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What is Komboglyze?

Komboglyze is an oral antidiabetic medication that contains a combination of two prescription antidiabetic drugs; Saxagliptin and Metformin. They work together to control your blood sugar levels. Saxagliptin belongs to a family of medications called DPP-4 inhibitors, and Metformin is an oral hypoglycemic medication that belongs to the biguanide family of antidiabetic drugs that are used to lower your blood sugar levels.

What is it used for?

Komboglyze is prescribed for the improvement of blood sugar level control in adult patients aged 18 years and older with type 2 diabetes mellitus. It is typically used alongside a healthy diet and regular exercise to help improve blood sugar levels in adult diabetics who are already being treated with:

  • a combination of Saxagliptin and Metformin, or Metformin and another drug
  • Saxagliptin, Metformin and another sulfonylurea drug
  • Saxagliptin, Metformin and insulin

How does it work?

Komboglyze contains a combination of two prescription antidiabetic medications, Saxagliptin and Metformin.

As mentioned above, saxagliptin belongs to a class of medicines called DPP-4 inhibitors, which stands for dipeptidyl peptidase-4 inhibitors. Saxagliptin helps to improve your blood sugar levels after a meal. It prevents the breakdown of important hormones involved in eating, appetite and digestion. These hormones play a large role in regulating blood sugar levels, and when the breakdown of these hormones is blocked it allows the pancreas to increase the amount of insulin production. It also decreases glucagon production in the pancreas, which normally would increase your blood sugar level. Saxagliptin also lowers blood sugar levels between meals and helps to decrease the amount of sugar made by your body.

Metformin is a member of the biguanide class of medicines, which helps you lower the amount of sugar made by your liver. It also increases insulin sensitivity, which increases your body’s absorption and processing of sugar in your blood. In addition to decreasing liver sugar production while increasing insulin sensitivity, Metformin enhances peripheral blood sugar absorption and decreases absorption of blood sugar from the gastrointestinal tract.

How to take this medication

Always follow the directions given to you by your doctor. Your doctor will tell you how many tablets to take and how often you need to take them. Kombogylze is generally taken twice a day along with meals to reduce the stomach upset that Metformin can cause.


Many things can change the dose of medication that a you need, such as body weight, other medical conditions and other medications. If your doctor has recommended a different dose from the ones listed here, do not change the way that you are taking the medication without consulting your doctor first. It is very important that you take this medication exactly as prescribed by your doctor.

The recommended daily dose of Kombogylze is based on the dose needed to effectively regulate your blood sugar levels and how well you tolerate the side effects. A typical beginning dose for adults who have not been taking Saxagliptin is the same dose of the Metformin you are taking along with 2.5mg saxagliptin, taken twice a day. If you are changing from taking Saxagliptin and Metformin individually, you might be prescribed the saxagliptin-metformin amount that you have been currently taking. The maximum recommend daily dose is 5mg Saxagliptin and 2000mg metformin.

If you should happen to miss a dose, take it as soon as you can, with food, and go back to your normal dosing schedule. If you do not remember until it is nearly time for your next dose, skip the missed dose and stick to your normal dosing schedule. Never take a double dose to make up for a missed one. If you are not sure what to do after you miss a dose, contact your doctor for advice.

Warnings and Precautions

Some drugs may interact with Kombogylze, so tell your doctor if you are taking:

  • Other diabetes drugs, such as Glyburide
  • Furosemide
  • Nifedipine
  • Cationic drugs (e.g. digoxin, amiloride, procainamide, morphine, quinine, quinidine, triamterene, ranitidine, vancomycin and trimethoprim)
  • Other drugs that may cause hyperglycemia (high blood sugar) and may lead to a loss of blood sugar control
  • ACE inhibitor drugs (may lower blood glucose)

Do not take this medicine if you:

