Saxagliptin And Metformin (Oral Route)

In conjunction with diet and exercise, the combination of Saxagliptin and Metformin are used for the treatment of high blood sugar levels in patients suffering from type II diabetes.

Overview

Saxagliptin and Metformin are prescribed in combination for the treatment of blood sugar levels in patients who suffer from type II diabetes.

This combination treatment will always be prescribed alongside a healthy diet and exercise. This treatment will not work effectively in patients who do not follow these plans.

Saxagliptin will help with the control of sugar levels in the blood by triggering the release of more insulin into the blood by the pancreas. It will also stop production of sugar by the liver.

Metformin will reduce the stomach's ability to absorb sugar into the blood, helps with the release of sugar from the liver and helps the body to use sugar more efficiently.

This medication is not suitable for patients who suffer from type I diabetes and should not be used in their treatment.

This medication is prescribed by your doctor as Kombiglyze XR and is available as an extended-release tablet. This tablet should be taken whole so that the medication can be released slowly into the bloodstream.

Conditions Treated

  • High blood sugar
  • Type II diabetes

Type of Medicine

  • Saxagliptin - Dipeptidyl peptidase-4 (DPP-4) inhibitor
  • Metformin – Biguanides

Side Effects

Saxagliptin and Metformin combination can have unwanted side effects on the body in addition to the desired effects of treatment. In some cases, medical attention may be required for the treatment of some of the side effects of these medications. Other side effects may not require medical attention.

You should contact your doctor immediately that you experience any of the following side effects from the use of Saxagliptin and Metformin:

Occurring more commonly:

  • Anxiousness
  • Bladder pain
  • Bloody urine
  • Blurring of vision
  • Body aches
  • Body pains
  • Chills when warm
  • Cloudy urine
  • Cold sweats
  • Confusion or disorientation
  • Cool or pale skin
  • Coughing
  • Depression or extreme and unwarranted sadness
  • Difficulty in breathing
  • Difficulty, burning or pain experienced during urination
  • Dizziness or faintness
  • Ear blockage or congestion
  • Feverishness
  • Headaches
  • Increase in hunger
  • Increased frequency of urge to urinate
  • Increased heartbeat
  • Loss of or changes of voice
  • Lower back pain or side pain
  • Nasal blockage
  • Nausea
  • Nightmares
  • Runny nose
  • Seizures or convulsions
  • Shakiness or trembling
  • Slurring of the speech
  • Sneezing
  • Soreness of the throat
  • Unusual tiredness or
  • Unusual weakness

Occurring only rarely:

  • Coughing or hoarseness of voice

Incidence unknown:

  • Black stools with a tarry appearance
  • Bleeding of the gums
  • Blood discovered in the urine or stools
  • Constipation
  • Dark-colored urine
  • Difficulty in swallowing
  • Hives appearing on body parts including face, feet and sex organs
  • Indigestion
  • Loss of Hunger
  • Pain occurring in the stomach, side, abdomen or possibly radiating around to the back
  • Puffy or swollen eyelids, face, lips, or tongue
  • Red spots appearing on the skin
  • Skin rash
  • Tightness experienced across the chest
  • Unusual bleeding
  • Unusual bruising
  • Vomiting
  • Yellow eyes
  • Yellow skin

Side effects can also occur that would not normally require the patient to seek medical attention. The following conditions would not usually necessitate contacting a doctor. If these side effects become bothersome, however, you should inform your doctor. Treatments may be given to alleviate these side effects, but you should check with your doctor before using any other medications to treat side effects as they may interact with the prescribed treatment:

Occurring more commonly:

  • Diarrhea
  • Muscle aching

Occurring less commonly:

  • Abdominal pain
  • Itchiness
  • Pain or tenderness experienced around the eyes and cheekbones
  • Reddening of the skin
  • Stomach pain
  • Weakness
  • Welts on the skin

Other side effects that have not been listed herein may also occur. In circumstances in which other side effects occur you should contact your doctor for advice. Contact the emergency services if you are concerned about your immediate wellbeing.

