FDA批准复方制剂Janumet缓释片用于治疗2型糖尿病 近日，美国食品药品管理局FDA批准Janumet XR(西他列汀/二甲双胍缓释片)用于治疗2型糖尿病。Janumet XR适合作为饮食和运动疗法的辅助用药，用于同时适宜采用西他列汀和缓释型二甲双胍治疗的2型糖尿病患者，以改善其血糖控制。 Janumet XR以糖尿病的3个重要缺陷为靶点：胰岛β细胞引起的胰岛素缺乏、胰岛素抵抗以及肝脏葡萄糖生成过量。 FDA批准Janumet XR是基于一项临床生物等效性研究的结果，该研究显示应用Janumet XR与相应剂量的这两种药物——西他列汀和缓释二甲双胍联用的效果相当。缓释二甲双胍与速释二甲双胍等效。 据默克公司称，西他列汀与二甲双胍联合用药所能使血红蛋白A1c(HbA1c)水平降低的程度大于西他列汀或二甲双胍单独用药。在一项对1,091例通过饮食和运动疗法未能充分控制血糖的2型糖尿病患者进行的随机、双盲、安慰剂对照的析因研究中，在24周时，速释型二甲双胍与西他列汀联合用药、每日2次治疗组的HbA1c水平相对于安慰剂对照组降低。西他列汀100 mg、每日1次+速释型二甲双胍2000 mg、每日1次治疗组(n=178)基线时的平均HbA1c水平为8.8%，安慰剂调整的平均降幅为2.1%(P<0.001)。 该研究的其他小组安慰剂调整的平均HbA1c降幅分别为1.6%(西他列汀100 mg、每日1次+速释型二甲双胍1000 mg、每日1次治疗组，n=183)、1.3%(速释型二甲双胍2000 mg、每日1次治疗组，n=177)，1.0%(速释型二甲双胍1000 mg、每日1次治疗组，n=178)及0.8%(西他列汀治疗组，n=175)(所有治疗组vs. 安慰剂组：P<0.001)。在24周时，初始治疗方案为西他列汀100 mg、每日1次+速释型二甲双胍2000 mg、每日1次的患者中有66%达到美国糖尿病学会(ADA)设定的目标血红蛋白A1c水平<7%，而采用速释型二甲双胍2000 mg、每日1次单药治疗组中有38%的患者达到此目标。在该研究的其他小组中，西他列汀100 mg、每日1次+速释型二甲双胍1000 mg、每日1次联合治疗组有43%、速释型二甲双胍1000 mg、每日1次治疗组有23%、西他列汀治疗组有20%的患者达到了ADA设定的血红蛋白A1c<7%的目标水平。 Janumet XR的说明书中包含一个有关乳酸酸中毒的黑框警告，该药禁用于有肾功能损害的患者。 目前已收到有关服用西他列汀联合(或不联合)二甲双胍的患者发生肾功能恶化的上市后报告，其中包括急性肾衰竭，有时甚至需要透析治疗。在开始Janumet治疗前及此后至少每年应进行一次肾功能评估，以确认其正常。 此外，上市后报告还涉及急性胰腺炎，其中包括服用西他列汀联合(或不联合)二甲双胍的患者发生致死性和非致死性出血性或坏死性胰腺炎。在开始Janumet XR治疗后，应该对患者密切监测胰腺炎的症状和体征。若疑似胰腺炎，则应立即停用Jamumet XR，并开始适当的处置。有胰腺炎病史的患者在接受Janumet XR治疗的过程中发生胰腺炎的风险是否会增加，尚不清楚。 市售的Janumet XR有100mg西他列汀/1000mg二甲双胍缓释片、50mg西他列汀/500mg二甲双胍缓释片以及50mg西他列汀/1000mg二甲双胍缓释片。Janumet XR的用法为每日1次，最好在晚餐后服用。应告知患者Janumet XR片在吞服前不得切割、压碎或咀嚼。 Janumet XR的剂量应根据患者当前的治疗方案、有效性和耐受性采取个体化原则，同时不要超过西他列汀和二甲双胍的每日最大推荐剂量(分别为100 mg和2000 mg)。初始联合治疗或联合治疗的维持用药也应采取个体化原则，并由医务人员判断决定。对于已经开始二甲双胍治疗的患者，Janumet XR的每日总推荐开始剂量为西他列汀100mg，二甲双胍仍遵循之前的处方剂量。 批准日期：2012年2月2日 公司：默克公司 JANUMET XR（西他列汀和二甲双胍盐酸[sitagliptin and metformin HCl extended-release]）缓释片剂 为口服使用 美国首次批准：2012 一般描述 JANUMET XR片剂含有两种口服降糖药的2型糖尿病患者的管理：西他列汀和盐酸二甲双胍缓释型。 西他列汀 西他列汀是一种口服活性的二肽基肽酶4（DPP-4）酶的抑制剂。一水合磷酸西他列汀的药物物质用于制造JANUMET XR。磷酸西他列汀一水合物化学磷酸盐（1:1）一水合物，用经验公式C16H15F6N5O•H3PO4•H2O和分子量为523.32。结构式为： 磷酸西他列汀水合物是一种白色至灰白色，结晶，非吸湿性粉末。它可溶于水和N，N-二甲基甲酰胺中，微溶于甲醇，极微溶于乙醇，丙酮，和乙腈;和不溶于异丙醇和乙酸异丙酯。 盐酸二甲双胍 盐酸二甲双胍（N，N-dimethylimidodicarbonimidic二酰胺盐酸盐）是一种白色至灰白色结晶的化合物与分子式为C4H11N5•盐酸和分子量为165.63。盐酸二甲双胍是易溶于水，是几乎不溶于丙酮，乙醚，和氯仿。二甲双胍的pKa 12.4。盐酸二甲双胍的1％水溶液的pH值是6.68。其结构式如下所示： JANUMET XR JANUMET XR由缓释二甲双胍与速释层西格列汀涂覆的片芯。西格列汀层涂覆与可溶性的聚合物薄膜。 JANUMET XR可用于口服含有64.25毫克磷酸西他列汀一水物（相当于50毫克西他列汀游离碱），或者500毫克的盐酸二甲双胍缓释型（50 mg/500毫克）或1000毫克盐酸二甲双胍缓释型片剂（ 50 mg/1000毫克）。此外，JANUMET XR可用于口服片含128.5毫克磷酸西他列汀一水物（相当于100毫克西他列汀游离碱）和1000毫克盐酸二甲双胍缓释型（100 mg/1000毫克）。 所有剂量的JANUMET XR的含有下列非活性成分：聚维​​酮，羟丙基甲基纤维素，胶态二氧化硅，硬脂酰富马酸钠，丙基没食子儿茶素没食子酸酯，聚乙二醇，和高岭土。 JANUMET XR 50 mg/500毫克的片剂包含额外的非活性成分的微晶纤维素。此外，可用于所有剂量的膜包衣包含下列非活性成分：羟丙甲纤维素，羟丙基纤维素，二氧化钛，FD＆C＃2/Indigo胭脂红铝色淀和巴西棕榈蜡。 JANUMET XR 50 mg/1000毫克的片剂薄膜包衣，也包含了非活性成分的黄色氧化铁。 作用机制 JANUMET XR JANUMET XR片结合了两种互补的作用机制的降糖药物，以改善成人2型糖尿病患者的血糖控制在：西他列汀，二肽基肽酶-4（DPP-4）抑制剂，盐酸二甲双胍缓释型，双胍类类的成员。 适应症及用法 JANUMET XR是一种二肽基肽酶-4（DPP-4）抑制剂，双胍类相结合的产物表示，作为辅助饮食和运动改善血糖控制与2型糖尿病的成年人中与西他列汀和二甲双胍缓释型治疗是适当的。 使用的重要限制： ■非1型糖尿病或糖尿病酮症酸中毒治疗。 ■未在胰脏炎病史的患者进行了研究。 用法用量 ■个体化的起始剂量为JANUMET XR根据病人目前的治疗方案。 ■可调节的有效性和耐受性的基础上的剂量，同时不超过建议的每日最高剂量为100 mg西他列汀和2000毫克二甲双胍缓释型。 ■管理每日一次，与一餐最好在晚上。