Ertugliflozin and Metformin

Hypoglycaemic excluding Insulin · Biguanide/Sodium-glucose co-transporter 2 (SGLT2) inhibitors

Indications

As an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus who are not adequately controlled on a regimen containing ertugliflozin or metformin, or in patients who are already treated with both ertugliflozin and metformin.

Dosage

Adults: Take twice daily with meals, with gradual dose increment. Individualize the starting dose based on the patient’s current regimen. Max: 7.5 mg ertugliflozin/1000 mg metformin twice daily. Children: Not recommended.

Adverse Effects

Female genital mycotic infections. Diarrhoea, nausea, vomiting, flatulence, abdominal discomfort, indigestion, asthenia, headache.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Type 1 DM, metabolic acidosis including diabetic ketoacidosis. Severe renal impairment (eGFR: 30-<60 mL/min/1.73m2), end-stage renal disease, dialysis. Hepatic impairment. Precautions: Moderate renal impairment. Hypotension, hypoglycaemia. Elderly.

Interactions

Insulin, insulin secretagogues. Carbonic anhydrase inhibitors, ranolazine, vandetanib, dolutegravir, cimetidine.

Advice to Patient

Take with meals. Avoid alcohol during treatment. Discontinue medication and inform prescriber if you experience unexplained hyperventilation, malaise, myalgia, unusual somnolence, slow or irregular heartbeat, sensation of feeling cold (esp. in the extremities). Seek medical advice if genital mycotic infections (vulvovaginitis in females, balanitis or balanoposthitis in males) occur.

Pharmacokinetics

ERTUGLIFLOZIN: Metabolism: Hepatic. Half-life elimination: 16.6 hrs. Time to peak, plasma: 1 hr. Excretion: Urine (1.5%). Faeces (33.8%). METFORMIN: Onset of action: Within days, max effects up to 2 wks. Metabolism: Not metabolized by the liver. Bioavailability: Absolute: Fasting: 50%-60%. Half-life elimination: Plasma: 4-9 hrs. Blood: Approx. 17.6 hrs. Time to peak, serum: Immediate release: 2-3 hrs. Extended release: 7 hrs. (Range: 4-8 hrs). Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.