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Kombiglyze XR (saxagliptin and metformin hydrochloride) is a prescription medication used to help control high blood sugar levels in adults with type 2 diabetes mellitus.
It contains two active ingredients, saxagliptin and metformin, which work together to improve blood sugar control.
Kombiglyze XR belongs to a class of medications called combination oral antidiabetic agents, also known as antihyperglycemic medications.
Type 2 diabetes is a chronic condition that develops when the body does not respond properly to insulin or cannot produce enough insulin to maintain normal blood sugar levels.
Insulin is a hormone produced by the pancreas that helps glucose move from the bloodstream into the body’s cells, where it can be used for energy.
When insulin does not work effectively, glucose can build up in the bloodstream, leading to high blood sugar levels.
Kombiglyze XR helps manage this condition by reducing glucose production in the liver, improving the body’s response to insulin, and supporting insulin release when blood sugar levels are elevated.
The medication is used alongside a healthy diet and regular physical activity to improve glycemic control in adults with type 2 diabetes.
According to its U.S. prescribing information, Kombiglyze XR is indicated as an additional treatment to diet and exercise for adults with type 2 diabetes mellitus.Â
Kombiglyze XR is primarily prescribed to manage type 2 diabetes, a condition that affects how the body processes glucose.
Glucose, commonly called blood sugar, is the body’s main source of energy.
After you eat, carbohydrates are broken down into glucose, which enters your bloodstream.
Your pancreas responds by releasing insulin. This hormone helps glucose move into muscle, fat, and other cells, where it can be used or stored.
However, in people with type 2 diabetes, this process does not work as effectively as it should.
Two major problems may develop: insulin resistance and reduced insulin production.
Insulin resistance occurs when the body’s cells do not respond properly to insulin.
As a result, glucose has difficulty moving from the bloodstream into the cells.
The pancreas may initially produce more insulin to compensate, but this response may become insufficient over time.
Consequently, blood sugar levels remain elevated.
Metformin, one of the active ingredients in Kombiglyze XR, helps improve the body’s response to insulin and reduces the amount of glucose released by the liver.
These effects help lower blood sugar levels, particularly between meals and overnight.
Reduced Insulin Production
As type 2 diabetes progresses, the pancreas may struggle to produce enough insulin to meet the body’s needs.
This can make it more difficult to control blood sugar levels after eating.
Saxagliptin, the other active ingredient in Kombiglyze XR, helps increase the activity of certain hormones called incretins.
Incretin hormones help the pancreas release insulin when blood sugar levels are elevated.
By increasing incretin activity, saxagliptin helps improve the body’s natural response to rising blood sugar levels.
Together, saxagliptin and metformin address different processes involved in type 2 diabetes.
Fasting blood sugar refers to the amount of glucose in your bloodstream after you have not eaten for several hours, usually overnight.
People with type 2 diabetes may experience high fasting blood sugar because the liver continues releasing glucose even when the body does not need additional energy.
Metformin helps reduce this excessive glucose production.
By limiting the amount of glucose released by the liver, Kombiglyze XR can help lower fasting blood sugar levels.
This action supports more consistent glucose control throughout the day.
However, the response to treatment varies depending on diet, physical activity, kidney function, and the severity of diabetes.
Your healthcare provider may recommend checking your fasting blood sugar to monitor treatment effectiveness.
Blood sugar naturally rises after eating because carbohydrates are digested and converted into glucose.
In people with type 2 diabetes, the body may not release enough insulin or respond effectively to insulin after meals.
This can cause blood sugar levels to remain elevated longer than normal.
Saxagliptin helps regulate this process by increasing the activity of incretin hormones.
These hormones signal the pancreas to release insulin when blood sugar levels rise.
Saxagliptin also helps reduce the release of glucagon, a hormone that tells the liver to release stored glucose.
By supporting insulin release and reducing unnecessary glucose production, saxagliptin helps lower blood sugar levels after meals.
This effect complements metformin’s action on liver glucose production and insulin sensitivity.
Kombiglyze XR may also help reduce glycated hemoglobin, commonly called HbA1c or A1C.
HbA1c is a blood test that reflects your average blood sugar levels over approximately the previous two to three months.
Healthcare providers use this test to evaluate how well diabetes treatment is working over time.
When blood sugar remains consistently high, more glucose attaches to hemoglobin, a protein found in red blood cells.
This causes HbA1c levels to increase.
By improving fasting and after-meal blood sugar control, Kombiglyze XR may help lower HbA1c levels.
Your healthcare provider will determine an appropriate HbA1c target based on your age, overall health, risk of low blood sugar, and other medical conditions.
For many nonpregnant adults, an HbA1c target below 7% may be appropriate, although individual targets can differ.
Regular HbA1c testing helps determine whether your diabetes treatment plan needs adjustment.
Kombiglyze XR combines two medications that lower blood sugar through different mechanisms.
