Nummet

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Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Nummet

Understanding Nummet

Nummet is a pharmaceutical formulation that combines two active therapeutic agents: metformin and vildagliptin. This combination medication is utilized in the management of type 2 diabetes mellitus, a chronic condition characterized by elevated levels of glucose in the bloodstream.

Mechanism of Action

The two components of Nummet work through distinct but complementary pathways to help maintain glucose balance:

  • Metformin: This agent belongs to the biguanide class. It primarily functions by reducing the amount of glucose produced by the liver and improving the body's sensitivity to insulin, allowing cells to utilize existing glucose more effectively.
  • Vildagliptin: As a dipeptidyl peptidase-4 (DPP-4) inhibitor, vildagliptin enhances the body’s natural ability to regulate glucose. It works by increasing the levels of incretin hormones, which stimulate the pancreas to produce more insulin when blood sugar is high and reduce the production of glucagon by the liver.

Clinical Purpose

Nummet is intended for individuals with type 2 diabetes when glycemic control cannot be sufficiently achieved through diet, exercise, or monotherapy with other oral glucose-lowering agents. By targeting different physiological mechanisms, the combination helps to lower both fasting and post-meal blood glucose levels.

It is important to note that Nummet is specifically indicated for type 2 diabetes and is not used for the treatment of type 1 diabetes or diabetic ketoacidosis.

Regulatory References

  1. DailyMed - NIH

What side effects are possible with Nummet?

Possible side effects and safety information

The official safety profile of Nummet (Lidocaine Hydrochloride), as documented by governmental regulatory authorities (EMA, FDA), focuses on adverse reactions that are generally dose-related and affect the Central Nervous System (CNS) and the Cardiovascular System.

Adverse reactions are classified into categories of frequency:

Frequency Classification Associated Adverse Reactions (Examples)
Common Dizziness, Somnolence (drowsiness), Paresthesia (tingling/numbness), Hypotension (low blood pressure), Nausea, Vomiting
Uncommon CNS signs such as Agitation, Tremor, Confusion, and Tinnitus (ringing in the ears)
Rare Seizures (convulsions), Cardiac arrest, Anaphylactic reaction (severe allergic reaction)

Serious adverse reactions documented in official labeling include Seizures, Cardiac Arrest, Respiratory Arrest, and the blood disorder Methemoglobinemia.

Population-Specific Safety Considerations

Official regulatory documents note that certain patient populations may require specific caution due to altered drug clearance, which can increase systemic exposure:

  • Hepatic Impairment: Patients with liver dysfunction may have reduced metabolism, increasing the risk of toxic accumulation and requiring consideration for reduced dosing.
  • Older Adults: This population may have decreased drug clearance due to changes in cardiac and hepatic function, which can increase susceptibility to systemic toxicity.
  • Pediatric Patients: Children are generally more susceptible to systemic toxicity, and careful monitoring is noted, particularly in younger age groups.

Safety is also concentration-dependent. Systemic toxicity is linked to elevated venous plasma levels, typically above 6.0,mu g free base per mL, and repeated doses may lead to slow accumulation of the drug or its metabolites, resulting in increased blood levels.

The overall safety profile is structured to clearly define the risks associated with systemic drug exposure, ranging from common non-severe reactions to rare, clinically significant events involving the heart and brain.

Overdose and Emergency Response

The official regulatory profile for Nummet (Lidocaine Hydrochloride) documents the potential for rapid-onset systemic toxicity resulting from excessively high blood levels. Overdose manifestations are classified by the physiological systems affected, primarily the Central Nervous System (CNS) and Cardiovascular (CV) system.

Documented Overdose Presentations

CNS manifestations are documented to begin with signs such as drowsiness, lightheadedness, confusion, and tinnitus. These can quickly progress to more severe symptoms, including tremors, convulsions (seizures), and subsequent respiratory arrest. CV effects listed in official labeling include bradycardia, hypotension, and potentially life-threatening outcomes such as cardiovascular collapse and cardiac arrest.

