Metformin is a well-liked prescription drug that’s used as a first-line remedy for kind 2 diabetes. It’s additionally an lively ingredient in lots of two- and three-ingredient mixture medication for diabetes.
Mixture medication for folks with kind 2 diabetes usually pair metformin with one other drug that has a distinct motion within the physique, thereby permitting for a number of strategies of decreasing blood glucose ranges.
This text will examine the usage of metformin mixture medication for kind 2 diabetes and can reply some frequent questions you may need about mixture medication.
Desk of Contents
What are mixture medication?
Mixture medication, which mix two drugs right into a single tablet, are extra complicated than two separate drugs, every with one medicine.
These medication mix a minimum of two totally different lively components into one prescription, with every medication in a selected, predetermined ratio. Every of the 2 (or extra) medication has a singular mechanism of motion, that means it has its personal set of results on the physique.
Mixture medication could also be permitted for a number of causes, together with that there could also be a synergistic impact — that means that the impact of the 2 medication when mixed is healthier than it will be if the 2 medication have been taken individually.
Mixture medication also can simplify medicine administration by decreasing the variety of drugs an individual must take, making it simpler to maintain observe of their routine.
Mixture medication, formally identified by the U.S. Meals and Drug Administration (FDA) as “fixed-dose mixture medication” (or FDCs), first started coming to market in vital numbers within the Nineteen Eighties in the US and actually accelerated in reputation by means 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 tablet, typically a few times every day.
Metformin helps to handle blood sugar ranges by reducing the quantity of glucose the liver produces, decreasing the quantity of glucose absorbed from the gastrointestinal tract, and decreasing insulin resistance (a situation by which the physique doesn’t use insulin effectively). It will possibly even assist with weight reduction.
Study extra in: Metformin and Weight Loss: Can a Capsule Assist You Lose Weight?
Nonetheless, metformin is just not all the time efficient sufficient by itself. In these instances, a healthcare supplier could suggest including a second medicine to the remedy routine.
That is usually within the type of a fixed-dose mixture drug (a single tablet containing two or extra drugs at particular doses).
Medical doctors think about many components when figuring out which metformin mixture drug will finest assist an individual handle their kind 2 diabetes. It could be essential to attempt a couple of mixture drug earlier than discovering the one which finest meets your blood sugar and different well being objectives whereas minimizing unwanted side effects.
Medicines that mix metformin with SGLT-2 inhibitors (a category of kind 2 diabetes medication first permitted in 2013) are each generally prescribed and are backed by strong proof.
These mixture medication, 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 means of the urine, which reduces total blood glucose ranges.
Metformin and SGLT2 mixture medication have been proven to provide a bigger HbA1c discount than simply metformin alone, and analysis in folks with diabetes has additionally indicated among the medicines on this class of mixture medication scale back the chance of coronary heart assault and different severe coronary heart circumstances when in comparison with taking metformin by itself.
Different less-common mixture medication 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 further lessons of kind 2 diabetes medicine).
Small-scale trials with this triple mixture drug yielded vital HbA1c enhancements. Subsequent triple-combination trials utilizing different lively components have proven broader effectiveness for bigger teams of individuals with kind 2 diabetes.
In large-scale trials, triple mixture medication similar to 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 medication (or another type of mixture drug) could 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 medication are acceptable for you and if the advantages outweigh any of the potential unwanted side effects.
Which antidiabetic medication could be taken together with metformin?
There’s a distinction between what medication could be taken on the similar time as metformin and what medication could be taken as a mix drug with metformin.
Metformin is usually well-tolerated and could be taken with quite a few different medication if prescribed by your physician. It’s all the time a good suggestion to inform your medical care staff what pharmaceuticals you take to verify there are not any surprising interactions.
Although loads of different medication could be taken concurrently metformin, there are solely a handful of metformin mixture medication which were permitted.
Metformin mixture medication checklist
FDA-approved metformin mixture medication at the moment accessible in the US 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)
*The entire medication listed above with “XR” embrace an extended-release formulation of metformin, which many individuals discover helps them keep away from gastrointestinal unwanted side effects and sensitivity that’s frequent with standard-release metformin.
What are the principle advantages of metformin mixture medication?
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 unwanted side effects
- Fewer drugs to maintain observe of and a extra manageable remedy routine
- Decrease prescription prices
What’s subsequent if metformin isn’t sufficient to handle kind 2 diabetes?
