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" What is\u00A0Komboglyze used for?   Type 2 diabetes.  Komboglyze tablets are licensed for use in people with type 2 diabetes whose blood sugar is not controlled by the maximum tolerated dose of metformin alone, or who are already taking metformin and saxagliptin as separate tablets. They are also licensed for use in combination with a sulphonylurea (eg gliclazide), when one of these combined with metformin has not controlled blood sugar well enough. Komboglyze tablets may also be used in combination with insulin. How does\u00A0Komboglyze work? Komboglyze tablets contain two active ingredients, metformin and saxagliptin.\u00A0 Metformin is a type of antidiabetic medicine known as a biguanide. It works in a number of ways to decrease the amount of sugar in the blood. Firstly, it reduces the amount of sugar produced by cells in the liver. Secondly, it increases the sensitivity of muscle cells to insulin. This enables these cells to remove sugar from the blood more effectively. Finally, it also delays absorption of sugar from the intestines into the bloodstream after eating. Saxagliptin is a type of antidiabetic medicine known as a dipeptidyl peptidase-4 (DPP-4) inhibitor. It helps to reduce blood sugar levels by preventing the breakdown of two incretin hormones, called glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). These hormones are normally produced naturally by the body in response to food intake. They stimulate the pancreas to produce insulin in response to increasing levels of glucose in the blood, and they also reduce the production of glucagon, which is a hormone that normally increases glucose production by the liver. These actions help control blood sugar levels.  This combination of medicines helps control blood sugar levels both directly after meals and between meals.   How do I take\u00A0Komboglyze?  One Komboglyze tablet should be taken twice a day, morning and evening.  The tablets should be taken with a meal.  If you forget to take a dose of\u00A0Komboglyze, take it with your next meal, unless you were due to take a tablet then anyway. In this case just take the dose you are due to take as usual and leave out the forgotten tablet. Do not take a double dose to make up for a missed tablet.  What should I know before taking\u00A0Komboglyze?  It is important that you continue to follow the diet and exercise advice given to you by your doctor or nurse while you are taking\u00A0Komboglyze. This medicine only helps to control your blood sugar levels and should not be used as a substitute for eating healthily and taking regular exercise.    Hypoglycaemia\u00A0(low blood glucose) has been commonly reported when\u00A0Komboglyze is used in combination with sulphonylurea medicines, eg gliclazide or glibenclamide, or with insulin. Symptoms of hypoglycaemia usually occur suddenly and may include cold sweats, cool pale skin, tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, excessive hunger, temporary vision changes, headache, nausea and palpitations. You should talk to your doctor or diabetes specialist about this and make sure you know what to do if you experience these symptoms.  Your ability to concentrate or react may be reduced if you have low blood sugar, and this can cause problems driving or operating machinery. You should take precautions to avoid low blood sugar when driving - discuss this with your doctor. This medicine may also cause dizziness, and if affected you should take care when driving or operating machinery.  Your doctor may want you to check your\u00A0blood sugar level from time to time while you are taking\u00A0Komboglyze. Make sure you discuss how to do this and how often with your GP, pharmacist or diabetes specialist.  You should\u00A0avoid drinking alcohol while you are taking\u00A0Komboglyze, as it can increase the risk of low blood sugar (hypoglycaemia) and lactic acidosis (see below). Metformin can cause a rare but serious condition called lactic acidosis, which is an excess of lactic acid in the blood. It is more likely to occur in people with decreased kidney function. Drinking excessive amounts of alcohol while taking this medicine, particularly on an empty stomach or if you have liver problems, can also increase the risk of lactic acidosis. Your doctor will monitor you for this side effect, but symptoms that might indicate its development include rapid and/or deep breathing and non-specific symptoms such as feeling weak, sick or generally unwell, vomiting, abdominal pain, or unusual muscle pains or discomfort. You should stop taking this medicine and consult your doctor if you experience any of these.   Your kidney function should be monitored regularly while you are taking\u00A0Komboglyze. Your doctor will usually want to check your kidney function once or twice a year, or more frequently if you are elderly or have any existing kidney problems. Your doctor will ask you to stop taking this medicine temporarily if you are going to have a certain type of X-ray involving an injection of iodinated dye (contrast agent). Tell your doctor that you are taking this medicine if you are due to have this type of X-ray. You should not start taking this medicine again until 48 hours after the X-ray, and only after your kidney function has been tested and found to be normal. Consult your doctor about your diabetes treatment if you are due to have surgery under a general or an epidural anaesthetic. In these situations blood sugar is normally controlled by insulin, so your doctor may ask you to stop taking this medicine 48 hours before surgery.  People with diabetes have a higher risk of developing foot ulcers and blistering of the skin. It is therefore important to have a good foot care routine. Consult your doctor if you get any new blisters or ulcers while taking this medicine. A few cases of inflammation of the pancreas (acute pancreatitis) have been reported in people taking saxagliptin and other medicines of this type. Symptoms of pancreatitis include unexplained, persistent, severe abdominal pain, sometimes spreading to the back. You should tell your doctor if you experience these symptoms while taking this medicine, so they can be investigated.   Who shouldn&amp;#039;t take\u00A0Komboglyze?  