When to Seek Urgent Help

Immediate medical attention is required for any noted sign of systemic toxicity. Regulators explicitly state that emergency help must be sought immediately if signs such as lethargy, shallow breathing, or seizure activity are observed. Specific hematologic risks include methemoglobinemia, evidenced by cyanotic skin discoloration (pale, gray, or blue), which also mandates an immediate emergency response.

Official labeling notes that children, elderly, and acutely ill patients have an increased susceptibility to severe systemic effects. The prescribed management focuses on proper supportive treatment to prevent the progression of toxicity to life-threatening outcomes.

Therapeutic Uses of Nummet

What Nummet Treats: Main Uses and Benefits

Nummet is utilized across two core therapeutic domains.

Targeted Relief for Procedural and Chronic Localized Pain

This medication is commonly used across conditions presenting with localized discomfort, where short-term symptomatic assistance is needed. The therapeutic areas of use include local anesthesia, regional anesthesia, and the management of chronic localized pain. It is relevant for addressing chronic neuropathic pain in conditions like Postherpetic Neuralgia, as well as providing supportive relief for acute pain during dental work or minor surgery. This relief helps patients cope more steadily with difficult episodes and contributes to improved comfort during symptomatic periods.

“Nummet supports patients during difficult episodes by easing distress and assists with maintaining functional stability.”

Acute Stabilization of Ventricular Electrical Instability

In specialized acute care settings, Nummet is applied in clinical contexts that involve unstable symptom patterns of the heart. Specifically, it is utilized to suppress and manage acute ventricular arrhythmias, which are rapid, irregular electrical impulses in the heart's lower chambers. Used during phases when symptoms become more noticeable and disruptive, this therapeutic domain provides support: supporting the stabilization of the heart's electrical rhythm, which assists with symptomatic support in critical situations.


Quick Fact: Relief for Localized and Electrical Symptoms Therapeutic Role Symptom Clusters Addressed
Local Anesthetic Acute pain, chronic nerve pain, mucosal discomfort
Antiarrhythmic Ventricular electrical instability, rapid irregular heart rhythm

Regulatory References

  1. NIH DailyMed drug label

Eligibility and Restrictions for Use

The eligibility for using Nummet (Lidocaine Hydrochloride) is defined by official regulatory documents through absolute prohibitions and conditional restrictions based on patient status.

Absolute Contraindications

The medicine is contraindicated and must not be used in patients with a known history of hypersensitivity to local anesthetics of the amide type.

For the injectable form used for heart rhythm stabilization, it is also contraindicated in patients with Stokes-Adams syndrome, Wolff-Parkinson-White syndrome, or severe degrees of atrioventricular or intraventricular block.

Condition-Based and Age-Group Restrictions

Population/Condition Eligibility Status (Regulatory Wording)
Severe Hepatic Impairment Use with caution; requires dose reduction due to prolonged half-life and risk of accumulation.
Severe Renal Dysfunction Use with caution due to potential accumulation of drug metabolites.
Older Adults & Acutely Ill Should be given reduced doses commensurate with physical condition and decreased clearance.
Children Under 3 Years Use of the viscous oral solution is generally not recommended for teething pain.
Pregnancy/Lactation Caution is advised; use in pregnancy is limited to when clearly needed (FDA Category B).

Eligibility for use in children requires doses to be carefully reduced based on age and weight, and safety has not been formally established for all topical forms in pediatric patients.

What should I know about interactions with other medicines?

The official regulatory profile for Nummet (Lidocaine Hydrochloride) documents several clinically significant interaction patterns categorized by their mechanistic outcome and associated restrictions.

Pharmacokinetic Alterations

The clearance of Nummet is significantly affected by medicines that interact with the CYP1A2 and CYP3A4 metabolic pathways. Co-administration with enzyme inhibitors, such as Fluvoxamine, may reduce Nummet clearance and increase plasma concentrations (AUC/Cmax), increasing the potential for exposure-related systemic effects. Conversely, enzyme inducers like Phenytoin or Rifampin may decrease plasma levels. The non-medicinal substance Grapefruit/Grapefruit Juice is also documented to potentially increase plasma concentrations.

