Ertugliflozin Metformin

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

  1. abdominal pain
  2. anorexia
  3. asthenia
  4. back pain
  5. balanitis
  6. candidiasis
  7. cystitis
  8. dehydration
  9. diabetic ketoacidosis
  10. diarrhea
  11. diuresis
  12. dysgeusia
  13. dyspepsia
  14. dysuria
  15. flatulence
  16. folate deficiency
  17. headache
  18. hypercholesterolemia
  19. hyperlipidemia
  20. hyperphosphatemia
  21. hypoglycemia
  22. hypotension
  23. hypovolemia
  24. increased urinary frequency
  25. infection
  26. lactic acidosis
  27. lower limb amputation
  28. megaloblastic anemia
  29. metallic taste
  30. nausea
  31. necrotizing fasciitis
  32. nocturia
  33. orthostatic hypotension
  34. pharyngitis
  35. phimosis
  36. polydipsia
  37. polyuria
  38. renal failure (unspecified)
  39. rhabdomyolysis
  40. syncope
  41. tissue necrosis
  42. urinary urgency
  43. vaginitis
  44. vitamin B12 deficiency
  45. vomiting
  46. 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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