Drug Class: SGLT-2 Inhibitor + Biguanide Combination (Extended-Release) | Form: Oral Extended-Release Tablet | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Diajard Mxr 5/1000mg Tablet?
Diajard Mxr 5/1000mg is a fixed-dose dual combination extended-release tablet containing Empagliflozin 5mg and Metformin Hydrochloride 1000mg — two well-established diabetes medicines working through completely different and complementary mechanisms. Empagliflozin removes excess sugar directly through the urine by blocking its reabsorption in the kidneys, while Metformin Extended-Release reduces the amount of glucose the liver produces and releases into the bloodstream. Together they deliver more complete 24-hour blood sugar control than either medicine alone — and the extended-release formulation of Metformin provides a smoother, more gradual release that significantly reduces the stomach upset commonly associated with standard Metformin tablets. Diajard Mxr is used alongside diet and exercise for the management of Type 2 Diabetes (ذیابیطس ٹائپ 2) and may also assist with modest weight loss and blood pressure reduction.
What is Diajard Mxr 5/1000mg Used For?
- Type 2 Diabetes Mellitus — improving blood sugar control in adults when diet, exercise, and single-agent therapy are not sufficient (ذیابیطس ٹائپ 2 میں شوگر کا کنٹرول)
- Dual oral therapy — as a convenient single extended-release tablet replacing separately taken Empagliflozin and Metformin
- Cardiovascular risk reduction — Empagliflozin has demonstrated reduction in cardiovascular death and hospitalisation for heart failure in Type 2 Diabetes patients with established cardiovascular disease
- Weight management support — Empagliflozin promotes modest but meaningful weight loss as excess calories are lost through urine as glucose
- It is not used for Type 1 Diabetes or diabetic ketoacidosis
How Does Diajard Mxr 5/1000mg Work?
Empagliflozin 5mg — SGLT-2 Inhibitor: The kidneys normally filter glucose from the blood and then reabsorb almost all of it back into the body through a protein called SGLT-2 (sodium-glucose co-transporter 2). Empagliflozin blocks this SGLT-2 protein — preventing glucose reabsorption and causing excess sugar to be eliminated directly through urine. This insulin-independent mechanism lowers blood sugar without relying on the pancreas — making dangerous hypoglycaemia much less likely. Additionally, the loss of glucose through urine results in mild calorie loss, contributing to modest weight reduction, and the associated sodium loss produces a mild blood pressure lowering effect.
Metformin HCl Extended-Release 1000mg — Biguanide: Metformin works primarily in the liver — reducing the amount of glucose the liver produces and releases into the bloodstream (hepatic gluconeogenesis). It also improves the sensitivity of muscle cells to insulin, helping the body use its own insulin more effectively. The extended-release formulation releases Metformin gradually over the course of the day — maintaining more stable blood levels, reducing peak concentrations, and significantly lowering the nausea, diarrhoea, and stomach discomfort that frequently occur with standard immediate-release Metformin tablets.
Combined Dual Effect: Empagliflozin removes excess glucose already in the blood through the kidneys while Metformin reduces the liver's contribution of new glucose — targeting two separate sources of high blood sugar simultaneously for more complete glycaemic control throughout the day and night.
Dosage and Administration
⚠️ Always take exactly as prescribed by your doctor. Never adjust the dose without medical advice. Always take with food. Never crush or chew this tablet — it is extended-release.
| Indication | Usual Adult Dose | Frequency | Maximum Daily Dose |
|---|---|---|---|
| Type 2 Diabetes | 1 tablet (5/1000mg) | Once or twice daily | As prescribed |
Critical Dosing Rules:
- Kidney function (eGFR) must be checked before starting Diajard Mxr and monitored regularly — Empagliflozin requires adequate kidney function to work and Metformin is unsafe in significant kidney impairment
- Empagliflozin should be temporarily stopped before any major surgery, serious illness, or prolonged fasting — risk of diabetic ketoacidosis
- Metformin must be stopped before iodinated contrast dye procedures (CT scans with dye) and restarted only after kidney function is confirmed normal — at least 48 hours later
- Do not use if eGFR is below 45 mL/min — both components have kidney-related restrictions
- If combined with insulin or a sulphonylurea, the dose of those medicines may need reduction to avoid hypoglycaemia
How to Take:
- Swallow the tablet whole with a full glass of water — never crush, split, or chew
- Always take with food or immediately after a meal — reduces stomach discomfort from Metformin
- Take at the same time each day for consistent blood sugar control
- Ensure good daily fluid intake — Empagliflozin increases urination and dehydration risk
- If a dose is missed, take it as soon as remembered the same day — skip if it is the next day; never double the dose
Active Ingredients
| Ingredient | Strength per Tablet |
|---|---|
| Empagliflozin | 5mg |
| Metformin Hydrochloride (Extended-Release) | 1000mg |
Who Should NOT Take Diajard Mxr 5/1000mg?