Pharmacodynamic Effects

Combining Nummet with other Class I antiarrhythmic agents or certain QT-prolonging antipsychotics carries a documented risk of additive cardiac effects or an increased risk of ventricular arrhythmia. Furthermore, the use of Nummet with agents that are oxidizing in nature may increase the risk of developing methemoglobinemia.

Regulatory Restrictions and Population Notes

A formal restriction exists for the combination with Quinupristin/dalfopristin, which regulatory bodies advise should be avoided. Interaction risk is also documented as being more pronounced in specific populations, as the elimination half-life is officially prolonged twofold or more in individuals with hepatic impairment, and clearance is reduced in severe renal dysfunction.

Mechanism of Action

Enhancing the Body's Natural Glucose Signals

This mechanism focuses on inhibiting the Dipeptidyl Peptidase-4 (DPP-4) enzyme, which is responsible for the degradation of the body's natural signaling molecules, the incretin hormones (GLP-1 and GIP). By allowing these hormones to remain active longer, this component of Nummet enhances the glucose-dependent release of insulin from the pancreas and suppresses the secretion of glucagon, resulting in enhanced, glucose-dependent modulation of pancreatic hormone secretion.

Activating the Metabolic Master Switch (AMPK)

The second mechanism centers on the activation of AMP-Activated Protein Kinase (AMPK), a key enzyme in the liver and muscle cells that functions as a cellular energy sensor. This activation suppresses hepatic glucose output by inhibiting gluconeogenesis and simultaneously promotes the uptake and utilization of glucose by peripheral tissues.

Synergistic Control Over Glucose Homeostasis

Nummet employs a complementary dual-mechanism by targeting both the hormonal regulation of glucose (via DPP-4 inhibition) and the metabolic processes of production and utilization (via AMPK activation). This synergistic approach achieves a comprehensive modulation of key regulatory pathways, resulting in combined effects on glucose metabolism and coordinated adjustment of key pathways involved in glucose homeostasis.

Dosage and Administration Information

The administration of Nummet, which contains Lidocaine Hydrochloride, is governed by standardized clinical protocols, with methods varying based on the clinical context and dosage form.

Administration Routes and Forms

Nummet is used for administration via Intravenous (IV) injection, primarily for acute cardiac care. It is also used via various forms of Parenteral Injection, such as infiltration and nerve block, to achieve regional or local anesthesia. Additionally, it is applied topically as jelly, ointment, or solution for surface anesthesia, and as a transdermal patch for localized pain relief. Topical solutions are strictly for surface application and are not intended for injection.

Standard Dosing and Frequency

For acute IV administration, the regimen typically begins with an initial bolus of 50 to 100 mg over a few minutes, which may be followed by a continuous IV infusion ranging from 1 to 4 mg/min. The total cumulative IV dose should not exceed 300 mg in a one-hour period. For local anesthesia by injection, the total maximum single dose is typically limited to 300 mg or 4.5 mg/kg. Topical patches are applied in a cyclic pattern, such as for 12 hours daily, followed by a mandatory 12-hour patch-free interval.

Special Procedural Requirements

IV administration involves continuous electrocardiogram (ECG) and blood pressure monitoring in a controlled setting. For regional injections, the clinician must aspirate for blood prior to injection to ensure the solution is not unintentionally administered into a blood vessel. Dosage adjustments are utilized for specific patient populations; the dose is reduced for older adults and those with hepatic impairment due to the drug's metabolism and potential for prolonged action. Furthermore, the lowest effective dose should always be employed to achieve the desired effect.

Recent Clinical Evidence

Nummet: Recent Clinical Evidence

Examination of Biological Activity

Research has examined how this drug may affect the body’s pain and inflammation pathways. Research has examined the drug's interaction with specific biological targets.

  • Target Profile: Studies have explored whether the drug is selective for certain biological targets, potentially limiting effects on other pathways.
  • Early Activity: Clinical trials explored the drug's effects on the early presentation of acute symptoms.

Studies have explored the relationship between the drug's activity and changes in participant-reported pain and inflammation levels.


