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Steglujan
Steglujan is a combination medication containing ertugliflozin and sitagliptin, used to help control blood sugar levels in adults with type 2 diabetes mellitus. Ertugliflozin is a SGLT2 inhibitor that helps lower blood sugar by causing the kidneys to remove glucose from the body through urine, while sitagliptin is a DPP-4 inhibitor that helps increase insulin production and decrease the liver’s glucose production. Together, these two medications help improve blood sugar control, especially when combined with diet and exercise.
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Frequently Asked Questions
How long does it take for Steglujan to start working?
You may start to see improvements in blood sugar levels within a few days to a few weeks of starting Steglujan. Full effects may take longer, and regular monitoring of blood sugar is essential.
Can Steglujan cause weight loss?
Some patients may experience mild weight loss while taking Steglujan, primarily due to the ertugliflozin component, which helps remove excess glucose through urine.
What should I do if I miss a dose of Steglujan?
If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once.
Can I take Steglujan with other diabetes medications?
Yes, Steglujan can be taken alongside other diabetes medications, but care must be taken to avoid the risk of low blood sugar (hypoglycemia), especially when used with insulin or sulfonylureas.
Is Steglujan safe for long-term use?
Steglujan is generally considered safe for long-term use in patients with type 2 diabetes, but regular monitoring of kidney function, blood sugar, and other vital signs is important.
Comprehensive Drug Guide
How Does Steglujan Work?
- Ertugliflozin: An SGLT2 inhibitor that works by preventing glucose reabsorption in the kidneys, leading to increased glucose excretion in the urine and lower blood sugar levels.
- Sitagliptin: A DPP-4 inhibitor that increases insulin production and decreases the liver’s glucose production by preventing the breakdown of incretin hormones.
Together, these mechanisms help improve glycemic control in individuals with type 2 diabetes by reducing blood sugar levels.
Common Dosages
- 5 mg ertugliflozin / 100 mg sitagliptin
- 15 mg ertugliflozin / 100 mg sitagliptin
Typical Dosing
- The usual starting dose of Steglujan is 5 mg ertugliflozin / 100 mg sitagliptin once daily.
- The dose can be increased to 15 mg ertugliflozin / 100 mg sitagliptin once daily based on glycemic control and tolerability.
- Steglujan should be taken in the morning, with or without food.
Typical Dosing
FDA Approved Indications
- Improving glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise.
Who Shouldn't Take Steglujan?
- Severe kidney impairment (eGFR below 30 mL/min/1.73 m²).
- Type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.
- Known hypersensitivity to ertugliflozin, sitagliptin, or any component of the formulation.
Advice From The Pharmacist
- Take Steglujan once daily, preferably in the morning, with or without food.
- Stay hydrated, as ertugliflozin can increase urination and may lead to dehydration. Be sure to drink plenty of water throughout the day.
- Monitor blood sugar levels regularly, especially when starting Steglujan or adjusting the dose. Report any unusual symptoms to your healthcare provider.
- Avoid alcohol consumption, as it can increase the risk of lactic acidosis or other side effects.
- If you miss a dose, take it as soon as you remember. If it’s close to your next dose, skip the missed dose and take the next one at your usual time. Do not double up on doses.
Side Effects of Steglujan
Common Side Effects
- Increased urination
- Genital yeast infections
- Urinary tract infections
- Nasopharyngitis (common cold symptoms)
- Headache
Uncommon/Severe Side Effects
- Ketoacidosis: Even when blood sugar levels are not very high, patients taking SGLT2 inhibitors like ertugliflozin may develop diabetic ketoacidosis, a serious condition requiring immediate medical attention.
- Pancreatitis: Sitagliptin has been associated with an increased risk of pancreatitis. Symptoms include severe abdominal pain, nausea, and vomiting.
- Dehydration: Excessive urination may lead to dehydration, particularly in older adults.
- Serious allergic reactions: Signs of allergic reactions, such as rash, hives, swelling, or difficulty breathing, require immediate medical attention.
Risks and Warnings of Steglujan
- Ketoacidosis: Patients should be aware of the symptoms of ketoacidosis, such as nausea, vomiting, abdominal pain, and shortness of breath, and seek medical attention immediately if these occur.
- Pancreatitis: Sitagliptin may increase the risk of pancreatitis. Discontinue Steglujan and contact your healthcare provider if severe abdominal pain occurs.
- Urinary tract infections and genital yeast infections: Ertugliflozin increases the risk of these infections due to the higher amount of glucose in the urine. Report any symptoms, such as burning during urination or unusual discharge, to your healthcare provider.
- Kidney function monitoring: Kidney function should be monitored before and during treatment with Steglujan, especially in patients with pre-existing kidney conditions.
Interactions with Steglujan
Common Drug Interactions
- Diuretics: Using Steglujan with diuretics can increase the risk of dehydration and low blood pressure due to increased urination.
- Insulin or sulfonylureas: Combining Steglujan with insulin or sulfonylureas (e.g., glipizide) can increase the risk of hypoglycemia (low blood sugar).
- ACE inhibitors or ARBs: These medications, used for high blood pressure or heart conditions, may increase the risk of kidney problems when combined with Steglujan.
Alternatives to Steglujan
- Januvia (sitagliptin): A DPP-4 inhibitor used to manage blood sugar levels in type 2 diabetes.
- Steglatro (ertugliflozin): An SGLT2 inhibitor used to improve blood sugar control in type 2 diabetes.
- Xigduo XR (dapagliflozin/metformin): A combination of an SGLT2 inhibitor and metformin for type 2 diabetes management.
- Jardiance (empagliflozin): Another SGLT2 inhibitor used to lower blood sugar in type 2 diabetes and reduce cardiovascular risk.
