Introduction: 
Dapajivan SM 10/100/500 is a combination medication containing Dapagliflozin (10 mg), Sitagliptin (100 mg), and Metformin (500 mg). It is used to manage Type 2 Diabetes Mellitus by helping to control blood sugar levels. This combination works in multiple ways: Dapagliflozin increases glucose excretion in the urine, Sitagliptin enhances insulin secretion, and Metformin improves insulin sensitivity and reduces glucose production in the liver.

Uses: 
Type 2 Diabetes Mellitus: Helps in controlling high blood sugar levels when diet, exercise, and monotherapy are insufficient.
Prevention of complications: Reduces the risk of heart disease, kidney damage, and nerve problems associated with uncontrolled blood sugar.

Side Effects: 
Common side effects:
Gastrointestinal issues: Nausea, vomiting, diarrhea, and abdominal discomfort.
Headache
Flatulence (gas)
Upper respiratory tract infections: Symptoms like sore throat, cough, or nasal congestion.

Serious side effects:
Lactic acidosis: Symptoms include deep or rapid breathing, nausea, and stomach pain.
Pancreatitis: Severe abdominal pain, nausea, and vomiting.
Kidney problems: Reduced urine output, swelling in the legs, or sudden weight gain

How to Use: 
Dosage: Take one tablet of Dapajivan SM 10/100/500 once daily, with or without food.
Administration: Swallow the tablet whole with water; do not crush or chew.
Missed Dose: If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Do not double the dose.

How Drug Works: 
Dapagliflozin (10 mg): Increases the excretion of glucose through urine by inhibiting the SGLT2 protein in the kidneys.
Sitagliptin (100 mg): Increases insulin secretion and decreases glucagon levels after meals by inhibiting the DPP-4 enzyme.
Metformin (500 mg): Reduces glucose production in the liver and improves insulin sensitivity in muscle cells.

Storage Instructions: 
Store at room temperature (below 30°C), away from moisture and direct sunlight.
Keep out of reach of children.

Safety Advice: 
Pregnancy: Not recommended during pregnancy; consult your doctor if you are pregnant or planning to conceive.
Breastfeeding: Avoid during breastfeeding unless specifically prescribed by a healthcare provider.
Kidney/Liver Disease: Use with caution in patients with kidney or liver issues; dosage adjustments may be necessary.
Pancreatitis: Inform your doctor if you have a history of pancreatitis.
Alcohol: Avoid excessive alcohol intake as it can increase the risk of lactic acidosis and hypoglycemia.

Lifestyle Advice
Maintain a balanced diet and engage in regular physical activity to optimize blood sugar control.
Regularly monitor your blood glucose levels as advised by your healthcare provider.
Stay well-hydrated to avoid dehydration, especially with Dapagliflozin.