逐渐升级的剂量，以减少由于二甲双胍的胃肠道副作用。 ■保持相同的JANUMET和Janumet XR之间变化时，西他列汀和二甲双胍每日总剂量，不超过建议的每日最高剂量为2000毫克二甲双胍缓释型。 ■燕子整体。不要分裂，压碎或咀嚼。 剂型和优势 JANUMET XR片剂：100毫克sitagliptin/1000毫克二甲双胍盐酸盐缓释型，50毫克sitagliptin/500毫克二甲双胍盐酸缓释型，和50毫克sitagliptin/1000的毫克metformin HCl的延长释放。 禁忌 ■肾功能不全，如血肌酐≥1.5毫克/分升[男性]，≥1.4毫克/分升[女性]或异常肌酐清除率。 ■代谢性酸中毒，包括糖尿病酮症酸中毒。 ■历史的严重的过敏反应（如过敏症或血管性水肿）JANUMET XR或它的组件之一。 警告和注意事项 ■乳酸性酸中毒：警惕过量饮酒。 JANUMET XR不建议在肝功能不全和肾功能不全的禁忌。确保前启动，并在此后至少每年肾功能正常。 ■暂时停止JANUMET XR患者接受放射学检查，血管内给药的碘造影剂材料，或任何外科手术，需要限制摄入的食物或液体。 ■有急性胰腺炎的上市后报告，包括在与JANUMET XR的组成部分之一，西他列汀或不二甲双胍治疗的患者致死性和非致死性出血性或坏死性胰腺炎。如果怀疑是胰腺炎，立即停止：JANUMET XR。 ■西他列汀与二甲双胍或不治疗的患者有急性肾功能衰竭的上市后报告，有时需要透析。在启动JANUMET XR，并在此后至少每年评估肾功能，并验证为正常。 ■维生素B12缺乏：二甲双胍可降低维生素B12的水平。每年测量血液参数。 ■当使用的胰岛素促分泌剂（例如，磺酰脲）或与胰岛素，可能需要低剂量的胰岛素促分泌剂或胰岛素低血糖症的风险降至最低。 ■已经有严重的过敏反应和过敏性反应与西他列汀治疗的患者，如过敏性休克，血管神经性水肿，包括Stevens-Johnson综合征和剥脱性皮肤条件的上市后报告。在这种情况下，及时停止JANUMET XR，评估其他潜在的原因，采取相应的监测和治疗，并启动替代治疗糖尿病。 ■目前还没有确凿的证据，大血管风险减少JANUMET XR或任何其它抗糖尿病药物的临床研究，建立。 不良反应 最常见的不良反应报告率≥5％的患者，同时开始对西他列汀和二甲双胍，比用安慰剂治疗患者更常见的是腹泻，上呼吸道感染，头痛等症状。 ■≥5％，与磺酰脲类和二甲双胍结合磺酰脲类和二甲双胍与安慰剂治疗的患者相比，更常见的结合西他列汀治疗的患者中报告的不良反应是低血糖和头痛。 ■低血糖与胰岛素和二甲双胍结合胰岛素和二甲双胍与安慰剂治疗的患者相比，更常见的结合西他列汀治疗的患者≥5％的不良反应报告。 药物相互作用 ■阳离子消除肾小管分泌的药物：请谨慎使用。 特殊人群中使用 ■JANUMET XR在​​18岁以下儿童的安全性和有效性尚未确立。 Janumet XR (sitagliptin and metformin extended release) Tablets Important Information JANUMET XR is indicated, as an adjunct to diet and exercise, to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both sitagliptin and metformin extended-release is appropriate. JANUMET XR should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. JANUMET XR has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking JANUMET XR. Selected Important Risk Information About JANUMET® XR (sitagliptin and metformin HCl extended-release) tabletsWARNING: LACTIC ACIDOSIS Lactic acidosis is a rare, but serious complication that can occur due to metformin accumulation. The risk increases with conditions such as sepsis, dehydration, excess alcohol intake, hepatic impairment, renal impairment, and acute congestive heart failure. The onset of lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, increasing somnolence, and nonspecific abdominal distress. Laboratory abnormalities include low pH, increased anion gap, and elevated blood lactate. If acidosis is suspected, JANUMET XR should be discontinued and the patient hospitalized immediately [see Warnings and Precautions]. JANUMET XR is contraindicated in patients with renal impairment (serum creatinine levels greater than or equal to 1.5 mg/dL for men and greater than or equal to 1.4 mg/dL for women or abnormal creatinine clearance); hypersensitivity to metformin hydrochloride; acute or chronic metabolic acidosis, including diabetic ketoacidosis; or history of a serious hypersensitivity reaction to JANUMET XR or sitagliptin, such as anaphylaxis or angioedema. Temporarily discontinue JANUMET XR in patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials, because use of such products may result in acute alteration of renal function. Avoid use in patients with hepatic disease. Temporarily discontinue for intercurrent serious