Saxagliptin helps the pancreas respond to rising blood sugar levels, while metformin reduces glucose production in the liver and improves insulin sensitivity.
This combination can provide greater glucose-lowering effects than either medication alone in selected patients.
Saxagliptin: DPP-4 Inhibitor
Saxagliptin belongs to a class of medications called dipeptidyl peptidase-4 inhibitors, commonly known as DPP-4 inhibitors.
The body naturally produces hormones called incretins after eating.
Two important incretin hormones are glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).
These hormones help regulate blood sugar levels by stimulating insulin release when glucose levels are elevated.
However, an enzyme called DPP-4 normally breaks down incretin hormones quickly.
Saxagliptin blocks the DPP-4 enzyme, allowing incretin hormones to remain active for longer.
This produces two important effects.
First, saxagliptin increases glucose-dependent insulin release. When blood sugar rises after a meal, incretin hormones signal the pancreas to release more insulin.
Second, saxagliptin helps reduce glucagon secretion. Glucagon is a hormone that increases blood sugar by signalling the liver to release glucose.
By reducing unnecessary glucagon activity, saxagliptin helps limit glucose production by the liver.
Because saxagliptin’s insulin-stimulating effect depends on blood sugar levels, it generally has a lower risk of causing hypoglycemia when used without insulin or sulfonylureas.
However, low blood sugar may still occur when Kombiglyze XR is combined with other glucose-lowering medications.
Metformin: Biguanide Antidiabetic Medication
Metformin belongs to a class of medications called biguanides.
Its main effect is to reduce the amount of glucose produced by the liver.
The liver normally releases glucose between meals and overnight to maintain the body’s energy supply.
However, people with type 2 diabetes may produce excessive amounts of glucose, contributing to high blood sugar levels.
Metformin helps reduce this excessive glucose production through several cellular processes.
It also improves the body’s sensitivity to insulin, making it easier for cells to use glucose.
Additionally, metformin can influence how glucose is absorbed and processed in the intestines.
Unlike medications that directly stimulate insulin release, metformin does not normally cause the pancreas to produce additional insulin.
This means metformin alone generally has a low risk of causing hypoglycemia.
Kombiglyze XR combines two active ingredients, saxagliptin and metformin, that work together to target several factors contributing to high blood sugar levels in adults with type 2 diabetes. Each ingredient works through a different mechanism, helping improve blood sugar control throughout the day.
Saxagliptin belongs to a class of medications called DPP-4 inhibitors. It works by blocking the enzyme dipeptidyl peptidase-4 (DPP-4), which normally breaks down hormones called incretins. These hormones help the pancreas release insulin when blood sugar levels rise, particularly after meals. Saxagliptin also reduces the release of glucagon, a hormone that signals the liver to produce and release glucose. By increasing incretin activity, saxagliptin helps regulate insulin and glucagon levels, improving blood sugar control after eating.
Metformin belongs to a class of medications called biguanides. It primarily works by reducing excessive glucose production in the liver, which helps lower fasting blood sugar levels. Metformin also improves insulin sensitivity, allowing the body’s cells to respond more effectively to insulin and absorb glucose from the bloodstream for energy. These actions help prevent unnecessary glucose buildup and support more consistent blood sugar control.
When used together, saxagliptin and metformin provide complementary blood sugar-lowering effects. Saxagliptin helps the pancreas release insulin when blood sugar rises and reduces unnecessary glucagon secretion, while metformin limits glucose production in the liver and improves how efficiently the body uses insulin. Together, these mechanisms help manage both fasting and after-meal blood sugar levels, providing more comprehensive glucose control than either medication may achieve alone in some patients.
However, Kombiglyze XR does not cure type 2 diabetes. It helps manage the condition when taken regularly as prescribed. Maintaining a balanced diet, engaging in regular physical activity, monitoring blood sugar levels, and attending routine healthcare appointments remain important parts of diabetes management. Your healthcare provider will assess your response to treatment and determine whether any medication or lifestyle adjustments are necessary to maintain appropriate blood sugar control.
The letters XR stand for extended-release.
Kombiglyze XR contains extended-release metformin, which is designed to release gradually as the tablet passes through the digestive system.
This allows the combination medication to be taken once daily.
Kombiglyze XR is generally taken with the evening meal to help reduce digestive side effects associated with metformin.
The tablets must be swallowed whole.
Do not crush, cut, or chew them because this may interfere with the extended-release formulation.
Your healthcare provider will determine the appropriate strength based on your current diabetes medications, blood sugar levels, kidney function, and response to treatment.Â
Kombiglyze XR begins affecting blood sugar regulation after treatment starts, but the time needed to notice improvement varies.
Some people may experience lower blood sugar readings within the first several days.
However, achieving consistent blood sugar control may take several weeks, especially if your healthcare provider gradually adjusts your dosage.
HbA1c levels generally take longer to reflect treatment benefits because the test measures average blood sugar over approximately two to three months.