Dosage

This medication should be taken only as directed by your doctor. Do not exceed the prescribed dose or the prescribed frequency of use.

This medication will be issued with a medication guide that you should read thoroughly and ensure that you understand before use. You should ask your doctor if you have any questions following this reading.

This medication will be prescribed with a dietary plan that you should follow closely This medication will not work correctly unless you control your diet and exercise appropriately. You will also need to regularly test sugar levels in blood and urine alongside the use of this treatment too.

This medication should be taken with a meal, preferably in the evening, to help reduce unwanted stomach discomfort. As your body gets used to the treatment this will become less necessary.

Do not crush, chew, dissolve or in any way break the extended-release capsules. These need to break down in your body to release the medication slowly.

You may find parts of the extended-release capsule in your stools. This is normal and should not raise concern.

Dosing with this medication will be different for each patient to whom it is prescribed. You should not change your dosing unless directed to by your doctor and you should ensure that you follow the correct pattern of dosing. Take this medication at the same time each day to ensure it becomes a habit and part of normal practice in your day.

The following dosing information is a guideline only. Do not change your dosing unless your doctor directs you to:

For oral dosage for the treatment of type II diabetes

For patients taking metformin in isolation:

  • Adults – Dose is not normally more than 5mg of saxagliptin and 2000mg of metformin taken once daily.
  • Children – Use and dose to be determined by the doctor.

For patients taking saxagliptin in isolation:

  • Adults – Initial dose is not normally more than 5mg of saxagliptin and 500mg of metformin taken once daily. The dose can be increased but is not normally more than 5mg of saxagliptin and 2000mg of metformin taken once daily.
  • Children – Use and dose to be determined by the doctor.

For patients taking 2.5mg of saxagliptin and extended-release metformin in combination:

  • Adults – One tablet once daily; a tablet contains 2.5mg of saxagliptin and 1000mg of metformin.
  • Children – Use and dose to be determined by the doctor.

If you miss a dose you should take it as soon as possible. If, however, you are close to your next dose then you should skip the dose and return to your regular schedule. Never take a double dose of the treatment.

Interactions

Certain medications can interact with one another and should not be used in conjunction with one another. In the most extreme of cases, these medications can react and cause severe side effects in the patient. In other cases, they may stop each other from working properly or may increase the risks of side effects occurring. You should inform your doctor of all medications that you are taking before beginning treatment with this medication. This is especially important with the following medications.

The use of this treatment alongside or in conjunction with the following medications is not recommended. Your doctor may wish to make changes to one or more prescription:

  • Tyropanoate Sodium
  • Metrizoic Acid
  • Metrizamide
  • Ipodate
  • Ioxitalamic Acid
  • Ioxaglate
  • Ioversol
  • Iotroxic Acid
  • Iotrolan
  • Iothalamate
  • Iotasul
  • Iosimide
  • Ioseric Acid
  • Iopronic Acid
  • Iopromide
  • Iophendylate
  • Iopentol
  • Iopanoic Acid
  • Iopamidol
  • Iomeprol
  • Iohexol
  • Ioglycamic Acid
  • Ioglicic Acid
  • Iodoxamic Acid
  • Iodopyracet
  • Iodohippuric Acid
  • Iodixanol
  • Iodipamide
  • Iodamide
  • Iocetamic Acid
  • Iocarmic Acid
  • Iobitridol
  • Iobenzamic Acid
  • Ethiodized Oil
  • Diatrizoate
  • Acetrizoic Acid

Use of the following treatments in conjunction with Saxagliptin and Metformin is not normally recommended. In some cases, the use of both may still be the best treatment for you, but your doctor may wish to adjust the dose you are taking or adjust the frequency with which you are using this treatment.

