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ALIMENTARY TRACT AND METABOLISM › DRUGS USED IN DIABETES › BLOOD GLUCOSE LOWERING DRUGS, EXCL. INSULINS › Combinations of oral blood glucose lowering drugs
metformin and saxagliptin
A10BD10
Forms & Strengths
- Tablets: 5mg/500mg, 5mg/1000mg, 2.5mg/500mg, 2.5mg/1000mg
- Combination product of metformin and saxagliptin
Adult Dosing
- Initial dose: 5mg/500mg twice daily or 5mg/1000mg once daily
- Titrate dose as needed, not to exceed 5mg/2000mg daily
- Take with meals to minimize gastrointestinal side effects
- Assess renal function before starting and annually thereafter
Pediatric Dosing
- Not recommended for pediatric patients under 18 years old
- Clinical trials have been conducted in pediatric patients but data are limited
Indications
- Type 2 diabetes mellitus as an adjunct to diet and exercise
- To improve glycemic control in adults with type 2 diabetes
Mechanism of Action
- Metformin decreases hepatic glucose production, improves insulin sensitivity
- Saxagliptin increases insulin secretion, decreases glucagon secretion by inhibiting DPP-4
- Combination therapy provides complementary mechanisms to improve glycemic control
Contraindications
- Renal impairment (eGFR <30 mL/min/1.73m^2) for metformin component
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to saxagliptin, metformin, or any component
Adverse Reactions
- Common: nausea, vomiting, diarrhea, abdominal pain, hypoglycemia
- Less common: upper respiratory infection, headache, pancreatitis, renal impairment
- Rare: lactic acidosis, severe hypersensitivity reactions
Drug Interactions
- Carbonic anhydrase inhibitors, cationic drugs may increase risk of lactic acidosis with metformin
- CYP3A4/5 inhibitors may increase saxagliptin levels
- Hypoglycemic agents may require dose adjustment when used with saxagliptin
Curated Content: Needs Vetting Before Put to Clinical Use