Dapagliflozin Saxagliptin Metformin

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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

  1. abdominal pain
  2. anaphylactoid reactions
  3. angioedema
  4. arthralgia
  5. back pain
  6. balanitis
  7. bone fractures
  8. bullous rash
  9. candidiasis
  10. cholestasis
  11. constipation
  12. cystitis
  13. dehydration
  14. diabetic ketoacidosis
  15. diarrhea
  16. diuresis
  17. elevated hepatic enzymes
  18. exfoliative dermatitis
  19. folate deficiency
  20. headache
  21. heart failure
  22. hepatitis
  23. hypercholesterolemia
  24. hyperlipidemia
  25. hyperphosphatemia
  26. hypoglycemia
  27. hypotension
  28. hypovolemia
  29. increased urinary frequency
  30. infection
  31. influenza
  32. lactic acidosis
  33. lymphopenia
  34. malaise
  35. megaloblastic anemia
  36. metabolic acidosis
  37. myalgia
  38. nausea
  39. necrotizing fasciitis
  40. new primary malignancy
  41. orthostatic hypotension
  42. pancreatitis
  43. pemphigus
  44. pharyngitis
  45. polyuria
  46. prostatitis
  47. rash
  48. renal failure (unspecified)
  49. rhabdomyolysis
  50. sinusitis
  51. thrombocytopenia
  52. tissue necrosis
  53. urticaria
  54. vaginitis
  55. vitamin B12 deficiency
  56. 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

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