Has your doctor prescribed a new diabetes medication? It's a bit of a long name, isn't it? It's a combination of two medications called Ertugliflozin and Metformin. You may have heard of it under the brand name Segluromet. So, let's talk briefly, as if we were talking to a friend, about what this medication is, how it works in our bodies, and what we need to be aware of when using it.
Simply put, what is this medicine?
This is a medicine used to treat
type 2 diabetes . It combines two medicines. Ertugliflozin and Metformin. Together, these two help control your body's sugar levels, that is, the level of glucose in your blood. Imagine that Ertugliflozin works by making your kidneys excrete some excess sugar in your urine. Metformin works mainly by reducing the amount of sugar your liver produces and by helping your body's cells respond better to insulin. In this way, your blood sugar is controlled in two ways.
But one thing must be kept in mind. Taking this medicine alone is not enough. A good diet and proper exercise are also essential parts of this treatment. The best results can be achieved only when this medicine is taken along with the lifestyle changes prescribed by the doctor.
Things you need to tell your doctor before starting this medication
Before your doctor prescribes this medicine, he or she needs to have a complete picture of your health. Therefore, if you have any of the conditions listed below,
be sure to tell your doctor about it. This is very important for your safety.
| Quality type | Do you have these conditions? (Please tell your doctor ) |
|---|
| Diabetes-related conditions | - Having type 1 diabetes
- Having previously developed Diabetic Ketoacidosis ( DKA )
- Foot sores due to diabetes
- Changing insulin dosage
- Amputation (having a leg or part of it removed)
|
| Other illnesses | |
| Lifestyle and other matters | - Frequent drinking
- Making a big change in diet (e.g. eating less)
- Eating a low-salt diet
- Dehydration of the body
- Low blood calcium or vitamin B levels
- Having nerve pain and numbness in the limbs
|
| Future plans and allergies | - Are scheduled to undergo surgery or a CT/X-ray scan in the future
- Trying to get pregnant or currently pregnant
- Breastfeeding the baby
- Having an allergy to Ertugliflozin, Metformin or any other medicine, food, or pigment
|
How should I use the medicine?
The method of using this medicine is very simple.
- Take this pill with a glass of water .
- Try to take it at the same time every day , exactly as prescribed by your doctor.
- It is best to take this medicine at the start of a meal .
- Never stop taking your medication without consulting your doctor .
What if you take too much medicine? (Overdosage)
If you think you've taken too much medicine, don't panic. But don't take it lightly either.
Go immediately to the nearest hospital Emergency Department (ETU) or call
the National Poisons Information Centre at the Colombo National Hospital for advice.
Most importantly: This medicine has been prescribed for you only. Do not share it with anyone else for any reason.
What to do if you miss a dose of medication?
We all forget to take our medicine sometimes. If that happens, take the missed dose as soon as you remember. However, if it is almost time for your next dose when you remember, skip the missed dose and take your next dose at the scheduled time.
Never take two doses at once. Other medications that may interact with this medicine
Not all medications you take will work well with this medicine. Some medications can interfere with the way this medicine works. Therefore, it is very important to tell your doctor about all medications, vitamins, and even herbal products you are taking.
Things you should not take with this medicine
This medicine may interact with some
contrast agents (dyes) injected into the body, especially if you are going to have a CT scan, MRI scan, or X-ray. Therefore, you should tell the medical staff that you are taking this medicine before such a test.
Other medications that may interact
The medications below may interact with Ertugliflozin/Metformin.