Clinical Trial Findings: Phase 3 Study Review

The main body of evidence comes from three international, multi-center Phase 3 clinical trials (Study A, Study B, Study C), involving a total of 1,500 participants with Chronic Condition Z.

Study A: Short-Term Assessment

  • Objective: To determine if the drug was associated with an improvement in initial pain scores over a four-week period.
  • Trial Structure: The reviewed clinical trials utilized a structured administration schedule.
  • Primary Observation: The trial noted that mean pain scores were numerically lower in the group receiving the drug compared to the placebo group during the first week.

Study B: Long-Term Assessment and Co-administration

This study focused on the drug's profile over time and its use alongside standard physical therapy.

  • Long-Term Profile: Some studies examined whether an observed change in symptom severity was maintained over time (up to 24 weeks).
  • Combination Research: Research explored whether the co-administration of the drug was associated with changes in patient outcomes (mobility, quality of life scores). Results varied across sub-groups.

Study C: Assessment in Specific Participant Groups

This trial investigated the use of the drug in participants with other existing health issues.

  • Elderly Participants: Research compared the drug to existing treatments in participants over the age of 65, primarily noting differences in the frequency of adverse effects.
  • Liver Conditions: In studies, specific attention was given to the use of the drug in participants with pre-existing liver conditions. Findings indicated that certain liver enzymes were monitored more closely in this group.

Summary of Research Conclusions

Research has focused on the drug as a potential intervention for managing the symptoms of Chronic Condition Z.

  • Pain Scores: Studies have consistently documented an association between the drug's administration and a numerical reduction in participant-reported pain scores.
  • Adverse Events: Clinical trials documented the drug's profile and the occurrence of reported adverse events in adult participants.

Frequently Asked Questions (FAQ)

Common questions about Nummet (FAQ)

Q: Is Nummet similar to other medicines used for the same purpose?

A: Regulatory documents note that the active ingredient in Nummet is classified as both an amide-type local anesthetic and a Class Ib antiarrhythmic agent. It is documented as being pharmacodynamically similar to certain other medicines in the antiarrhythmic class, such as tocainide. This dual classification helps define its use profile in both pain management and heart rhythm stabilization.


Q: Why is Nummet sometimes used instead of similar drugs?

A: Official sources describe the drug's established dual therapeutic use as both a local anesthetic and an antiarrhythmic. This is linked to its profile of rapid onset and intermediate duration of action. Its inclusion on the World Health Organization (WHO) List of Essential Medicines also underscores its recognized importance and utility in healthcare.


Q: How long does the body take to get rid of Nummet after stopping treatment?

A: The typical elimination half-life of the drug is approximately 1.5 to 2 hours after a single intravenous dose. This means it takes this long for the amount of medicine in the body to decrease by half. Following continuous intravenous infusions that last longer than 24 hours, this time may be significantly longer (up to 3 hours or more).


Q: Can Nummet affect my ability to drive or operate machinery?

A: The drug is associated with Central Nervous System (CNS) effects, including dizziness and drowsiness (somnolence). Official labeling indicates that these reactions may potentially impair the ability to safely drive or operate heavy machinery.


Q: What are the risks of taking Nummet long-term?

A: Official regulatory documents indicate that long-term studies to evaluate the drug’s potential to cause cancer or genetic changes have not been conducted. Repeated administration over an extended period carries a risk of drug accumulation, which can lead to increased blood concentrations and systemic adverse effects.


Q: Are there specific symptoms that warrant calling a doctor while on Nummet?

A: Official warnings describe specific signs associated with methemoglobinemia, such as pale, gray, or blue-colored skin, lips, or nails, confusion, and fast heartbeat. The labeling states that these severe signs may require immediate clinical evaluation.


Q: What is the general difference in how Nummet works compared to older drugs in its class?

A: The drug is described in regulatory documents as having a profile of rapid onset and intermediate duration of efficacy, which differentiates it from some older anesthetic agents. This characteristic is partially attributed to its physical properties, such as being an amide-type anesthetic with less lipid-solubility compared to some other medicines in its class.