  • Have unstable or insulin dependent (type 1) diabetes
  • Have metabolic acidosis (including diabetic ketoacidosis or lactic acidosis or history of either)
  • Currently have or have had a liver or kidney problem
  • Have or have had heart failure or cardiovascular problems (abrupt failure of blood circulation) or cardiorespiratory insufficiency
  • Drink excessive amounts of alcohol
  • Are highly stressed, have severe infections/inflammation, are experiencing trauma, are about to have surgery, or during a surgery recovery phase
  • Have severe dehydration
  • Are currently breastfeeding
  • Are pregnant or are planning to become pregnant
  • Are about to receive an injection of dye or contrast agent for an imaging procedure
  • Have any allergies to Saxagliptin, Metformin or any of the ingredients, or if you are allergic to other drugs belonging to the DPP-4 class

Side effects

Komboglyze contains Metformin, which in some cases can cause lactic acidosis. Lactic acidosis is a serious condition that can cause death and must be treated in the hospital. Alcohol may increase the risk of lactic acidosis, so it is recommended to not drink a lot of alcohol while taking it.

Heart Failure has also been reported in patients treated with Kombogylze. Heart failure is when your heart is unable to pump enough blood to meet the needs of the body.

Common negative effects may include:

  • upper respiratory tract infection
  • nausea
  • headache
  • urinary tract infection (UTI)
  • diarrhea
  • upset stomach (gas, abdominal bloating)
  • loss of appetite

Hypoglycemia (low blood sugar levels) is more likely to occur in people who are taking a sulfonylurea drug or are on insulin treatment. If you have any signs or symptoms of hypoglycemia, you should first check your blood sugar levels and treat them if they are low, then call your doctor. Symptoms of hypoglycemia include headache, shaking, rapid heartbeat, sweating, hunger, changes in vision, and change in mood.

Serious negative effects may include:

  • Allergic (hypersensitivity) reactions, symptoms of which include swelling of the lips, face, or throat, difficulties breathing, hives, rash, itching, flaking or peeling skin
  • pancreatitis (inflammation of the pancreas)
  • lactic acidosis (an excess of lactic acid in your blood)

Talk to your doctor about any side effects that do not go away. These are not all of the possible negative effects. Call your doctor if you have any questions about side effects.

What is Komboglyze 2.5mg/1000mg?

Komboglyze is a combination oral antidiabetic drug (OAD) that is composed of two main ingredients: 2.5mg of saxagliptin and 1000mg of metformin. Saxagliptin is an orally active antihyperglycemic agent that functions by inhibiting the action of the dipeptidyl peptidase-4 (DPP-4) enzyme. Incretin hormones like glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are released following an oral glucose load. These incretin hormones promote the release of insulin in a glucose-dependent manner from pancreatic beta cells. GLP-1 also slows down the release of glucagon, which is a peptide hormone that converts glycogen into glucose, from the pancreatic alpha cells. This results in the reduced production of glucose in the liver. However, these incretin hormones are almost instantly inactivated by DPP-4, which will lead to an increased level of blood glucose.

What is it used for?

Since Komboglyze is a potent DPP-4 inhibitor, it will inhibit the action of the DPP-4 enzyme, resulting in an increased level of incretin hormones, and consequently reduced fasting and postprandial blood glucose readings. Another component in Komboglyze—metformin—is a potent biguanide, which also regulates blood glucose level by increasing insulin sensitivity for better cellular uptake and usage of glucose. Metformin also slows down the production and absorption of glucose in the liver and intestine. The starting daily dose of Komboglyze for patients who had not taken saxagliptin is based on the current dose of metformin, with additional 2.5mg of saxagliptin taken twice daily. The maximum daily dose is 5mg of saxagliptin and 2000mg of metformin. This drug should be taken twice daily with food to reduce any gastrointestinal side effects associated with metformin.

Why use this drug?

Use medication as part of an overall diabetes management plan that includes a healthy diet and regular exercise to successfully treat type 2 diabetes mellitus. Diabetic patients who are already on separate saxagliptin and metformin tablets may be also switched to Komboglyze instead. Komboglyze can also be used concomitantly with other OADs, or even insulin, for better glycemic control.