Do not take if you:
- Are allergic to Empagliflozin, Metformin, or any ingredient in the tablet
- Have Type 1 Diabetes or diabetic ketoacidosis
- Have moderate to severe kidney disease (eGFR below 45 mL/min)
- Have severe liver disease
- Are severely dehydrated or have very low blood volume
- Drink excessive alcohol regularly
- Are having surgery requiring general anaesthesia — temporarily stop beforehand
- Are under 18 years of age
- Are pregnant or breastfeeding
Always consult your doctor before taking Diajard Mxr if you have:
- Mild kidney impairment — dose adjustment and close monitoring required
- Recurrent urinary tract infections (پیشاب کی نالی کا بار بار انفیکشن) — Empagliflozin increases glucose in urine, raising infection risk
- History of genital fungal infections — Empagliflozin increases risk in both men and women
- Heart failure or established cardiovascular disease (دل کی بیماری)
- History of pancreatitis (لبلبے کی سوزش)
- Low blood pressure or are on diuretics — dehydration risk with Empagliflozin
- Are taking insulin or sulphonylureas — hypoglycaemia risk increases
- Are planning a low-carbohydrate diet or prolonged fasting — ketoacidosis risk with Empagliflozin
Side Effects
Common Side Effects:
- Urinary tract infections — burning or pain during urination, frequent urination (پیشاب کی نالی کا انفیکشن) — Empagliflozin related
- Genital fungal infections — itching or discharge in genital area — more common in women; Empagliflozin related
- Increased urination — expected effect of Empagliflozin
- Nausea or mild stomach discomfort — significantly reduced with extended-release Metformin compared to standard tablets
- Mild dizziness — particularly on standing, from mild blood pressure lowering
- Metallic taste — Metformin related; usually temporary
Serious Side Effects — Stop Taking and Seek Medical Help Immediately:
- Diabetic ketoacidosis (DKA) — nausea, vomiting, stomach pain, extreme tiredness, difficulty breathing, fruity breath — can occur even with near-normal blood sugar with SGLT-2 inhibitors; this is a life-threatening emergency (طبی ہنگامی صورتحال)
- Lactic acidosis — rare but life-threatening Metformin complication; severe muscle pain, difficulty breathing, stomach pain, feeling very cold or dizzy — seek emergency care immediately
- Fournier's gangrene — rare but serious bacterial infection of genital and surrounding area — severe pain, swelling, redness, or fever in genital region; seek emergency care without delay
- Severe urinary tract infection — high fever, back or side pain, shaking — may indicate kidney infection (pyelonephritis)
- Severe hypotension — extreme dizziness or fainting — particularly in elderly or dehydrated patients
- Severe allergic reaction — swelling of face, lips, tongue or throat, difficulty breathing, widespread rash (یہ طبی ہنگامی صورتحال ہے)
- Acute kidney injury — significantly reduced urination, extreme fatigue, ankle swelling — stop immediately and seek medical care
Drug Interactions
| Medicine / Substance | Possible Interaction |
|---|---|
| Insulin or Sulphonylureas (e.g., Glimepiride, Glibenclamide) | Increased hypoglycaemia risk — dose reduction of insulin or sulphonylurea usually required when adding Empagliflozin |
| Diuretics (e.g., Furosemide, Hydrochlorothiazide) | Additive fluid loss with Empagliflozin — increased dehydration, low blood pressure, and kidney impairment risk; monitor closely |
| Iodinated contrast dye (CT/X-ray imaging) | Metformin must be stopped before and 48 hours after contrast procedure — acute kidney injury and lactic acidosis risk |
| ACE Inhibitors / ARBs (e.g., Enalapril, Losartan) | Combined fluid loss effect with Empagliflozin — increased low blood pressure and kidney stress risk; monitor kidney function |
| NSAIDs (e.g., Ibuprofen, Diclofenac) | Reduce kidney blood flow — increase Metformin accumulation and kidney impairment risk |
| Corticosteroids (e.g., Prednisolone) | Raise blood sugar and counteract diabetes control — monitor glucose closely |
| Alcohol (شراب) | Increases lactic acidosis risk with Metformin and raises ketoacidosis risk with Empagliflozin — avoid completely |
| Cimetidine | Reduces Metformin clearance — increases Metformin blood levels; monitor for side effects |
| Rifampicin | Reduces Empagliflozin blood levels — may reduce its effectiveness; inform your doctor |
Storage Instructions
- Store below 25°C in a cool, dry place
- Protect from moisture and direct sunlight
- Keep in original packaging until use
- Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں)
- Do not use after the expiry date printed on the pack
Frequently Asked Questions (FAQs)
Q: Why must I never crush or chew Diajard Mxr tablets? Diajard Mxr contains extended-release Metformin — crushing or chewing destroys the controlled-release mechanism, releasing the full dose at once and significantly increasing nausea and side effects.
Q: Can Diajard Mxr 5/1000mg cause low blood sugar on its own? Neither Empagliflozin nor Metformin alone typically causes hypoglycaemia — however the risk increases significantly when combined with insulin or sulphonylurea medicines.
Q: Why does Diajard Mxr need to be stopped before a CT scan with dye? The iodinated contrast dye used in CT scans can temporarily reduce kidney function — if Metformin accumulates due to reduced kidney clearance, it can cause a dangerous condition called lactic acidosis.
Q: Can Diajard Mxr help with weight loss? Empagliflozin causes modest but meaningful weight loss by removing excess glucose — and calories — through urine; however it should be used as part of a healthy diet and exercise plan, not as a standalone weight loss medicine.
Medical Disclaimer: This information is for general awareness only and does not replace advice from your doctor or pharmacist. Type 2 Diabetes requires ongoing medical supervision — never adjust or stop your diabetes medication without consulting your healthcare provider.