conditions, infection, or surgery. There have been postmarketing reports of worsening renal function, including acute renal failure, sometimes requiring dialysis. Measure renal function before initiation of therapy with JANUMET XR and at least annually thereafter. In patients in whom development of renal dysfunction is anticipated, particularly in elderly patients, renal function should be assessed more frequently and JANUMET XR discontinued if evidence of renal impairment is present. Lactic acidosis is fatal in approximately 50% of cases. The reported incidence of lactic acidosis in patients receiving metformin hydrochloride is approximately 0.03 cases/1000 patient-years, with approximately 0.015 fatal cases/1000 patient-years. Reported cases have occurred primarily in diabetic patients with significant renal impairment, including both intrinsic renal disease and renal hypoperfusion, often in the setting of multiple concomitant medical/surgical problems and multiple concomitant medications. Patients with congestive heart failure requiring pharmacologic management, in particular those with unstable or acute congestive heart failure who are at risk of hypoperfusion and hypoxemia, are at increased risk of lactic acidosis. The risk of lactic acidosis increases with the degree of renal dysfunction and the patient’s age. The risk of lactic acidosis may, therefore, be significantly decreased by regular monitoring of renal function in patients taking JANUMET XR. In particular, treatment of the elderly should be accompanied by careful monitoring of renal function. In addition, metformin should be promptly withheld in the presence of any condition associated with hypoxemia, dehydration, or sepsis. There have been postmarketing reports of acute pancreatitis, including fatal and nonfatal hemorrhagic or necrotizing pancreatitis, in patients taking sitagliptin with or without metformin. After initiating JANUMET XR, observe patients carefully for signs and symptoms of pancreatitis. If pancreatitis is suspected, promptly discontinue JANUMET XR and initiate appropriate management. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking JANUMET XR. Alcohol potentiates the effect of metformin on lactate metabolism. Patients should be warned against excessive alcohol intake while receiving JANUMET XR. Intravascular contrast studies with iodinated materials can lead to acute alteration of renal function and have been associated with lactic acidosis in patients receiving metformin. Therefore, in patients in whom any such study is planned, JANUMET XR should be temporarily discontinued at the time of or before the procedure, withheld for 48 hours subsequent to the procedure, and reinstituted only after renal function has been re-evaluated and found to be normal. There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with JANUMET XR or any other antidiabetic drug. Use With Medications Known to Cause Hypoglycemia Sitagliptin When sitagliptin was used in combination with a sulfonylurea or insulin, medications known to cause hypoglycemia, the incidence of hypoglycemia was