It may be discouraging in case your blood sugar ranges stay elevated even after taking metformin and making dietary and way of life modifications.
Many individuals with kind 2 diabetes marvel what choices they’ve left if their blood sugar is out of vary even whereas taking metformin, or if it seems 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 medication have totally different lively components and totally different mechanisms of motion, they usually have “synergistic” results, bringing down your blood sugar greater than taking every drug individually would.
Mixture medication are additionally thought-about to be one of the best subsequent step after metformin remedy as a result of their unwanted side effects are effectively understood and are typically much less severe than with different medication.
A physician can also think about 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 power.
Artificial insulin is normally 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 kind 2 diabetes, insulin remedy tends to assist decrease blood sugar ranges extra rapidly than different drugs, but it surely requires cautious administration and may include vital unwanted side effects, like severe low blood sugar (hypoglycemia), if you happen to take an excessive amount of insulin directly.
In case your common blood sugar ranges (as measured by an HbA1c take a look at or long-term use of a steady glucose monitor [CGM]) don’t come down, and if you happen to’re already taking the most advisable dose of metformin or a mix drug, then your physician could think about insulin remedy.
If metformin alone simply isn’t sufficient to handle your blood sugar, it’s necessary to speak with a health care provider about different choices. Everybody’s wants, response to pharmaceuticals, and total medical historical past are totally different, so discussing the professionals and cons of various kinds of remedy along with your physician is a good place to start out.
Study extra: The Greatest Alternate options to Metformin for Sort 2 Diabetes Administration.
Ceaselessly requested questions
What’s the distinction between taking two drugs and taking a mix drug?
Mixture medication are available in a single tablet and are prescribed below a single prescription. They’ve been examined collectively, and the doses of the 2 (or extra) lively 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 lively components right into a single tablet or dose. Mixture remedy makes use of two or extra totally different medication to deal with a situation and it might additionally contain taking a number of drugs in numerous methods (e.g., taking a every day metformin tablet, plus injectable semaglutide [Ozempic] or insulin).
Mixture remedy also can contain the usage of medical gadgets, similar to insulin pumps.
What drawbacks are there to metformin mixture medication?
As a result of mixture medication have mounted ratios of their lively components, it could be tougher to regulate the dosages than if you happen to have been taking metformin and the opposite drug as two separate drugs.
Moreover, as a result of every lively ingredient additionally has its personal potential unwanted side effects, rising the variety of lively components in a prescription drug usually can enhance the variety of undesirable unwanted side effects.
See extra in: Metformin Aspect Results (Widespread and Critical).
What’s the most secure medicine for kind 2 diabetes?
Pharmacists and docs typically advise that metformin is likely one of the most secure and most studied medication for managing blood sugar in folks with kind 2 diabetes.
(Nonetheless, it is very important be aware that metformin is just not appropriate for everybody. As an example, its use is just not advisable in folks with sure circumstances, similar to extreme kidney impairment, metabolic acidosis, or those that have had a hypersensitivity response to it.)
Learn extra in: Is Metformin Secure?
Many metformin mixture medication even have glorious security profiles.
Nonetheless, it’s all the time necessary to debate remedy choices along with your physician to get individualized steerage.
Closing ideas
Managing kind 2 diabetes successfully requires a personalized strategy, contemplating the distinctive well being wants and responses of every particular person. Metformin, as a cornerstone of diabetes remedy, gives vital advantages, notably when mixed with different drugs.
These mixture therapies supply a extra full and efficient strategy to managing blood glucose, usually main to higher outcomes than utilizing metformin alone.
Nonetheless, it’s necessary to do not forget that each remedy plan needs to be as distinctive as the person it serves. What works successfully for one particular person might not be the only option for one more.
And whereas metformin mixture medication have strong proof for controlling blood glucose ranges and promising outcomes concerning cardiovascular advantages, they aren’t with out their potential drawbacks. The issue of constructing dosage changes and the potential unwanted side effects have to be fastidiously weighed in opposition to the advantages.
As with all medical remedy, ongoing dialogue with healthcare professionals and a dedication to non-public well being objectives are key to discovering the simplest technique for managing kind 2 diabetes.
Prompt subsequent article: Every thing You Have to Know About Metformin.