Metformin/evogliptin

Detailed article on the combination drug Metformin/Evogliptin

Metformin/Evogliptin is a combination medication used in the management of type 2 diabetes mellitus. This combination leverages the complementary mechanisms of action of two different classes of antidiabetic agents: metformin, a biguanide, and evogliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor.

Pharmacology

Metformin

Metformin is a well-established oral antihyperglycemic agent that primarily works by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. It is the first-line medication for the treatment of type 2 diabetes, particularly in overweight and obese patients, and those with normal kidney function.

Evogliptin

Evogliptin is a DPP-4 inhibitor that works by increasing the levels of incretin hormones, which are involved in the physiological regulation of glucose homeostasis. Incretins such as GLP-1 (glucagon-like peptide-1) increase insulin synthesis and release from pancreatic beta cells and decrease glucagon release from pancreatic alpha cells, thereby reducing blood glucose levels.

Mechanism of Action

The combination of metformin and evogliptin provides a synergistic effect in controlling blood glucose levels. Metformin primarily reduces fasting plasma glucose levels, while evogliptin helps in controlling postprandial glucose spikes by enhancing the incretin effect. Together, they provide a comprehensive approach to managing hyperglycemia in type 2 diabetes patients.

Clinical Use

Metformin/evogliptin is indicated for the treatment of type 2 diabetes mellitus in adults, particularly in patients who are inadequately controlled on metformin alone or those who are already being treated with both metformin and evogliptin as separate tablets. It is used as an adjunct to diet and exercise to improve glycemic control.

Side Effects

Common side effects of metformin include gastrointestinal disturbances such as diarrhea, nausea, and abdominal discomfort. Evogliptin, like other DPP-4 inhibitors, is generally well-tolerated but may cause nasopharyngitis, headache, and upper respiratory tract infections. Rarely, DPP-4 inhibitors have been associated with pancreatitis.

Contraindications

The use of metformin/evogliptin is contraindicated in patients with severe renal impairment, metabolic acidosis, including diabetic ketoacidosis, and hypersensitivity to any of the components of the medication.

Also see

• Type 2 diabetes mellitus
• Metformin
• Dipeptidyl peptidase-4 inhibitor
• Glucagon-like peptide-1