Your healthcare provider may recommend monitoring fasting and after-meal blood sugar levels to evaluate your response.
Do not increase your dosage if your blood sugar does not improve immediately.
Continue following your prescribed treatment plan and discuss persistent high blood sugar readings with your healthcare provider.
Kombiglyze XR is intended for adults with type 2 diabetes and is not recommended for treating type 1 diabetes or diabetic ketoacidosis.
Diabetic ketoacidosis is a serious medical emergency that requires immediate treatment.
Common side effects of the combination may include nausea, diarrhea, headache, and upper respiratory symptoms.
More serious risks include metformin-associated lactic acidosis, pancreatitis, and heart failure concerns associated with saxagliptin.
Lactic acidosis is a rare but potentially life-threatening condition involving excessive acid buildup in the blood. Seek emergency medical care if you develop unusual weakness, severe muscle pain, difficulty breathing, marked sleepiness, or significant abdominal discomfort.
Saxagliptin has also been associated with an increased risk of hospitalization for heart failure in clinical research. Tell your healthcare provider if you have heart failure or develop unusual shortness of breath, rapid weight gain, or swelling in your legs.
Kidney function should be assessed before starting Kombiglyze XR and periodically during treatment because impaired kidney function can increase the risk of medication-related complications.
Kombiglyze XR combines saxagliptin and metformin to help adults with type 2 diabetes control blood sugar through complementary mechanisms. Saxagliptin supports the body’s incretin response, while metformin reduces liver glucose production and improves insulin sensitivity.
Kombiglyze XR is a prescription medication used to help manage blood sugar levels in adults with type 2 diabetes.
It contains two active ingredients that work together to improve blood sugar control. Saxagliptin helps the pancreas release insulin when blood sugar levels are high, while metformin reduces glucose production in the liver and improves the body’s response to insulin.
Kombiglyze XR is an extended-release tablet taken by mouth once daily, usually with the evening meal. The extended-release formulation allows the metformin component to be released gradually as the tablet passes through the digestive system.
Taking Kombiglyze XR with food helps reduce digestive side effects, such as nausea, diarrhea, and stomach discomfort.
Swallow the tablet whole with water. Do not crush, cut, or chew it because doing so may interfere with the extended-release mechanism and change how the medication is absorbed.
Your healthcare provider will determine the appropriate dosage based on your blood sugar levels, kidney function, current diabetes medications, and response to treatment.
Follow these instructions to take Kombiglyze XR safely and effectively:
Kombiglyze XR works best when taken consistently as part of a diabetes management plan.
Do not take additional tablets if your blood sugar remains elevated unless your healthcare provider specifically instructs you to adjust your medication.
The recommended dosage of Kombiglyze XR depends on your current diabetes treatment, blood sugar control, kidney function, and how well you tolerate metformin.
Kombiglyze XR is available in several strengths containing different amounts of saxagliptin and extended-release metformin.
These include 2.5 mg/1,000 mg, 5 mg/500 mg, and 5 mg/1,000 mg tablets.
For adults with normal kidney function, the maximum recommended daily dosage is generally 5 mg of saxagliptin and 2,000 mg of extended-release metformin.
Your healthcare provider may start treatment with a lower metformin dose and increase it gradually to reduce gastrointestinal side effects.
However, the appropriate starting dosage depends on whether you already take metformin or another diabetes medication.
For example, someone already taking metformin may require a different starting strength than someone who has never taken it.
Kombiglyze XR is not recommended for initiation in people with an estimated glomerular filtration rate (eGFR) between 30 and 45 mL/min/1.73 m² and is contraindicated when eGFR is below 30 mL/min/1.73 m².
Additional dosage considerations apply when kidney function is reduced because saxagliptin and metformin can accumulate in the body.
Never change your dosage or switch between tablet strengths without consulting your healthcare provider.
Kombiglyze XR is generally taken with the evening meal to improve medication tolerability and help maintain a consistent dosing schedule.
Metformin, one of its active ingredients, commonly causes digestive symptoms when treatment begins.
These may include nausea, diarrhea, abdominal discomfort, and gas.
Taking the medication with food can help reduce these effects.
The extended-release formulation also allows metformin to be released gradually, which may improve gastrointestinal tolerability compared with some immediate-release formulations.
If you experience persistent stomach problems despite taking Kombiglyze XR with food, contact your healthcare provider.
Your healthcare provider may review your dosage, assess other possible causes, or recommend another treatment.
Do not change the timing of your medication without medical advice.
Kombiglyze XR is formulated to release metformin gradually over an extended period.
This design helps maintain medication availability throughout the day and allows once-daily administration.
Breaking, crushing, or chewing the tablet may interfere with this release mechanism.
As a result, the medication may not be released as intended, potentially increasing side effects or affecting blood sugar control.
Always swallow Kombiglyze XR tablets whole.
