Komboglyze

• Komboglyze is a tablet medication used to lower blood sugar levels in people with type 2 diabetes
• Komboglyze works in several ways to help keep blood sugar levels within the normal range
• It contains two different medications, metformin and saxagliptin
• Komboglyze may be prescribed when metformin alone has not had the desired clinical effect
• It is important to read the patient leaflet for a full list of side effects and cautions.

Our bodies rely on insulin which is made by the pancreas. Insulin helps to control the amount of glucose (sugar) in the blood. If the body starts to make less insulin, our blood sugar levels are left to rise unchecked. In some people, the body has also stopped responding properly to any insulin that is being produced. The rising blood sugar levels will lead to diabetes.

High levels of glucose in the blood over a prolonged period can cause damage to the blood vessels, nerves, kidneys, and eyes. Some patients will eventually require amputation of extremities including the toes or feet. It is therefore very important to keep your blood glucose levels under control, even if you currently feel well.

The two medications in Komboglyze help to lower the blood sugar levels in different ways.

Metformin works in more than one way to control blood glucose levels. Its first mechanism of action is to prevent the liver from releasing too much sugar into the bloodstream. It also prompts the body to respond better to any insulin that is still naturally being produced. These actions combined help to lower blood sugar levels to a healthier range. 

Saxagliptin also has two modes of action. It stimulates the pancreas to make more insulin, helping to bring the blood sugar levels down. It also reduces the production of glucagon, which in turn prevents the liver from releasing as much sugar into the bloodstream. 

These actions combined help to lower blood sugar levels. After starting Komboglyze, it can take up to three months to see the full effect. It is therefore important to see this as a long term treatment and take your medication regularly.

Komboglyze is a tablet that is swallowed with some water. It is usually taken twice a day. Taking the tablet with a meal may help to prevent digestive side effects.

Komboglyze is available in two different strength tablets:

• 2.5mg/850mg tablets contain 2.5mg of saxagliptin and 850mg of metformin
• 2.5mg/1000mg tablets contain 2.5mg of saxagliptin and 1000mg of metformin.

Your dose will depend on your current medication and response to treatment so far. The maximum daily dose is 1 tablet twice daily.

Your dose may be lower if you have kidney disease (or impaired renal function).

Like all medications, Komboglyze can have some side effects. The most common side effects include:

• Upper respiratory tract infection (chest infection)
• Urinary tract infection
• Gastroenteritis (infection of the digestive system causing diarrhoea and vomiting)
• Sinusitis (infection of the sinuses)
• Nasopharyngitis (infections of the throat and nose)
• Headache
• Vomiting (being sick)
• Nausea (feeling sick)
• Rash.

If you think you have an infection, or the side effects persist, you should seek advice from your doctor promptly.

When taken with another anti-diabetic medication such as insulin or a sulphonylurea, Komboglyze may cause hypoglycaemia or a ‘hypo’ (low blood sugar levels). Hypos should be treated immediately with a sugary sweet or drink, and medical assistance. 

Occasionally, tablets containing metformin can cause more serious side effects including:

• Severe tiredness with fast or shallow breathing
• Feeling cold or having a slow heartbeat
• Jaundice (yellowing of the skin and whites of the eyes)
• Skin rashes
• Mouth ulcers, muscle weakness, or changes to your vision.

If these occur, speak to a doctor straight away.

Serious allergic reactions happen very rarely. If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip swelling or tongue swelling, call 999 immediately.

Komboglyze may not be suitable for everyone. You should tell your prescriber if you:

• Are hypersensitive to any of the ingredients
• Have ever had diabetic ketoacidosis (DKA)
• Have severe kidney disease
• Have heart failure
• Have respiratory (lung) failure
• Have recently had a heart attack
• Have liver disease
• Have alcohol dependence or alcoholism
• Are pregnant, trying to conceive, or breastfeeding – a different anti-diabetic medication should be prescribed if any of these apply.

Some medications can interact with Komboglyze. You may be advised that Komboglyze will not suit you if you already take:

• Diltiazem
• Rifampicin
• Cimetidine
• Ketoconazole
• Bronchodilators for asthma
• Steroids
• Carbamazepine
• Diuretics (‘water tablets’)
• NSAIDs (anti-inflammatory pain relief)
• Medications for high blood pressure.

If you are due to have imaging such as a CT scan that requires contrast to be injected, you should speak to your doctor as you may need to stop taking Komboglyze beforehand.

Because Komboglyze may not suit everyone, we will complete a Consultation with you including a health questionnaire. This will ensure that the medication will be suitable for you.

A qualified prescriber will review your current medications, including any herbal remedies or supplements, to ensure that Komboglyze will not interact with them. 

Once prescribed, Komboglyze will be ordered on your behalf via electronic prescription. Komboglyze will then be conveniently dispatched from one of our partner pharmacies.