increased over that of placebo used in combination with a sulfonylurea or insulin. Therefore, patients also receiving insulin or an insulin secretagogue (eg, sulfonylurea) may require a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia. The incidence (and rate) of hypoglycemia based on all reports of symptomatic hypoglycemia were: 16.4% (0.82 episodes/patient-year) for sitagliptin 100 mg in combination with metformin and glimepiride, 0.9% (0.02 episodes/patient-year) for placebo in combination with metformin and glimepiride, 8.2% (0.61 episodes/patient-year) for placebo in combination with metformin and insulin, and 15.3% (0.98 episodes/patient-year) for sitagliptin in combination with metformin and insulin. Adverse reactions with sitagliptin in combination with metformin and rosiglitazone through Week 18 were: upper respiratory tract infection (sitagliptin, 5.5%; placebo, 5.2%) and nasopharyngitis (6.1%, 4.1%). Through Week 54 they were: upper respiratory tract infection (sitagliptin, 15.5%; placebo, 6.2%), nasopharyngitis (11.0%, 9.3%), peripheral edema (8.3%, 5.2%), and headache (5.5%, 4.1%). Metformin hydrochloride Hypoglycemia does not occur in patients receiving metformin alone under usual circumstances of use but could occur when caloric intake is deficient, when strenuous exercise is not compensated by caloric supplementation, or during concomitant use with other glucose-lowering agents (such as sulfonylureas and insulin) or ethanol. Elderly, debilitated, or malnourished patients and those with adrenal or pituitary insufficiency or alcohol intoxication are particularly susceptible to hypoglycemic effects. There have been postmarketing reports of serious hypersensitivity reactions in patients treated with sitagliptin, one of the components of JANUMET XR, such as anaphylaxis, angioedema, and exfoliative skin conditions including Stevens-Johnson syndrome. Onset of these reactions occurred within the first 3 months after initiation of treatment with sitagliptin, with some reports occurring after the first dose. If a hypersensitivity reaction is suspected, discontinue JANUMET XR, assess for other potential causes for the event, and institute alternative treatment for diabetes. Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with JANUMET XR. There have been postmarketing reports of severe and disabling arthralgia in patients taking DPP-4 inhibitors. The time to onset of symptoms following initiation of drug therapy varied from 1 day to years. Patients experienced relief of symptoms upon discontinuation of the medication. A subset of patients experienced a recurrence of symptoms when restarting the same drug or a different DPP-4 inhibitor. Consider DPP-4 inhibitors as a possible cause for severe joint pain and discontinue drug if appropriate. In clinical studies, the most common adverse reactions reported, regardless of investigator assessment of causality, in ≥5% of patients treated with either sitagliptin in combination with metformin or placebo were as follows: diarrhea (7.5% vs 4.0%), upper respiratory tract infection (6.2% vs 