  • Vandetanib
  • Tosufloxacin
  • Thioctic Acid
  • Sparfloxacin
  • Simeprevir
  • Rufloxacin
  • Ritonavir
  • Prulifloxacin
  • Pefloxacin
  • Pazufloxacin
  • Pasireotide
  • Paritaprevir
  • Ombitasvir
  • Ofloxacin
  • Octreotide
  • Norfloxacin
  • Nadifloxacin
  • Moxifloxacin
  • Lomefloxacin
  • Levofloxacin
  • Lanreotide
  • Idelalisib
  • Gemifloxacin
  • Gatifloxacin
  • Flumequine
  • Fleroxacin
  • Enoxacin
  • Eliglustat
  • Dolutegravir
  • Dofetilide
  • Dasabuvir
  • Cobicistat
  • Ciprofloxacin
  • Ceritinib
  • Bupropion
  • Besifloxacin
  • Balofloxacin
  • Aspirin

Use of the following medications in conjunction with the following treatments can increase the risks of suffering from certain side effects or can make the side effects experienced more severe. Use together would not normally be recommended, but your doctor may still prescribe both. In this case, they may wish to make changes to the dose or frequency of use of one or more of these medications.

  • Tranylcypromine
  • Timolol
  • Sotalol
  • Selegiline
  • Safinamide
  • Rifampin
  • Rasagiline
  • Ranolazine
  • Psyllium
  • Propranolol
  • Procarbazine
  • Practolol
  • Pindolol
  • Phenelzine
  • Penbutolol
  • Patiromer
  • Oxprenolol
  • Nialamide
  • Nebivolol
  • Nadolol
  • Moclobemide
  • Metoprolol
  • Metipranolol
  • Methylene Blue
  • Linezolid
  • Levobunolol
  • Labetalol
  • Isocarboxazid
  • Iproniazid
  • Guar Gum
  • Glucomannan
  • Furazolidone
  • Fenugreek
  • Esmolol
  • Celiprolol
  • Carvedilol
  • Carteolol
  • Bitter Melon
  • Bisoprolol
  • Betaxolol
  • Atenolol
  • Acebutolol

Interactions with other medications may also exist. These medications have been listed because of severity, but you should inform your doctor of all treatments you are taking. This includes over the counter medications, prescribed medications, herbal remedies, vitamin supplements and any other substances you take.

Medical problems not treated by Saxagliptin and Metformin but from which you also suffer can also have an impact on the use of this treatment. You should inform your doctor of all medical conditions from which you suffer or from which you have suffered in the past. This is especially important with regards to the following conditions:

The following conditions can cause the side effects of this treatment to be worsened:

  • Excessive alcohol consumption
  • Congestive heart failure
  • Dehydration
  • History of gallstones
  • Hypertriglyceridemia
  • Kidney disease
  • Liver disease
  • History of pancreas problems
  • Sepsis
  • Weakened physical condition

The following conditions may be worsened by this treatment:

  • Anemia
  • Vitamin B12 deficiency

The following condition may be more likely to recur with use of this treatment:

  • Angioedema

Risk of heart failure may be increased when used in patients suffering from the following:

  • History of heart failure
  • Kidney disease

Other medical conditions not listed herein can also impact the use of this treatment. This list has been compiled for severity and may not be all-inclusive.

Warnings

Before beginning use of this treatment, you should assess the risks of use and weigh them against the benefits of using the treatment. You should make this decision with your doctor having considered all of the factors listed herein. You should make particular note to consider the following:

Allergies

Inform your doctor if you have ever suffered an unusual reaction to any medications in the past. You should also inform them of any allergies you have to dyes, preservatives, animals, foods of other substances.

Pediatric

Safety and efficiency of this treatment in children has not been determined. Other treatments should be used if required.

Geriatric

Age-related limitations to use in the elderly population have not been found. Be cautious of age-related health problems that may impact the effective and safe use of this medication. These can include kidney problems, liver problems and heart problems. This medication would not be recommended for use in patients aged 80 or older and suffering from a kidney problem.

Pregnancy

There is believed to be minimal risks to the use of this treatment when pregnant. You should discuss your pregnancy with your doctor before treatment and should inform your doctor if you believe you may get pregnant or may have become pregnant during use.

Breastfeeding

There have been no studies carried out to determine potential risk. You should weigh the benefits of breastfeeding against the potential risks of taking this medication while breastfeeding with your doctor.

