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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 teneligliptin
A10BD28
Forms & Strengths
- Metformin HCl 500 mg / Teneligliptin 20 mg tablet
- Metformin HCl 1000 mg / Teneligliptin 20 mg tablet
Adult Dosing
- Type 2 Diabetes Mellitus: One tablet twice daily with meals, adjusted based on renal function and glycemic response
- Maximum daily dose: Metformin 2000 mg / Teneligliptin 40 mg
Pediatric Dosing
- Safety and efficacy in pediatric patients (<18 years) have not been established
Indications
- Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus inadequately controlled on metformin or teneligliptin monotherapy, or already treated with the combination
Mechanism of Action
- Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization
- Teneligliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that prolongs the action of incretin hormones (GLP-1 and GIP), increasing insulin secretion and decreasing glucagon levels in a glucose-dependent manner
Contraindications
- Hypersensitivity to metformin, teneligliptin, or any excipient
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
- History of serious hypersensitivity reaction, such as anaphylaxis, to any DPP-4 inhibitor
Adverse Reactions
- Hypoglycemia (especially when used with insulin or sulfonylureas)
- Gastrointestinal disturbances (diarrhea, nausea, vomiting, abdominal pain)
- Nasopharyngitis
- Headache
- Lactic acidosis (very rare, associated with metformin accumulation)
Drug Interactions
- Cationic drugs eliminated by renal tubular secretion (e.g., cimetidine) may increase metformin plasma concentrations
- Strong CYP3A4 inducers (e.g., rifampin) may decrease teneligliptin exposure
- Alcohol may potentiate the effect of metformin on lactate metabolism
- Carbonic anhydrase inhibitors may increase risk of metabolic acidosis
- Insulin and insulin secretagogues (sulfonylureas) increase the risk of hypoglycemia
Curated Content: Needs Vetting Before Put to Clinical Use