Metformin is a well-liked prescription drug that’s used as a first-line therapy for sort 2 diabetes. It’s additionally an energetic ingredient in lots of two- and three-ingredient mixture medicine for diabetes.
Mixture medicine for individuals with sort 2 diabetes usually pair metformin with one other drug that has a unique motion within the physique, thereby permitting for a number of strategies of reducing blood glucose ranges.
This text will examine the usage of metformin mixture medicine for sort 2 diabetes and can reply some frequent questions you may need about mixture medicine.
What are mixture medicine?
Mixture medicine, which mix two drugs right into a single capsule, are extra advanced than two separate drugs, every with one treatment.
These medicine mix a minimum of two completely different energetic components into one prescription, with every medication in a particular, predetermined ratio. Every of the 2 (or extra) medicine has a singular mechanism of motion, that means it has its personal set of results on the physique.
Mixture medicine could also be authorised for a number of causes, together with that there could also be a synergistic impact — that means that the impact of the 2 medicine when mixed is healthier than it will be if the 2 medicine have been taken individually.
Mixture medicine can even simplify treatment administration by lowering the variety of drugs an individual must take, making it simpler to maintain observe of their routine.
Mixture medicine, formally identified by the U.S. Meals and Drug Administration (FDA) as “fixed-dose mixture medicine” (or FDCs), first started coming to market in vital numbers within the Nineteen Eighties in america and really accelerated in recognition by way of the mid-Nineties.
What’s the finest mixture with metformin?
Simply by itself, metformin is available in many manufacturers and is taken every day as an oral capsule, usually a few times every day.
Metformin helps to handle blood sugar ranges by reducing the quantity of glucose the liver produces, reducing the quantity of glucose absorbed from the gastrointestinal tract, and lowering insulin resistance (a situation wherein the physique doesn’t use insulin effectively). It could actually even assist with weight reduction.
Study extra in: Metformin and Weight Loss: Can a Capsule Assist You Lose Weight?
Nonetheless, metformin isn’t all the time efficient sufficient by itself. In these circumstances, a healthcare supplier could advocate including a second treatment to the therapy routine.
That is usually within the type of a fixed-dose mixture drug (a single capsule containing two or extra drugs at particular doses).
Docs take into account many components when figuring out which metformin mixture drug will finest assist an individual handle their sort 2 diabetes. It could be essential to attempt multiple mixture drug earlier than discovering the one which finest meets your blood sugar and different well being objectives whereas minimizing uncomfortable side effects.
Medicines that mix metformin with SGLT-2 inhibitors (a category of sort 2 diabetes medicine first authorised in 2013) are each generally prescribed and are backed by strong proof.
These mixture medicine, which embrace pairings with empagliflozin (model names Synjardy and Synjardy XR), dapagliflozin (Xigduo XR), and ertugliflozin (Segluromet), work by serving to the kidneys to excrete extra glucose by way of the urine, which reduces total blood glucose ranges.
Metformin and SGLT2 mixture medicine have been proven to provide a bigger HbA1c discount than simply metformin alone, and analysis in individuals with diabetes has additionally indicated a few of the medicines on this class of mixture medicine cut back the danger of coronary heart assault and different critical coronary heart circumstances when in comparison with taking metformin by itself.
Different less-common mixture medicine which were proven to be extremely efficient in reducing HbA1c ranges are “triple mixture therapies” that embrace metformin plus a DPP-4 inhibitor and a sulfonylurea (two extra courses of sort 2 diabetes treatment).
Small-scale trials with this triple mixture drug yielded vital HbA1c enhancements. Subsequent triple-combination trials utilizing different energetic components have proven broader effectiveness for bigger teams of individuals with sort 2 diabetes.
In large-scale trials, triple mixture medicine reminiscent of Trijardy (which mixes empagliflozin, linagliptin, and metformin) have been proven to enhance HbA1c ranges by greater than 1.1% in comparison with taking metformin alone.
It is very important be aware that whereas triple mixture medicine (or every other sort of mixture drug) might be an efficient method to assist handle blood sugar ranges, they aren’t proper for everybody.
A physician or different medical supplier will consider if these medicine are acceptable for you and if the advantages outweigh any of the potential uncomfortable side effects.
Which antidiabetic medicine might be taken together with metformin?
There’s a distinction between what medicine might be taken on the similar time as metformin and what medicine might be taken as a mix drug with metformin.
Metformin is mostly well-tolerated and might be taken with plenty of different medicine if prescribed by your physician. It’s all the time a good suggestion to inform your medical care workforce what pharmaceuticals you take to ensure there are not any surprising interactions.
Although loads of different medicine might be taken concurrently metformin, there are solely a handful of metformin mixture medicine which were authorised.
Metformin mixture medicine record
FDA-approved metformin mixture medicine at present out there in america embrace:
- ActoPlus Met (metformin and pioglitazone)
- ActoPlus Met XR* (metformin XR and pioglitazone)
- Avandamet (metformin and rosiglitazone)
- Glucovance (metformin and glyburide)
- Invokamet (metformin and canagliflozin)
- Invokamet XR (metformin XR and canagliflozin)
- Janumet (metformin and sitagliptin)
- Janumet XR (metformin XR and sitagliptin)
- Jentadueto (metformin and linagliptin)
- Jentadueto XR (metformin XR and linagliptin)
- Kazano (metformin and alogliptin)
- Kombiglyze XR (metformin XR and saxagliptin)
- Metformin and glipizide (generic variations solely)
- Qternment XR (metformin, saxagliptin, and dapagliflozin)
- Segluromet (metformin and ertugliflozin)
- Synjardy (metformin and empagliflozin)
- Synjardy XR (metformin XR and empagliflozin)
- Xigduo XR (metformin XR and dapagliflozin)
- Trijardy XR (metformin XR, empagliflozin, and linagliptin)
*All the medicine listed above with “XR” embrace an extended-release formulation of metformin, which many individuals discover helps them keep away from gastrointestinal uncomfortable side effects and sensitivity that’s frequent with standard-release metformin.
