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Drug interaction
My mother has prediabetes. Hba1c stays around 6. Has been prescribed Istamet 50/500 (sitagliptin+metformin) 1 tab before breakfast. Another dr has prescribed Veloz IT 20 (rabeprazole+itopride) before breakfast. Can these two be taken together?
Thyronorm 50mcg is prescribed for recently diagnosed TSH of 10. She has bp and liver disease for which she takes carvedilol (betablocker) and rifaximin 550 (antibiotic). She also takes Ecosprin AV 75/20.
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Yes can be taken together
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Hi,
Ideally for someone with prediabetes we don't suggest medicines. Was she already on medicines for diabetes??
She can take all the above mentioned medicines together. That's not an issue
Take care
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First take tab thyroxine after 30 minutes take tab veloz and then istamet just 5 minute before food
Fore more detail consult
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Continue
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Both are different class of drugs .
Istamet is for high glucose
Veloz if for acidity and vomit . ( to cure side effects related to antihyperglycemics )
No interaction .
Shw can take medicine as prescribed .
Health Tips
Check HBA1C every 2-3 months .
Keep check on FBS/PPBS
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Points to be consider:
1. At Hba1c of 6 - there is no indication of giving medicine ( history seems in complete)
2. Indication for Veloz It 20 prescrintion is not clear
3. Yes these two medicine can be taken bogether, but add vitamin b12 supplementation because both medicine cause vit b12 deficincy if used for long time
4. What is the indication for add rifagut ( liver disease - severity should be speciafic)
5. Why thyronorm is prescribed at TSH of 10 in 70 year old elderly patient- Not need at all
Next Steps
Required detail past medical history and disease severity assessment and reconsideration of her drug therapy
Health Tips
Consult on practo for more information
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Your mother has been prescribed Istamet 50/500 (Sitagliptin + Metformin) for prediabetes (HbA1c ~6), which is an appropriate therapy in early glycemic dysregulation, especially if lifestyle measures alone are insufficient.
She has also been advised to take Veloz IT 20 (Rabeprazole + Itopride) before breakfast. This combination is generally used for acid-peptic disorders and delayed gastric emptying. It is safe to be taken along with Istamet, provided she takes them as advised — usually both before breakfast, with a slight gap (e.g., 10–15 minutes apart) to avoid potential minor absorption issues.
Important considerations:
1. Thyronorm 50 mcg for newly diagnosed hypothyroidism (TSH 10):
This should be taken alone on an empty stomach, at least 30–45 minutes before breakfast or any other medication (including Veloz IT or Istamet).
Ideally, she should take Thyronorm early in the morning, then wait 30–45 minutes before taking Veloz IT and Istamet.
2. Carvedilol (beta-blocker):
Safe in liver disease and beneficial in portal hypertension if present. No major interaction with other medications listed.
3. Rifaximin 550 mg:
Often used in liver disease with minimal systemic absorption. Safe with other listed medications.
4. Ecosprin AV 75/20 (Aspirin + Atorvastatin):
Should be taken after dinner, not with the morning medications.
Caution is required in liver disease — monitor liver enzymes periodically.
Summary of Timing Recommendation:
6:30 AM – Thyronorm 50 mcg with plain water, empty stomach.
7:15 AM – Veloz IT 20 + Istamet 50/500 before breakfast.
8:00 AM – Breakfast.
9:00 AM onwards – Carvedilol, Rifaximin, etc., as per doctor's timing.
After Dinner – Ecosprin AV.
Final note: Periodic monitoring of liver function tests, TSH, lipid profile, and HbA1c is recommended. Please consult her primary physician for adjustments based on clinical condition.
Next Steps
mentioned above
Health Tips
mentioned above
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Dr. A Raja Prasanna Kumar
Pulmonologist
46 yrs exp
Hyderabad
Yes you can use. Pl consult.
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Avoid fried food and spicy food
Water intake more
Green leafy vegetables and fruits
Fiber meal
Do connect and consult
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Dr. Ram Brahma Reddy
Diabetologist
6 yrs exp
Hyderabad
Kindly consult
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Dr. Sachin Mane
Diabetologist
12 yrs exp
Beed
History not specify about her liver disease ... HbA1c is good so please consult with fasting n post prandial sugar and details of history
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Dr. Chaithra H
Diabetologist
5 yrs exp
Bangalore
Continue medication as prescribed by doctor.
For prediabetic condition dose is little high.
Watch for symptoms of hypoglycemia.
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