Dapagliflozin Saxagliptin Metformin Brand Name– QTERNMET
What is Dapagliflozin Saxagliptin Metformin
Dapagliflozin saxagliptin metformin is a combination product containing a sodium-glucose cotransporter 2 (SGLT2) inhibitor, a dipeptidyl peptidase-4 (DPP-4) inhibitor and a biguanide antidiabetic agent.
The combination product is indicated in the treatment of adults with type 2 diabetes mellitus.
When dapagliflozin and saxagliptin are added to a metformin regimen, the combination results in a further mean hemoglobin A1C reductions which may help patients achieve target A1C goals.
Dapagliflozin has also been shown to reduce the risk of hospitalization for heart failure (HF) compared with placebo.
As with other SGLT2 inhibitor/metformin combinations, dapagliflozin; saxagliptin; metformin should not be used in patients with severe renal impairment as dapagliflozin efficacy is reduced and the risk of metformin-related lactic acidosis is increased.
Metformin is first-line in the treatment of type 2 DM. Additional therapy with an SGLT2 inhibitor with evidence of reducing HF and/or chronic kidney disease (CKD) progression should be considered in patients with indicators of high-risk or established CKD or HF, independent of baseline A1C or individualized A1C target. SGLT2 inhibitors with proven CV-risk reduction, like dapagliflozin, are also an alternative treatment option in DM patients with indicators of high-risk or established CV disease who cannot tolerate a glucagon-like peptide-1 receptor agonist (GLP-1 RA).
DPP-4 inhibitors, like saxagliptin, are therapeutic options that are generally well tolerated, have a neutral effect on weight and minimal risk of hypoglycemia
Indications
- type 2 diabetes mellitus
For the treatment of type 2 diabetes mellitus in combination with diet and exercise
Side Effects
- abdominal pain
- anaphylactoid reactions
- angioedema
- arthralgia
- back pain
- balanitis
- bone fractures
- bullous rash
- candidiasis
- cholestasis
- constipation
- cystitis
- dehydration
- diabetic ketoacidosis
- diarrhea
- diuresis
- elevated hepatic enzymes
- exfoliative dermatitis
- folate deficiency
- headache
- heart failure
- hepatitis
- hypercholesterolemia
- hyperlipidemia
- hyperphosphatemia
- hypoglycemia
- hypotension
- hypovolemia
- increased urinary frequency
- infection
- influenza
- lactic acidosis
- lymphopenia
- malaise
- megaloblastic anemia
- metabolic acidosis
- myalgia
- nausea
- necrotizing fasciitis
- new primary malignancy
- orthostatic hypotension
- pancreatitis
- pemphigus
- pharyngitis
- polyuria
- prostatitis
- rash
- renal failure (unspecified)
- rhabdomyolysis
- sinusitis
- thrombocytopenia
- tissue necrosis
- urticaria
- vaginitis
- vitamin B12 deficiency
- vomiting
Monitoring Parameters
- blood glucose
- CBC
- glycosylated hemoglobin A1c (HbA1c)
- LFTs
- serum cholesterol profile
- serum creatinine/BUN
Contraindications
- acidemia
- acute heart failure
- acute myocardial infarction
- adrenal insufficiency
- alcoholism
- arthralgia
- balanitis
- bladder cancer
- breast-feeding
- burns
- cardiac disease
- cardiogenic shock
- children
- dehydration
- diabetic ketoacidosis
- dialysis
- diarrhea
- ethanol ingestion
- ethanol intoxication
- exfoliative dermatitis
- fever
- gastroparesis
- geriatric
- GI obstruction
- heart failure
- hepatic disease
- history of angioedema
- hypercholesterolemia
- hypercortisolism
- hyperglycemia
- hyperthyroidism
- hypoglycemia
- hypotension
- hypothyroidism
- hypovolemia
- hypoxemia
- ileus
- infants
- infection
- laboratory test interference
- lactic acidosis
- malnutrition
- metabolic acidosis
- pancreatitis
- pernicious anemia
- pituitary insufficiency
- polycystic ovary syndrome
- pregnancy
- pyelonephritis
- radiographic contrast administration
- renal disease
- renal failure
- renal impairment
- sepsis
- serious rash
- surgery
- tissue necrosis
- trauma
- type 1 diabetes mellitus
- urinary tract infection (UTI)
- vaginitis
- vomiting
Interactions
No information is available regarding drug interactions associated with Dapagliflozin Saxagliptin Metformin