Your doctor will need to carry out regular check-ups with you when you are taking this medication. This is especially important during the first few weeks of using this medication. Blood tests and urine test may be required in order to check for unwanted side effects that are occurring.

You should inform your doctor or dentist that you are taking this medication before you have any surgeries or diagnostics carried out. You may need to stop use temporarily before they will be able to carry out certain procedures. This includes procedures that make use of contrast dyes.

An excess of metformin in the body can cause a condition called lactic acidosis. You should be aware of the symptoms of this condition because it can cause rapid and severe health impacts. Look out for the symptoms of lactic acidosis including:

  • Abdominal discomfort
  • Stomach pain
  • Diarrhea
  • Rapid breathing
  • Discomfort
  • Muscle pains
  • Muscle cramping
  • Unusual sleepiness
  • Unusual tiredness
  • Unusual weakness

If you experience more than one of these symptoms then you should seek emergency medical attention.

Pancreatitis can occur during the use of this treatment. You should look out for the symptoms of this condition and contact your doctor immediately if you experience them:

  • Chills
  • Severe pain in the stomach
  • Constipation
  • Nausea
  • Vomiting
  • Feverishness
  • Lightheadedness

Heart problems can also occur through use. If you notice a change in your heart rate, weight gain or swelling of the extremities then these can be symptoms of a heart problem and you should contact your doctor immediately.

Anaphylaxis or angioedema can occur through the use of this medication. These allergic reactions can threaten your life and should be treated immediately. Call the emergency services straight away if you experience any of the following symptoms after treatment:

  • Hive-like swellings that appear on your body. These may appear on your: Face, Lips, Tongue, Eyelids, Throat, Hands, Legs, Feet, and Sex organs
  • Troubled breathing
  • Tightness in the chest
  • Rash
  • Itching

Saxagliptin and Metformin combination can cause a drop in the blood sugar level. Missing meals, exercising excessively, drinking excessively, taking certain medications and taking diabetes medications may make this worse. If you notice a drop in your blood sugar levels then you should inform your doctor. You should learn to recognize these symptoms so that you can treat this quickly and prevent serious medical problems from occurring. Low blood sugar levels need to be treated before the conditions cause you to pass into unconsciousness. The symptoms of hypoglycemia to look out for are as follows:

  • Anxiousness
  • Behavior change
  • Blurring of vision
  • Cold sweats
  • Confusion
  • Paleness of the skin
  • Difficulty following normal thought patterns
  • Disorientation
  • Excessive hunger
  • Increased heart rate
  • Nightmares
  • Restlessness
  • Shakiness or trembling

This medication can cause the patient to experience severe joint pain. You should call your doctor if you experience this after taking the medication.

Do not take other medications along with this treatment unless they have been discussed with your doctor beforehand.

Storage

  • Always keep treatment out of the reach of children.
  • Dispose of any unwanted or outdated medication properly as directed by your healthcare professional.
  • This medication should be stored in a sealed container at room temperature. Do not expose to the light, moisture or heat.

Summary

Saxagliptin and Metformin are prescribed for the treatment of patients who suffer from a high blood sugar content triggered by type II diabetes. This treatment is not suitable for use on insulin-dependent sufferers of type I diabetes.

This medication will always be prescribed by the doctor along with both a dietary plan and an exercise plan aimed to help the patient reduce the levels of sugar in their blood. The patient must follow these plans closely or the treatment prescribed will not work effectively. The treatment in conjunction with diet and exercise will help the patient to keep blood sugar levels both low and steady, but failure to follow the set plans will lead to spikes that will put the patient at risk.

Saxagliptin will help with the control of sugar levels in the blood by triggering the release of more insulin into the blood by the pancreas. It will also stop production of sugar by the liver.

Metformin will reduce the stomach's ability to absorb sugar into the blood, helps with the release of sugar from the liver and helps the body to use sugar more efficiently.

This medication interacts with a wide range of other medications and can be impacted by other existing medical conditions. Patients should ensure that their doctor is aware of their full medical condition before beginning this treatment.

Resources
Last Reviewed:
January 30, 2018
Last Updated:
January 27, 2018