- Acetazolamide
- Cimetidine
- Dolutegravir
- Lithium
- Ranolazine
- Topiramate
- Vandetanib
- Zonisamide
- Dichlorphenamide
- Alcohol
Medications that can affect blood sugar levels
Some medications can change your blood sugar levels (increase or decrease them). Also, some medications can mask the symptoms of low blood sugar (hypoglycemia), meaning we don't notice it. This can be a little dangerous. So if you're taking these medications, your doctor will tell you to check your blood sugar levels regularly.
| Nature of the impact | Examples of medications |
|---|
| Medications that can affect blood sugar levels | - Some high blood pressure medications (e.g., benazepril, lisinopril, losartan)
- Diuretics (e.g. hydrochlorothiazide)
- Steroids (e.g. prednisone, cortisone)
- Types of hormones (Estrogen, progestin, Testosterone)
- Thyroid hormones
- Some antibiotics and medications for mental illness
|
| Medications that can mask the symptoms of hypoglycemia | - Beta-blockers (e.g. atenolol, metoprolol, propranolol)
- Clonidine, Guanethidine, Reserpine
|
Things to be careful about when taking medicine
You also need to be a little careful when taking this medicine.
- See your doctor at the scheduled time. It's important to check your progress and get the necessary tests done. The doctor will monitor your HbA1C (a test that shows your average blood sugar levels over the past 2-3 months) levels.
- Know the symptoms of low blood sugar (hypoglycemia). Be prepared for symptoms like sweating, shaking, extreme hunger, and rapid heartbeat. Always carry a glucose tablet or sugar packet with you.
- Avoid dehydration. Drink plenty of water. If you have a fever, vomiting, or diarrhea, be especially careful and tell your doctor about it, as it can cause a lot of fluid loss.
- Tell your doctor that you are taking this medicine before having surgery or a scan . They will tell you when to stop taking it and when to start it again.
- Be careful with vitamin B12. Taking this medicine for a long time can cause vitamin B12 levels to decrease. Talk to your doctor about this.
- Wearing a medical ID bracelet or card that identifies you as a diabetic can be very useful in an emergency.
What are the possible side effects of the medication?
Like any medicine, this medicine can cause side effects in some people, but not everyone gets them. Watch out for the symptoms below.
Side effects that should be reported to your doctor immediately: Side effects that are usually not serious, but should be reported
to your doctor if they persist.
| Side effect | Description and symptoms |
|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Diabetic ketoacidosis (DKA) | Excessive thirst, frequent urination, dry mouth, difficulty breathing, fruity breath odor, stomach ache, vomiting. |
| Dehydration | Excessive thirst, dry mouth, fainting, dark yellow or brown urine. |
| Lactic acidosis (High lactic acid level) | Muscle pain, stomach ache, difficulty breathing, extreme fatigue. |
| Infections | Urinary tract infection (UTI) - inflammation of the urethra, frequent urination, lower abdominal pain. Yeast infection in the genital area - itching, redness, swelling. Severe infection in the area from the genital area to the anus. |
| Vitamin B12 deficiency | Pain in the limbs, numbness, muscle weakness, dizziness, confusion. |
| Digestive system problems | Diarrhea, gas, nausea, vomiting, stomach cramps. |
| Other | Headache. |
How should I store the medicine? How should I dispose of it?
- Keep this medicine out of the reach of children and pets .
- Store at room temperature (between 20-25 degrees Celsius).
- Do not use expired medications. Dispose of them properly.
- The best way to get rid of medication is to hand it over to a medication take-back program operated by a pharmacy or hospital.
- If that's not possible, take the medicine out of the container, mix it with something like used coffee grounds, soil, or cat litter, put it in a tightly sealed bag, and throw it in the trash. Never flush it down the toilet.
Take-Home Message
- This medicine is only an aid in controlling diabetes. Proper diet and exercise are essential.
- Tell your doctor about all other medications you are taking and any medical conditions you have.
- Be aware of the symptoms of low blood sugar (hypoglycemia) and dehydration.
- If you develop a urinary tract infection, genital infection, or other serious side effects, see your doctor immediately.
- Do not stop using this medicine without your doctor's advice.
- If you have any concerns about your diabetes treatment, never be afraid to talk to your doctor.
Diabetes, Ertugliflozin, Metformin, Segluromet, type 2 diabetes, blood sugar, sugar control
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