If your prescribed dose requires more than one tablet, take the tablets according to your healthcare provider’s instructions rather than splitting a larger tablet.
Some people may notice a soft, tablet-shaped material in their stool while taking extended-release metformin.
This can be the empty shell of the extended-release tablet and does not necessarily mean the medication was not absorbed.
If you have difficulty swallowing the tablet, ask your healthcare provider about other diabetes medications or formulations.
If you forget to take Kombiglyze XR, follow the missed-dose instructions provided by your healthcare provider.
According to the medication’s patient information, you should take your next dose as prescribed unless your healthcare provider instructs you otherwise.
Do not take an extra dose the following day to make up for a missed tablet.
Taking more Kombiglyze XR than prescribed may increase the risk of side effects, including gastrointestinal problems and metformin-related complications.
If you miss several doses or are unsure when to restart your medication, contact your pharmacist or healthcare provider.
Taking Kombiglyze XR at the same time each evening may help you remember your medication.Â
Maintaining adequate hydration is important when managing type 2 diabetes and taking medications containing metformin.
Dehydration may occur if you experience persistent vomiting, severe diarrhea, fever, or difficulty drinking enough fluids.
When your body becomes dehydrated, kidney function may temporarily decrease.
This is important because metformin is eliminated through the kidneys. Reduced kidney function can increase the risk of metformin accumulation and a rare but serious complication called lactic acidosis.
Drink adequate fluids throughout the day unless your healthcare provider has recommended fluid restrictions because of heart disease, kidney problems, or another medical condition.
Drinking excessive amounts of water does not make Kombiglyze XR more effective at lowering blood sugar.
If you experience severe vomiting, diarrhea, dehydration, or an illness that prevents normal eating and drinking, contact your healthcare provider promptly. You may need temporary instructions for managing your diabetes medications.
Taking Kombiglyze XR consistently helps support ongoing blood sugar control.
Type 2 diabetes develops when the body becomes resistant to insulin or cannot produce enough insulin to maintain normal blood glucose levels.
Kombiglyze XR combines two medications that address different causes of high blood sugar.
Saxagliptin helps increase the activity of incretin hormones, which support insulin release when blood sugar levels rise and help reduce glucagon secretion.
Metformin reduces excessive glucose production in the liver and improves the body’s response to insulin.
Together, these medications help lower fasting and after-meal blood sugar levels.
However, Kombiglyze XR does not permanently cure type 2 diabetes.
Continue taking it regularly, even if your blood sugar readings improve, unless your healthcare provider recommends changing treatment.
Consistent medication use, balanced nutrition, physical activity, and regular blood sugar monitoring all contribute to effective long-term diabetes management.
Kombiglyze XR may be prescribed alongside certain other diabetes medications when additional blood sugar control is needed.
However, combining glucose-lowering medications may increase the risk of hypoglycemia, particularly when Kombiglyze XR is taken with insulin or a sulfonylurea.
Hypoglycemia occurs when blood sugar levels become too low.
Possible symptoms include sweating, trembling, dizziness, sudden hunger, headache, confusion, and a rapid heartbeat.
Your healthcare provider may recommend adjusting the dose of insulin or a sulfonylurea to reduce this risk.
Other medications may also affect the safety or effectiveness of Kombiglyze XR.
For example, certain medications that strongly inhibit the CYP3A4/5 enzyme can increase saxagliptin exposure and may require a lower saxagliptin dose.
Tell your healthcare provider about all prescription medications, over-the-counter drugs, vitamins, and herbal supplements you use.
Do not begin taking another diabetes medication or change your current treatment without medical advice.
Kombiglyze XR can cause side effects ranging from mild digestive discomfort to rare but serious complications.
Metformin commonly causes nausea, diarrhea, and abdominal discomfort, particularly when treatment begins or the dosage increases.
More serious concerns include lactic acidosis, a rare condition in which lactic acid accumulates in the bloodstream.
Symptoms may include unusual weakness, muscle pain, difficulty breathing, excessive sleepiness, and significant abdominal discomfort.
Saxagliptin has also been associated with pancreatitis, serious allergic reactions, and an increased risk of hospitalization for heart failure in certain patients.
Contact your healthcare provider promptly if you develop persistent abdominal pain, unexplained swelling, rapid weight gain, or unusual shortness of breath.
Seek emergency medical attention if you develop symptoms suggesting lactic acidosis.
Your healthcare provider may also temporarily stop Kombiglyze XR before certain imaging procedures involving iodinated contrast or during situations that increase the risk of dehydration or reduced kidney function.
Contact your healthcare provider if you experience persistent nausea, diarrhea, dizziness, unusual fatigue, or difficulty maintaining your recommended blood sugar levels.
Tell your healthcare provider if you develop kidney problems, become dehydrated, experience significant changes in your eating habits, or begin taking new medications.