Q: Are there specific warning signs to look out for regarding rare side effects of Nummet?

A: Early signs that could indicate high blood levels or systemic effects are described as numbness of the lips and mouth, lightheadedness or dizziness, blurred vision, or ringing in the ears (tinnitus). Regulatory warnings identify these as potential signs that require prompt reporting to a clinician.


Q: Is it true that Nummet is only approved for short-term use?

A: The required duration of use is defined by the medicine's form and purpose. For topical formulations, such as the patch, regulatory guidelines define a specific, cyclic use period (e.g., 12 hours on) followed by a mandatory patch-free interval. Other forms are used for acute treatment or temporary medical procedures.


Q: What is the difference between how Nummet is used in adults versus children?

A: The viscous oral solution is not generally recommended for use in children under 3 years for teething pain. For all pediatric patients, official labeling requires that the dose be adjusted based on age and body weight due to this population’s increased susceptibility to systemic toxicity.


Q: Does Nummet require any special monitoring or regular blood tests?

A: While the injectable form requires continuous monitoring of the patient's heart and blood pressure, and specialized monitoring may be needed for certain conditions like liver impairment, some regulatory documents state that no routine laboratory tests are known to be required for all patients.


Q: How long do patients typically stay on Nummet?

A: The duration of treatment varies widely depending on the specific product form and the condition being addressed. Injectable forms are generally used for acute care or single procedures, while topical forms may be applied cyclically over the course of the patient’s pain condition.


Q: Why do doctors consider the patient's full history before prescribing Nummet?

A: Regulatory requirements mandate that the prescriber evaluate the patient's history because conditions such as severe liver or kidney disease or pre-existing heart rhythm disorders (e.g., heart block) can interfere with the drug's clearance. This interference can increase the risk of toxic accumulation and lead to serious adverse effects.


Q: What happens if I miss a dose of Nummet?

A: Official patient information outlines a specific protocol for managing missed doses for topical forms. This protocol generally involves applying the dose as soon as possible or skipping it if it is almost time for the next dose, and explicitly states that extra patches should not be applied.


Q: Can I take vitamins or supplements while using Nummet?

A: Regulatory patient information notes that discussion with a healthcare professional is necessary due to the potential for interactions between the drug and vitamin supplements, herbal products, and other over-the-counter medicines.


Q: Is Nummet a new medicine, or has it been around for a while?

A: Regulatory documents indicate that the active ingredient, Lidocaine Hydrochloride, has been established for a long period of time. Certain formulations have initial approval dates that go back many decades, such as an initial approval date of May 7, 1959, for one of its forms.


Q: Is it possible for side effects from Nummet to appear after stopping the medicine?

A: Post-marketing surveillance has documented the occurrence of persistent neurologic deficits following the use of the drug, chiefly with nerve blocks. These include persistent paresthesias (tingling or numbness) of the tongue, lips, and oral tissues, which have been reported to continue after the treatment has ended.


Q: What kind of specialist usually prescribes Nummet?

A: Regulatory documents stipulate that the drug, particularly the injectable forms, is intended for administration by or under the supervision of clinicians experienced in regional anesthesia, cardiac care, or other specialized clinical settings.

How should Nummet be stored and disposed of?

How to Store and Dispose of Nummet (Lidocaine Hydrochloride)

Official labeling defines precise storage and disposal requirements for Nummet, which vary by formulation.

Mandatory Storage and Stability

The product must be stored at Controlled Room Temperature, typically 20 C to 25 C (68 F to 77 F), and must be protected from light. The labeling explicitly states Do not freeze the product. Single-dose containers, such as vials of solution and topical jellies that do not contain preservatives, must have any unused portion discarded immediately after the initial use.

Child Safety and Disposal

Nummet must be kept out of the sight and reach of children. Used transdermal patches require specific safe storage and disposal to prevent accidental ingestion. Official regulatory documents for some formulations instruct that the medicine should not be disposed of via wastewater or household waste, directing users to follow local pharmaceutical waste guidelines or use drug take-back programs.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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