metformin + sitagliptin at a glance
Medicine class
Biguanide plus DPP-4 inhibitor.
Food
Take with meals to reduce metformin-related stomach and bowel effects.
Low blood glucose
Risk is greater with insulin or a sulphonylurea.
What is metformin + sitagliptin used for?
Used in adults with type 2 diabetes as an adjunct to diet and exercise.
When maximum tolerated metformin has not provided adequate glucose control.
For people already controlled with sitagliptin and metformin as separate tablets.
Alongside a sulphonylurea, a PPAR-gamma agonist or insulin when appropriate metformin-based treatment is insufficient.
How does metformin + sitagliptin work?
Metformin reduces glucose production by the liver and improves the body's response to insulin. Sitagliptin blocks DPP-4, prolonging incretin activity so insulin release increases and glucagon falls when blood glucose is raised.
metformin + sitagliptin preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg + 1000 mg, 50 mg + 850 mg
How to take metformin + sitagliptin
Follow the dispensing label and take the film-coated tablets with meals. Do not stop treatment without discussing it with the prescriber, because blood glucose may rise.
Taking the tablet with food helps reduce digestive effects.
Maintain the diet and exercise plan agreed with the diabetes team.
Ask a pharmacist before altering or crushing the tablet.
metformin + sitagliptin side effects
Common or expected effects
- Nausea, vomiting, diarrhoea, abdominal discomfort, reduced appetite or wind.
- Metallic taste.
- Headache or dizziness.
- Reduced vitamin B12 levels, particularly with prolonged metformin exposure or other risk factors.
- Low blood glucose, especially with insulin or a sulphonylurea.
Get urgent medical advice
- Persistent severe abdominal pain, which may indicate acute pancreatitis.
- Symptoms of lactic acidosis, including vomiting, abdominal pain, muscle cramps, severe weakness, breathing difficulty or feeling cold.
- Facial or throat swelling, breathing difficulty, or a severe blistering or peeling rash.
- Markedly reduced urine or other signs of acute kidney injury during illness or dehydration.
metformin + sitagliptin in pregnancy
The fixed metformin–sitagliptin product should not be used during pregnancy because adequate pregnancy data for sitagliptin are lacking. Anyone pregnant or planning pregnancy should have treatment reviewed promptly by their diabetes or maternity team rather than stopping it without support.
metformin + sitagliptin while breastfeeding
The selected fixed combination is contraindicated during breastfeeding because transfer and safety information for sitagliptin are insufficient. Treatment should be reviewed with the prescriber.
metformin + sitagliptin interactions
Important interactions commonly involve kidney function, blood glucose or lactic-acidosis risk.
Insulin or sulphonylureas
Increase the risk of hypoglycaemia; clinical review and glucose monitoring are required.
Iodinated contrast agents
The medicine must be temporarily withheld around intravascular contrast procedures and restarted only after renal function is confirmed stable.
NSAIDs, ACE inhibitors, angiotensin-II receptor blockers and diuretics
Can worsen kidney function and increase metformin accumulation and lactic-acidosis risk.
Common questions about metformin + sitagliptin
Answers are fully visible for fast scanning and source review.
What is metformin + sitagliptin used for?
It improves blood-glucose control in adults with type 2 diabetes when suitable metformin-based treatment, diet and exercise have not been sufficient.
Why should it be taken with food?
Food helps reduce nausea, abdominal discomfort and other digestive effects associated with metformin.
Does it cause low blood sugar?
It is less likely by itself, but risk rises when combined with insulin or a sulphonylurea.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.