Ertugliflozin Metformin Brand Name– SEGLUROMET
What is Ertugliflozin Metformin
Ertugliflozin metformin is a combination of 2 oral antidiabetic agents.
Ertugliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor. Metformin is a biguanide agent that improves insulin sensitivity.
The product is used to improve glycemic control in adults with type 2 diabetes mellitus (DM). In clinical trials, when ertugliflozin was added to metformin, an additional mean 0.7% to 1% decrease in hemoglobin A1C was attained.
SGLT2 inhibitor therapy has been shown to reduce the incidence of heart failure (HF), and some SGLT2 inhibitors have reduced overall cardiovascular (CV) risk.
This drug product is not recommended for use in the presence of severe renal impairment, as ertugliflozin efficacy is reduced and the risk for 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 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)
Indications
- type 2 diabetes mellitus
For the treatment of type 2 diabetes mellitus in combination with diet and exercise when treatment with both ertugliflozin and metformin is appropriate
Side Effects
- abdominal pain
- anorexia
- asthenia
- back pain
- balanitis
- candidiasis
- cystitis
- dehydration
- diabetic ketoacidosis
- diarrhea
- diuresis
- dysgeusia
- dyspepsia
- dysuria
- flatulence
- folate deficiency
- headache
- hypercholesterolemia
- hyperlipidemia
- hyperphosphatemia
- hypoglycemia
- hypotension
- hypovolemia
- increased urinary frequency
- infection
- lactic acidosis
- lower limb amputation
- megaloblastic anemia
- metallic taste
- nausea
- necrotizing fasciitis
- nocturia
- orthostatic hypotension
- pharyngitis
- phimosis
- polydipsia
- polyuria
- renal failure (unspecified)
- rhabdomyolysis
- syncope
- tissue necrosis
- urinary urgency
- vaginitis
- vitamin B12 deficiency
- vomiting
- weight loss
Monitoring Parameters
- blood glucose
- CBC
- glycosylated hemoglobin A1c (HbA1c)
- serum cholesterol profile
- serum creatinine/BUN
Contraindications
- acidemia
- acute heart failure
- acute myocardial infarction
- adrenal insufficiency
- alcoholism
- balanitis
- breast-feeding
- burns
- cardiac disease
- cardiogenic shock
- children
- dehydration
- diabetic ketoacidosis
- dialysis
- diarrhea
- ethanol ingestion
- ethanol intoxication
- fever
- geriatric
- heart failure
- hepatic disease
- hypercholesterolemia
- hypoglycemia
- hypotension
- hypothyroidism
- hypovolemia
- hypoxemia
- infants
- infection
- lactic acidosis
- lower limb amputation
- malnutrition
- metabolic acidosis
- pernicious anemia
- pituitary insufficiency
- polycystic ovary syndrome
- pregnancy
- pyelonephritis
- radiographic contrast administration
- renal disease
- renal failure
- renal impairment
- sepsis
- surgery
- tissue necrosis
- trauma
- type 1 diabetes mellitus
- urinary tract infection (UTI)
- vaginitis
- vomiting
Interactions
- Abacavir; Dolutegravir; Lamivudine
- Abacavir; Lamivudine, 3TC
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- Acebutolol
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- Acetaminophen; Dextromethorphan; Phenylephrine
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