What are the primary advantages of metformin mixture medicine?
Utilizing a metformin combo drug as a substitute of a number of medicines individually can have quite a lot of advantages, together with:
- Improved effectiveness of the drugs
- A lower in uncomfortable side effects
- Fewer drugs to maintain observe of and a extra manageable therapy routine
- Decrease prescription prices
What’s subsequent if metformin isn’t sufficient to handle sort 2 diabetes?
It may be discouraging in case your blood sugar ranges stay elevated even after taking metformin and making dietary and life-style adjustments.
Many individuals with sort 2 diabetes marvel what choices they’ve left if their blood sugar is out of vary even whereas taking metformin, or if it appears like metformin is dropping its effectiveness over time.
Study extra in: Indicators Metformin Is Working (Or Isn’t Working)
As mentioned above, oftentimes a health care provider will prescribe a metformin mixture drug to enhance blood sugar management.
As a result of these medicine have completely different energetic components and completely different mechanisms of motion, they usually have “synergistic” results, bringing down your blood sugar greater than taking every drug individually would.
Mixture medicine are additionally thought of to be one of the best subsequent step after metformin remedy as a result of their uncomfortable side effects are properly understood and are usually much less critical than with different medicine.
A physician can also take into account starting insulin remedy together with metformin.
Insulin is a hormone produced within the pancreas that helps transfer glucose from the blood into the physique’s cells for use for vitality.
Artificial insulin is often taken as an injection to complement the physique’s personal insulin (if any continues to be being produced). Insulin is available in many formulations, which broadly embrace rapid-acting (bolus) insulin and long-acting (basal) insulin.
In sort 2 diabetes, insulin remedy tends to assist decrease blood sugar ranges extra shortly than different drugs, however it requires cautious administration and might include vital uncomfortable side effects, like critical low blood sugar (hypoglycemia), when you take an excessive amount of insulin without delay.
In case your common blood sugar ranges (as measured by an HbA1c check or long-term use of a steady glucose monitor [CGM]) don’t come down, and when you’re already taking the utmost really useful dose of metformin or a mix drug, then your physician could take into account insulin remedy.
If metformin alone simply isn’t sufficient to handle your blood sugar, it’s essential to speak with a health care provider about different choices. Everybody’s wants, response to pharmaceuticals, and total medical historical past are completely different, so discussing the professionals and cons of several types of therapy along with your physician is a good place to start out.
Study extra: The Greatest Options to Metformin for Kind 2 Diabetes Administration.
Incessantly requested questions
What’s the distinction between taking two drugs and taking a mix drug?
Mixture medicine are available a single capsule and are prescribed beneath a single prescription. They’ve been examined collectively, and the doses of the 2 (or extra) energetic components have been calibrated to work collectively.
What’s the distinction between a mix drug and a mix remedy?
A mixture drug combines two or extra energetic components right into a single capsule or dose. Mixture remedy makes use of two or extra completely different medicine to deal with a situation and it could actually additionally contain taking a number of drugs in numerous methods (e.g., taking a every day metformin capsule, plus injectable semaglutide [Ozempic] or insulin).
Mixture remedy can even contain the usage of medical units, reminiscent of insulin pumps.
What drawbacks are there to metformin mixture medicine?
As a result of mixture medicine have fastened ratios of their energetic components, it could be tougher to regulate the dosages than when you have been taking metformin and the opposite drug as two separate drugs.
Moreover, as a result of every energetic ingredient additionally has its personal potential uncomfortable side effects, rising the variety of energetic components in a prescription drug usually can enhance the variety of undesirable uncomfortable side effects.
See extra in: Metformin Facet Results (Widespread and Critical).
What’s the most secure treatment for sort 2 diabetes?
Pharmacists and docs usually advise that metformin is likely one of the most secure and most studied medicine for managing blood sugar in individuals with sort 2 diabetes.
(Nonetheless, it is very important be aware that metformin isn’t appropriate for everybody. For example, its use isn’t really useful in individuals with sure circumstances, reminiscent of extreme kidney impairment, metabolic acidosis, or those that have had a hypersensitivity response to it.)
Learn extra in: Is Metformin Protected?
Many metformin mixture medicine even have glorious security profiles.
Nonetheless, it’s all the time essential to debate therapy choices along with your physician to get individualized steering.
Closing ideas
Managing sort 2 diabetes successfully requires a custom-made strategy, contemplating the distinctive well being wants and responses of every particular person. Metformin, as a cornerstone of diabetes therapy, provides vital advantages, notably when mixed with different drugs.
These mixture therapies provide a extra full and efficient strategy to managing blood glucose, usually main to raised outcomes than utilizing metformin alone.
Nonetheless, it’s essential to do not forget that each therapy plan needs to be as distinctive as the person it serves. What works successfully for one particular person might not be your best option for an additional.
And whereas metformin mixture medicine have strong proof for controlling blood glucose ranges and promising outcomes concerning cardiovascular advantages, they don’t seem to be with out their potential drawbacks. The problem of creating dosage changes and the potential uncomfortable side effects should be fastidiously weighed towards the advantages.
As with every medical therapy, ongoing dialogue with healthcare professionals and a dedication to private well being objectives are key to discovering the best technique for managing sort 2 diabetes.
Advised subsequent article: Every little thing You Have to Know About Metformin.
