Zukanorm M 500 Tablet is a combination oral antihyperglycemic agent containing Metformin 500 mg and Vildagliptin 50 mg, indicated for the management of type 2 diabetes mellitus. Metformin, a biguanide, primarily acts by decreasing hepatic glucose production, improving insulin sensitivity, and enhancing peripheral glucose uptake and utilization. Vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, increases the levels of incretin hormones, thereby stimulating insulin release and suppressing glucagon secretion in a glucose-dependent manner. The synergistic action of these two agents helps achieve better glycemic control by addressing multiple pathophysiological defects associated with type 2 diabetes. Zukanorm M 500 is typically prescribed when diet, exercise, and monotherapy with either agent alone have not provided adequate glycemic control. It is important to monitor renal function before and during treatment, as Metformin is contraindicated in patients with significant renal impairment. Common side effects may include gastrointestinal disturbances such as nausea, vomiting, and diarrhea, while Vildagliptin is generally well tolerated but may rarely cause hypersensitivity reactions. This combination should be used under medical supervision with regular monitoring of blood glucose levels to optimize therapeutic outcomes and minimize adverse effects.