Seek urgent medical evaluation if you experience severe abdominal pain that may spread to your back, particularly if accompanied by vomiting.
Seek emergency medical care if you experience severe weakness, difficulty breathing, marked drowsiness, or other symptoms suggesting lactic acidosis.
Kombiglyze XR should be taken once daily with the evening meal, swallowed whole, and used consistently as prescribed. Following your medication schedule, maintaining a balanced diet, staying appropriately hydrated, and monitoring blood sugar levels can help improve diabetes control while reducing the risk of treatment-related complications.
Kombiglyze XR (Metformin/Saxagliptin) is available in the following forms and strength:
Kombiglyze XR is a prescription medication used to improve blood sugar control in adults with type 2 diabetes mellitus.
It contains two active ingredients that work together to lower blood sugar levels. Saxagliptin is a DPP-4 inhibitor that helps the pancreas release insulin when blood sugar is elevated. Metformin is a biguanide that reduces glucose production in the liver and improves the body’s response to insulin.
Although Kombiglyze XR can help manage type 2 diabetes, it may cause side effects or serious complications in certain individuals.
Before starting treatment, tell your healthcare provider about your medical history, particularly if you have kidney disease, heart failure, liver problems, or a history of pancreatitis.
Understanding these warnings and precautions can help you recognize possible complications and use Kombiglyze XR safely.
Kombiglyze XR may increase the risk of pancreatitis, a condition that causes inflammation of the pancreas.
The pancreas is an organ located behind the stomach. It produces digestive enzymes that help break down food and hormones, including insulin and glucagon, that regulate blood sugar levels.
Pancreatitis develops when the pancreas becomes inflamed, causing pain and potentially interfering with normal digestive functions.
Cases of acute pancreatitis have been reported in people taking saxagliptin, one of the active ingredients in Kombiglyze XR.
The exact relationship between saxagliptin and pancreatitis is not fully understood. However, pancreatitis is an important warning associated with this medication.
Possible symptoms include:
Pancreatitis can become serious and may require hospital treatment.
Tell your healthcare provider if you have previously experienced pancreatitis, gallstones, or other pancreatic problems.
Stop taking Kombiglyze XR and seek immediate medical attention if you develop severe, persistent abdominal pain, particularly if the pain spreads to your back or occurs with vomiting.
Your healthcare provider will assess whether pancreatitis is present and determine whether another diabetes medication is needed.Â
Kombiglyze XR contains saxagliptin, which has been associated with an increased risk of hospitalization for heart failure in clinical studies.
Heart failure occurs when the heart cannot pump blood effectively enough to meet the body’s needs.
This does not necessarily mean the heart has stopped working. Instead, the heart may struggle to circulate blood efficiently, causing fluid to accumulate in the lungs, legs, or other parts of the body.
People with existing heart disease or impaired kidney function may be at greater risk of complications.
Possible symptoms of heart failure include:
These symptoms should not be ignored, especially if they develop after starting Kombiglyze XR.
Tell your healthcare provider if you have heart failure, coronary artery disease, or kidney disease before beginning treatment.
Your healthcare provider will consider your cardiovascular risk factors and determine whether Kombiglyze XR is appropriate.
Contact your healthcare provider promptly if you develop new swelling, rapid weight gain, or worsening shortness of breath.
Seek emergency medical attention if you experience severe difficulty breathing, chest pain, or fainting.
Lactic acidosis is a rare but potentially life-threatening complication associated with metformin, one of the active ingredients in Kombiglyze XR.
It occurs when lactic acid accumulates in the bloodstream faster than the body can remove it.
Lactic acid is normally produced during metabolism. The body usually processes and removes it without difficulty.
However, certain medical conditions may interfere with this process or cause metformin to accumulate in the body.
When lactic acid levels become excessively high, the blood becomes too acidic. This can affect the heart, kidneys, and other vital organs.
Possible symptoms include:
The risk of lactic acidosis increases in people with significant kidney impairment, liver disease, dehydration, severe infections, or conditions that reduce oxygen delivery to body tissues.
Excessive alcohol consumption may also increase the risk.
Lactic acidosis is a medical emergency. If you develop symptoms suggesting this condition, stop taking Kombiglyze XR and seek emergency medical attention immediately.
Kombiglyze XR carries an FDA boxed warning about metformin-associated lactic acidosis because of its potential severity.Â
Kombiglyze XR should be used cautiously in people with kidney disease or reduced kidney function.
The kidneys are responsible for removing metformin and a substantial amount of saxagliptin-related drug material from the body.
When kidney function decreases, these medications may accumulate in the bloodstream.
Metformin accumulation is particularly concerning because it increases the risk of lactic acidosis.
It is important to understand that Kombiglyze XR does not commonly cause direct kidney damage. The main concern is that existing or newly developed kidney impairment may make the medication less safe.
Your healthcare provider will assess your kidney function before starting Kombiglyze XR and periodically during treatment.
