or biguanides, β-blockers, MAOIs & salicylic acid prep. Drugs like thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid may cause hypoglycemia. When such drugs are administered to a patient receiving metformin, the patient should be closely observed to maintain adequate glycemic control.

Dosage
One tablet Thrice Daily.

Administration
Should be taken immediately before food with water or with first mouth of food.

Packing
A strip of 10 tablets.
In a box 10x10 tablets.