Metformin+Ertugliflozin, Segluromet
Description: Antidiabetic Agent, Biguanide; Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor
Strengths: 2.5mg/500mg; 2.5mg/1000mg 7.5mg/500mg, 7.5mg/1000mg
“Alert: US Warning
Metformin has been reported to cause lactic acidosis resulting in death, hypothermia, hypotension, and resistant bradyarrhythmias. The onset of metformin-associated lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal pain. If metformin-associated lactic acidosis is suspected, discontinue Segluromet and use general supportive measures in a hospital setting. Prompt hemodialysis is recommended.
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Segluromet is a combination drug of metformin and ertugliflozin.
Metformin: Decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization).
Ertugliflozin: By inhibiting sodium-glucose cotransporter 2 (SGLT2) in the proximal renal tubules, ertugliflozin reduces reabsorption of filtered glucose from the tubular lumen and lowers the renal threshold for glucose causing an increase in urinary excretion of glucose, therefore lowering blood glucose levels.
Indications For Use
Diabetes mellitus, Type 2
Precautions
Before using Metformin+Ertugliflozin, Segluromet make sure your physician is aware of any allergies or medications you currently take, pre-existing medical conditions and activities you perform. Ertugliflozin (SGLT2) inhibitor has been linked to increased incidences of bone fractures, genital mycotic infections (eg. vulvovaginal mycotic infection, vulvovaginal candidiasis, vulvovaginitis, candida balanitis, balanoposthitis), hypotension, and ketoacidosis. Acute renal injury and serious urinary tract infections including urosepsis and pyelonephritis have been reported with using SGLT2 inhibitors like ertugliflozin. Metformin can cause lactic acidosis and patients who have signs/symptoms should seek medical assistance if required. Metformin+Ertugliflozin, Segluromet should be avoided in patients with unstable heart failure, hepatic and/or renal impairment.
Usual Dosing
Usual (Oral):
Initial: Individualize initial dose based on patient’s current antidiabetic regimen. May gradually increase dose based on effectiveness and tolerability.
Pharmacist Tips On Using
How to Take: Administer twice daily with meals.
Side Effects
Genitourinary fungal infection, headache, hypovolemia, hypoglycemia, increased thirst, weight loss, severe hypoglycemia, increased urine output, vulvovaginal pruritus, back pain, renal insufficiency, nasopharyngitis, diarrhea, flatulence, nausea, vomiting, chest discomfort, flushing, palpitations, diaphoresis, nail disease, cyanocobalamin deficiency, abdominal distention, abdominal distress, abdominal pain, abnormal stools, dyspepsia, heartburn, chills, dizziness, headache, asthenia, myalgia, dyspnea, flu-like symptoms, upper respiratory tract infection
Note this is not a complete list of side effects, only the most common.
Frequently Asked Questions
What do I do if the side effects are not tolerable?
If the side effects are causing a lot of distress speak to our physician as soon as possible to discuss options.