Kidney function is commonly evaluated using a blood test that estimates the glomerular filtration rate, known as eGFR.
The prescribing information provides the following recommendations:
Your healthcare provider may also recommend more frequent kidney testing if you are older or have additional risk factors for kidney problems.
Tell your healthcare provider if you develop persistent vomiting, diarrhea, dehydration, or an illness that may affect kidney function.
These conditions may temporarily increase the risk of metformin-related complications.
Do not adjust your medication dosage without medical advice.
Kombiglyze XR may increase the risk of hypoglycemia, particularly when taken with insulin or certain other diabetes medications.
Hypoglycemia occurs when blood sugar levels fall below the normal range, commonly defined as less than 70 mg/dL (3.9 mmol/L).
The saxagliptin and metformin combination generally has a low risk of causing hypoglycemia when used without medications that directly increase insulin levels.
However, the risk becomes greater when Kombiglyze XR is combined with insulin or sulfonylureas, such as glimepiride or gliclazide.
Possible symptoms include:
Severe hypoglycemia may cause seizures, loss of consciousness, or an inability to swallow safely.
If your blood sugar is below 70 mg/dL (3.9 mmol/L) and you are awake and able to swallow, follow your healthcare provider’s hypoglycemia treatment plan.
A common approach is to consume approximately 15 grams of fast-acting carbohydrates, wait 15 minutes, and recheck your blood sugar.
If your blood sugar remains low, repeat the treatment.
Seek emergency assistance if someone becomes unconscious, has a seizure, or cannot safely swallow. Never give food or drinks by mouth to an unconscious person.
Your healthcare provider may adjust your insulin or sulfonylurea dosage to reduce the risk of hypoglycemia while taking Kombiglyze XR.
Kombiglyze XR may cause digestive side effects, particularly during the first few weeks of treatment.
These symptoms are primarily associated with the metformin component.
Metformin affects glucose processing in the liver and intestines. It can also influence normal digestive activity, which may contribute to gastrointestinal discomfort.
Common symptoms include nausea, diarrhea, abdominal pain, gas, and stomach upset.
These effects are often more noticeable when treatment begins or the dosage increases.
For many people, digestive symptoms improve as the body adjusts to the medication.
Taking Kombiglyze XR with the evening meal may help reduce stomach irritation.
The extended-release formulation is also designed to release metformin gradually, which may improve digestive tolerability for some individuals.
However, persistent vomiting or severe diarrhea can lead to dehydration.
Dehydration may reduce kidney function and increase the risk of metformin accumulation.
Contact your healthcare provider if digestive symptoms become severe, persistent, or interfere with your ability to eat and drink normally.
Do not increase or decrease your dosage without medical advice.
Tell your healthcare provider if you have liver disease or a history of abnormal liver function tests before taking Kombiglyze XR.
The liver plays an important role in processing nutrients, maintaining blood sugar levels, and clearing lactate from the bloodstream.
When liver function becomes significantly impaired, the body’s ability to process lactate may decrease.
This can increase the risk of lactic acidosis in people taking metformin.
Although Kombiglyze XR is not primarily known for causing common direct liver damage, existing liver impairment is an important safety concern.
The official prescribing information recommends avoiding Kombiglyze XR in patients with hepatic impairment because of the increased risk of lactic acidosis.
Possible symptoms of liver problems include yellowing of the skin or eyes, dark urine, persistent nausea, abdominal discomfort, and unusual fatigue.
Tell your healthcare provider if you have cirrhosis, hepatitis, or another liver condition.
Your healthcare provider may recommend a different diabetes treatment if Kombiglyze XR is not appropriate for your medical condition.
Long-term use of Kombiglyze XR may increase the risk of vitamin B12 deficiency because it contains metformin.
Vitamin B12 is an essential nutrient that helps maintain healthy red blood cells, nerve function, and normal DNA production.
Metformin can interfere with vitamin B12 absorption in the digestive system.
Over time, this may cause vitamin B12 levels to decrease, particularly in people who already have low vitamin B12 intake or absorption problems.
Possible symptoms include:
Vitamin B12 deficiency can sometimes cause nerve symptoms that resemble diabetic peripheral neuropathy.
This makes it important to investigate new or worsening numbness or tingling rather than assuming diabetes is the only cause.
Your healthcare provider may recommend periodic blood tests to check for anemia and vitamin B12 deficiency.
Vitamin B12 levels may need to be measured more frequently if you have symptoms or risk factors for deficiency.
If your levels are low, your healthcare provider may recommend dietary changes or vitamin B12 supplementation.
Tell your healthcare provider or surgeon if you are taking Kombiglyze XR before undergoing surgery or another medical procedure.
Certain procedures may require you to stop eating or drinking temporarily.
Surgery can also affect hydration, blood pressure, kidney function, and oxygen delivery to the body’s tissues.
These changes may increase the risk of metformin-associated lactic acidosis.