People with\u00A0type 1 diabetes. People with\u00A0diabetic keto-acidosis\u00A0(due to severe and inadequately treated diabetes). People with moderate to severely decreased kidney function. People with\u00A0liver problems. People with acute\u00A0heart failure\u00A0or\u00A0who have recently had a heart attack. People with conditions that cause breathing to be ineffective, ie to not effectively oxygenate the blood or remove carbon dioxide from the lungs (respiratory failure). People with reduced blood flow to vital internal organs (shock). People with severe infections or blood poisoning (sepsis). People who are dehydrated. People who drink large amounts of alcohol or who suffer from\u00A0alcoholism. Women who are\u00A0pregnant\u00A0or\u00A0breastfeeding. People who are allergic to any ingredient of the medicine.  People who have had a serious allergic reaction to another DPP4 inhibitor, eg sitagliptin, vildagliptin. Komboglyze is not recommended for children and adolescents under 18 years of age, because its safety and effectiveness have not been established in this age group.  Komboglyze should be used with caution in  People over 75 years of age. People with an underactive immune system, either due to a disease or a treatment.  Can I take\u00A0Komboglyze while pregnant or\u00A0breastfeeding?  The safety of saxagliptin for use during pregnancy has not been established. It should not be used during pregnancy. Diabetes mellitus is usually controlled using insulin during pregnancy, because this provides a more stable control of blood sugar. Metformin many also sometimes be used. However, as Komboglyze contains a combination of metformin and saxagliptin it should not be used during pregnancy.  If you get pregnant while taking\u00A0Komboglyze, or want to plan a pregnancy, you should seek medical advice from your doctor.  It is not known if saxagliptin passes into breast milk. Metformin does pass into breast milk. The manufacturer states that Komoboglyze should not be used by breastfeeding mothers. Seek further medical advice from your doctor.  What are the possible side effects of\u00A0Komboglyze? Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with\u00A0Komboglyze. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect. Very common (affect more than 1 in 10 people)  Low blood sugar levels (hypoglycaemia - when used with a sulphonylurea or insulin). See what should I know\u00A0above.  Common (affect between 1 in 10 and 1 in 100 people)  Upper respiratory tract infection.   Urinary tract infection. Gastroenteritis.  Sinusitis. Inflammation of the nose and throat, causing a blocked or runny nose and sore throat.  Metallic taste.  Headache. Feeling or being sick. Dizziness. Muscle pain.  Indigestion.  Fatigue.  Uncommon (affect between 1 in 100 and 1 in 1000 people)   Erectile dysfunction. Joint pain.  Inflammation of the pancreas (acute pancreatitis) - see what should I\u00A0know\u00A0above. Allergic reactions. Dermatitis, itching or hives.  Other side effects have been reported with both metformin and saxagliptin used on their own. These side effects are also possible with Komboglyze. You can read more about the possible side effects of the individual ingredients in our factsheets on\u00A0Onglyza (saxagliptin)\u00A0and\u00A0metformin. If you want any more information about the possible side effects of\u00A0Komboglyze you should talk to your doctor or pharmacist, or read the leaflet that comes with the medicine. If you think you have experienced a side effect, did you know you can report this using the\u00A0yellow card website? Can I take\u00A0other medicines with Komboglyze?  It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with Komboglyze. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe. The following medicines may reduce the blood level of saxagliptin and so could make it less effective at controlling blood sugar:  carbamazepine dexamethasone phenobarbital phenytoin  rifampicin.  There may be an increased risk of developing lactic acidosis if you take medicines that can affect your kidney function with metformin. These include the following:  diuretic medicines such as furosemide  non-steroidal anti-inflammatory drugs (NSAIDs) such as\u00A0ibuprofen or naproxen. It&amp;#039;s best to check with your doctor before taking this type of painkiller with\u00A0Komboglyze.  If you are prescribed\u00A0any of the following medicines with\u00A0Komboglyze you may be more likely to get low blood sugar (hypoglycaemia),\u00A0so your doctor may want you to monitor your blood sugar levels more frequently if you start treatment with one of these:  ACE inhibitors such as\u00A0captopril  disopyramide MAOI antidepressants, such as\u00A0phenelzine,\u00A0tranylcypromine\u00A0or\u00A0isocarboxazid other antidiabetic medicines, such as sulphonylureas (eg gliclazide, glibenclamide) or insulin.  Medicines that increase blood sugar levels as a side effect may make\u00A0Komboglyze less effective at controlling blood sugar. Medicines that can increase blood sugar levels include the following:  antipsychotic medicines, such as chlorpromazine, olanzapine, risperidone  beta-2-agonists, such as salbutamol, salmeterol   corticosteroids, such as prednisolone  glucosamine  oestrogens and progestogens, such as those found in oral contraceptives or HRT   diuretics, such as bendroflumethiazide or furosemide.   Your doctor may want to monitor your blood sugar if you start or stop treatment with any of these while taking\u00A0Komboglyze. Octreotide and lanreotide may also affect blood sugar levels. If you are being treated with one of these medicines your doctor may want to check your blood sugar levels and adjust your metformin dose if necessary. The\u00A0following medicines may increase the blood level of metformin, which could increase the risk of its side effects. Your doctor may need to reduce your metformin\u00A0dose if you regularly take one of these:  cimetidine  dolutegravir  rilpivirine\u00A0 telaprevir  topiramate\u00A0 vandetanib.  A drop in the number of blood cells called platelets in the blood has been seen in some people taking the antihistamine\u00A0ketotifen\u00A0in combination with metformin. The manufacturer of ketotifen recommends that it should be avoided in people taking metformin. Other medicines containing the same active ingredients There are currently no other medicines available in the UK that contain both metformin and saxagliptin as the active ingredients. Onglyza tablets contain just saxagliptin. Metformin is also available on its own, both without a brand name, ie as the\u00A0generic\u00A0medicine and under various brand names such as Glucophage. Last updated 13.07.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/diabetes/a8903/komboglyze-saxagliptin-metformin/>