5.1%), and headache (5.9% vs 2.8%). In patients treated with sitagliptin in combination with metformin and sulfonylurea or placebo in combination with metformin and sulfonylurea: hypoglycemia (16.4% vs 0.9%) and headache (6.9% vs 2.7%). In patients treated with sitagliptin in combination with metformin and insulin or placebo in combination with metformin and insulin: hypoglycemia (15.3% vs 8.2%). Other adverse events with an incidence of ≥5% included nasopharyngitis for sitagliptin monotherapy and hypoglycemia (13.7% vs 4.9%), diarrhea (12.5% vs 5.6%), and nausea (6.7% vs 4.2%) for extended-release metformin vs placebo when added to glyburide. JANUMET XR Rx Add Drug To My List Compare to related Drugs View/edit/Compare drugs in my list Select the drug indication to add to your list JANUMET XR Diabetes  Only 4 drugs may be compared at once Generic Name and Formulations: Sitagliptin, metformin (as HCl) ext-rel; 50mg/500mg, 50mg/1000mg, 100mg/1000mg; tabs. Company: Merck & Co., Inc.   Select therapeutic use: Diabetes Indications for JANUMET XR: Adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes when treatment with both sitagliptin and metformin extended-release is appropriate. Limitations Of use: Not for treatment of type 1 diabetes or diabetic ketoacidosis. Not studied in patients with history of pancreatitis. Adult: Individualize. Swallow whole. Take once daily with a meal, preferably in the evening. Not currently treated with metformin: initially 100mg/1000mg daily. Previously on metformin alone: initially 100mg daily of sitagliptin plus metformin dose. Previously on metformin 850mg twice daily or 1000mg twice daily: start with two 50mg/1000mg tablets taken together once daily. Previously on Janumet: switch on a mg/mg basis. Max 100mg sitagliptin/2000mg metformin per day. Children: <18yrs: not established. Contraindications: Renal impairment (Scr ≥1.5mg/dL [men], ≥1.4mg/dL [women], or abnormal CrCl). Metabolic acidosis, diabetic ketoacidosis. Warnings/Precautions: Confirm normal renal function before starting and monitor (esp. in elderly). Discontinue if lactic acidosis, renal impairment, shock, acute MI or CHF, sepsis, hypoxemia, pancreatitis, serious hypersensitivity reactions, or severe joint pain is suspected or occurs. Avoid if clinical or lab evidence of hepatic disease. May need to suspend therapy during periods of stress or if dehydration occurs or before surgery. Monitor hematology (esp. serum Vit. B12 in susceptible patients). Elderly, debilitated, uncompensated strenuous exercise, malnourished or deficient caloric intake, adrenal or pituitary insufficiency, or alcohol intoxication: increased risk of hypoglycemia. History of angioedema to other DPP-4 inhibitors. Concomitant intravascular iodinated contrast agents (suspend during and for 48hrs after use). Pregnancy (Cat.B). Nursing mothers. Interactions: Caution with concomitant topiramate or other carbonic anhydrase inhibitors (eg, zonisamide, acetazolamide, dichlorphenamide); may induce metabolic acidosis. Cationic drugs eliminated by renal tubular secretion (eg, amiloride, digoxin, morphine, procainamide, quinine, quinidine, ranitidine, triamterene, trimethoprim, vancomycin); monitor. Avoid excessive alcohol intake (potentiates effects of metformin on lactate). Diuretics, steroids, estrogens, oral contraceptives, phenothiazines, phenytoin, thyroid products, nicotinic acid, sympathomimetics, calcium channel blockers, isoniazid, others may cause hyperglycemia. May need lower dose of concomitant sulfonylurea or insulin to reduce risk of hypoglycemia. β-blockers may mask hypoglycemia. Pharmacological Class: Dipeptidyl peptidase-4 (DPP-4) inhibitor + biguanide. Adverse Reactions: Diarrhea, URTI, headache, nasopharyngitis, hypoglycemia; pancreatitis, hypersensitivity reactions, severe and disabling arthralgia; rare: lactic acidosis (may be fatal). Metabolism: Sitagliptin: hepatic (CYP3A4, 2C8) Elimination: Renal (major), fecal. Generic Availability: NO How Supplied: XR tabs 50mg/500mg, 50mg/1000mg—60, 180, 1000; 100mg/1000mg—30, 90, 1000 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=64beb3d2-3aeb-4cd5-ba11-dacf6c9a5b50 -------------------------------------------------------------- 注：以下产品不同规格和不同价格，采购以咨询为准！ --------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (100/1000)mg/tab 30tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (100/1000)毫克/片 30片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck --------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (100/1000)mg/tab 90tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (100/1000)毫克/片 90片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck --------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (100/1000)mg/tab 1000tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (100/1000)毫克/片 1000片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck --------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (50/1000)mg/tab 60tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (50/1000)毫克/片 60片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck --------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (50/1000)mg/tab 180tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (50/1000)毫克/片 180片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck --------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (50/1000)mg/tab 1000tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (50/1000)毫克/片 1000片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck ---------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (50/500)mg/tab 60tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (50/500)毫克/片 60片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck ---------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (50/500)mg/tab 180tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (50/500)毫克/片 180片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck ---------------------------------------------------------------- 产地国家: 美国 原产地英文商品名: JANUMET XR 24HR TAB (50/500)mg/tab 1000tabs/btl 原产地英文药品名: SITAGLIPTIN PHOSPHATE/METFORMIN HCL 中文参考商品译名: JANUMET24小时缓释片 (50/500)毫克/片 1000片/瓶 中文参考药品译名: 磷酸西他列汀/盐酸二甲双胍 生产厂家中文参考译名: 默克 生产厂家英文名: Merck