For this reason, your healthcare provider may recommend temporarily stopping Kombiglyze XR before or during certain procedures.
The timing depends on the type of surgery, your kidney function, and how quickly you are expected to resume normal eating and drinking.
Your healthcare provider will explain when to stop the medication and when it is safe to restart.
Do not make these changes independently unless you have received specific instructions.
Kombiglyze XR may also need to be temporarily discontinued before certain imaging tests that use iodinated contrast dye.
These tests may include some CT scans and angiography procedures.
Iodinated contrast can occasionally affect kidney function.
If kidney function decreases, metformin may accumulate and increase the risk of lactic acidosis.
According to prescribing information, Kombiglyze XR should be stopped at or before iodinated contrast administration in certain higher-risk situations, including patients with eGFR between 30 and 60 mL/min/1.73 m², liver disease, alcoholism, heart failure, or when contrast is administered through an artery.
Kidney function is generally reassessed approximately 48 hours after the procedure, and treatment is restarted only when kidney function is stable.
Tell your healthcare provider if you are scheduled for an imaging procedure involving contrast dye.Â
Some people may experience allergic reactions to saxagliptin, metformin, or another ingredient in Kombiglyze XR.
A serious allergic reaction may involve the skin, face, mouth, throat, or respiratory system.
Possible symptoms include:
Rare serious reactions associated with saxagliptin include anaphylaxis, angioedema, and severe skin reactions.
Angioedema causes swelling beneath the skin, particularly around the face, lips, and throat.
Anaphylaxis is a severe allergic reaction that can become life-threatening.
Stop taking Kombiglyze XR and seek emergency medical attention if you experience difficulty breathing, swelling of the tongue or throat, or symptoms of anaphylaxis.
Tell your healthcare provider if you have previously experienced a serious allergic reaction to saxagliptin, metformin, or another DPP-4 inhibitor.
Saxagliptin belongs to the DPP-4 inhibitor class of medications, which has been associated with rare cases of severe joint pain and a blistering skin condition called bullous pemphigoid.
Severe Joint Pain
Some people taking DPP-4 inhibitors have developed severe and disabling joint pain.
The pain may affect one or several joints and can interfere with walking, working, or completing everyday activities.
Symptoms may begin shortly after starting treatment or develop after months or years of use.
Contact your healthcare provider if you experience new, severe, or persistent joint pain while taking Kombiglyze XR.
Your healthcare provider may determine whether the medication is contributing to your symptoms.
Bullous pemphigoid is a skin condition that causes large, fluid-filled blisters.
It develops when the immune system mistakenly attacks structures that help hold the layers of the skin together.
Symptoms may include persistent itching, red patches, and tense blisters that can rupture and leave painful areas.
Cases requiring hospitalization have been reported in patients taking DPP-4 inhibitors.
Contact your healthcare provider promptly if you develop unexplained blisters or skin erosions.
Your healthcare provider may stop Kombiglyze XR and arrange further evaluation if bullous pemphigoid is suspected.Â
Contact your healthcare provider if you experience persistent nausea, diarrhea, unusual fatigue, low blood sugar episodes, swelling in your feet, or new joint pain while taking Kombiglyze XR.
Tell your healthcare provider if you develop kidney problems, become dehydrated, experience worsening heart failure symptoms, or have an upcoming surgical or imaging procedure.
Seek immediate medical attention if you develop severe, persistent abdominal pain that may indicate pancreatitis.
Seek emergency medical care if you experience symptoms of lactic acidosis, severe difficulty breathing, chest pain, fainting, or a serious allergic reaction.
These symptoms may indicate a potentially life-threatening condition requiring urgent evaluation.
No. Kombiglyze XR is approved for treating adults with type 2 diabetes mellitus. It is not approved or recommended for treating type 1 diabetes. Type 1 diabetes is an autoimmune condition in which the immune system attacks the insulin-producing cells in the pancreas. As a result, the body produces little or no insulin. People with type 1 diabetes need insulin therapy to control their blood sugar levels and prevent serious complications. Kombiglyze XR contains two medications that work differently. Saxagliptin helps the pancreas release more insulin when blood sugar levels are elevated, while metformin reduces glucose production in the liver and improves the body’s response to insulin. These effects can help manage type 2 diabetes, but they cannot replace the insulin treatment required by people with type 1 diabetes. Kombiglyze XR is also not intended to treat diabetic ketoacidosis (DKA), a serious condition caused by insufficient insulin and the buildup of acids called ketones in the bloodstream. If you have type 1 diabetes, do not use Kombiglyze XR as a substitute for insulin. Your healthcare provider will recommend a treatment plan based on your specific diabetes diagnosis and medical needs.
Kombiglyze XR may be appropriate for some people with mild kidney impairment, but its use depends on how well their kidneys are functioning. The kidneys are responsible for removing metformin and saxagliptin-related substances from the body. When kidney function decreases, these medications may accumulate in the bloodstream and increase the risk of side effects. Metformin accumulation is particularly concerning because it can increase the risk of lactic acidosis, a rare but potentially life-threatening condition involving excessive acid buildup in the blood. Before prescribing Kombiglyze XR, your healthcare provider will assess your kidney function using a blood test called the estimated glomerular filtration rate (eGFR). Kombiglyze XR should not be used in people with severe kidney impairment, defined as an eGFR below 30 mL/min/1.73 m². Starting treatment is also not recommended when eGFR is between 30 and 45 mL/min/1.73 m². If kidney function decreases below an eGFR of 45 during treatment, your healthcare provider will reassess whether Kombiglyze XR remains appropriate. A change in medication or dosage may be necessary. Your healthcare provider may recommend regular blood tests to monitor kidney function and ensure treatment remains safe. Do not adjust your Kombiglyze XR dosage without medical advice. If you have kidney disease, tell your healthcare provider before starting treatment.
Kombiglyze XR may begin lowering blood sugar levels within the first few days of treatment. However, the time needed to achieve noticeable and consistent blood sugar control varies from person to person. Kombiglyze XR contains two active ingredients, saxagliptin and metformin, which work together to manage high blood sugar levels in adults with type 2 diabetes. Saxagliptin helps the pancreas release insulin when blood sugar levels rise, particularly after meals. It also reduces the release of glucagon, a hormone that signals the liver to produce more glucose. Metformin works by reducing excessive glucose production in the liver and improving the body’s sensitivity to insulin. These effects help lower fasting and after-meal blood sugar levels. Some people may notice improvements in their daily blood sugar readings within several days. However, achieving stable blood sugar control may take several weeks, particularly if your healthcare provider gradually increases your dosage. Your HbA1c level, which reflects average blood sugar over approximately two to three months, takes longer to show the full benefits of treatment. Your healthcare provider may recommend regular blood sugar monitoring and repeat HbA1c testing to evaluate how well Kombiglyze XR is working. Continue taking Kombiglyze XR exactly as prescribed, even if your blood sugar readings begin improving. Do not increase your dosage or stop treatment without consulting your healthcare provider.
Kombiglyze XR should generally be avoided in people with liver impairment because of the increased risk of a serious complication called lactic acidosis. Lactic acidosis occurs when lactic acid builds up in the bloodstream faster than the body can remove it. Although this condition is rare, it can be life-threatening. Metformin, one of the active ingredients in Kombiglyze XR, can increase the risk of lactic acidosis in certain circumstances. The liver normally helps remove lactate from the bloodstream. However, when liver function becomes impaired, the body’s ability to process lactate may decrease. This may increase the risk of lactic acidosis, particularly in people with significant liver disease. Possible symptoms of lactic acidosis include unusual weakness, muscle pain, difficulty breathing, severe tiredness, abdominal discomfort, and feeling unusually cold. If you have cirrhosis, hepatitis, or another condition affecting liver function, tell your healthcare provider before starting Kombiglyze XR. Your healthcare provider may recommend a different diabetes medication rather than simply adjusting the Kombiglyze XR dosage. This distinction is important because the official prescribing information recommends avoiding Kombiglyze XR in patients with hepatic impairment, rather than relying on dose reduction alone. Seek emergency medical attention if you develop symptoms suggesting lactic acidosis while taking Kombiglyze XR.
| Generic name: | Metformin/Saxagliptin |
|---|---|
| Formulation: | Tablet |
| Strength(s): | 2.5/1000mg, 5/500mg |
| Quantities Available: | 56, 84, 112 |
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When ordering Kombiglyze XR (metformin/saxagliptin) from a Canadian pharmacy, you can typically purchase up to a 90-day supply at one time, which is common for prescription medications to ensure adequate management of chronic conditions without frequent refills.
Here’s what you need to know:
Dosage and Quantity: Kombiglyze XR is commonly prescribed in dosages of 2.5/1000 mg, 5/500 mg, or 5/1000 mg, taken once daily. For a 90-day supply, this means you would order 90 tablets (90 days x 1 tablet per day).
No, we do not sell metformin/saxagliptin directly on our website. However, you can still enjoy low prices on Kombiglyze XR, which contains metformin/saxagliptin as active ingredients. To purchase Kombiglyze XR, you will need a valid prescription from your healthcare provider. We require this prescription to dispense the medication safely and appropriately. You can submit your prescription by mailing it to us, faxing it, or uploading it through your online account.
Yes, we ship Kombiglyze XR (metformin/saxagliptin) to both the United States and Puerto Rico.
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Online Pharmacies Canada has provided information from third parties intended to increase awareness and does not contain all the information about Kombiglyze XR (Metformin/Saxagliptin). Talk to your doctor or other qualified medical practitioners for medical attention or advice, or if you have any concerns about Kombiglyze XR (Metformin/Saxagliptin).
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