TM Owner Merck & Co.
Steglujan 5mg + 100mg Tablet
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Indications & Clinical Uses
- Steglujan tablets combine two oral antidiabetic medicines in one tablet: ertugliflozin (as ertugliflozin L-pyroglutamic acid), a sodium-glucose co-transporter 2 (SGLT2) inhibitor, and sitagliptin (as sitagliptin phosphate monohydrate), a DPP-4 inhibitor, manufactured by Merck & Co. It is approved as an adjunct to diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus who need both components, typically after they are already controlled on ertugliflozin and sitagliptin separately, or when switching from another combination.
- It is not recommended for type 1 diabetes, for people with a history of pancreatitis, and is not approved for children.
- Steglujan is available as 5 mg/100 mg and 15 mg/100 mg tablets, taken once daily in the morning with or without food, and is a self-administered oral tablet rather than a hospital-administered medicine.
Side Effects
- Steglujan's label carries no boxed warning.
- The most common side effects are genital yeast infections (up to about 12% of women, up to about 4% of men), urinary tract infections (around 4%), headache and nasopharyngitis (common cold-type symptoms).
- Serious reactions needing urgent attention include diabetic ketoacidosis (nausea, vomiting, stomach pain, tiredness and breathing difficulty, which can occur with near-normal blood sugar), sudden severe stomach pain that may spread to the back with or without vomiting (possible acute pancreatitis from the sitagliptin component), signs of a rapidly worsening genital or perineal infection (rare Fournier's gangrene), joint pain, and any new blistering skin rash (bullous pemphigoid).
- New pain, tenderness, redness or swelling of the leg or foot should also be reported because of a small increased amputation risk.
Precautions & Warnings
- Before starting Steglujan, your healthcare provider checks kidney function; it is contraindicated with an eGFR below 30 mL/min/1.73m2, end-stage renal disease or dialysis, and should be stopped before major surgery or prolonged fasting because of ketoacidosis risk.
- Steglujan is contraindicated after a serious hypersensitivity reaction to ertugliflozin or sitagliptin, such as anaphylaxis, angioedema or Stevens-Johnson syndrome, and should be used cautiously in anyone with a history of pancreatitis.
- It can cause volume depletion, so use carefully with diuretics or in older adults, and heart failure risk should be monitored.
- Practise good genital hygiene to reduce yeast infection risk.
- Safety in pregnancy is not established for the ertugliflozin component beyond early pregnancy; discuss contraception and pregnancy plans with your healthcare provider.
- Do not double a missed dose.
Avoid Interactions
- Tell your healthcare provider about all medicines and supplements you take.
- Combining Steglujan with insulin or sulfonylureas increases the risk of low blood sugar, so a lower dose of the other medicine may be needed.
- Steglujan can lower blood lithium levels, so lithium concentrations should be monitored closely when starting or stopping treatment.
- Because Steglujan increases glucose in the urine, urine glucose tests and the 1,5-anhydroglucitol (1,5-AG) blood test become unreliable for monitoring while you take it.
- There is no specific food restriction, but avoid dehydration and excess alcohol, which raises the risk of low blood sugar and pancreatitis.
- Check with your pharmacist before combining Steglujan with other diabetes medicines, diuretics, or drugs that affect kidney function.
References
Frequently Asked Questions
Steglujan combines ertugliflozin and sitagliptin in one tablet to improve blood sugar control in adults with type 2 diabetes, alongside diet and exercise. It works two ways: increasing glucose loss in urine and boosting the body's own insulin response after meals.
Steglujan is a tablet taken once daily in the morning, with or without food, at either 5 mg/100 mg or 15 mg/100 mg strength. If you miss a dose, take it as soon as you remember that day; do not double up.
Common side effects of Steglujan (ertugliflozin/sitagliptin) include genital yeast infections, urinary tract infections and headache. Seek urgent care for severe stomach pain spreading to the back (possible pancreatitis), nausea with unusual tiredness (possible ketoacidosis), joint pain or a new blistering skin rash.
Avoid dehydration and excess alcohol while taking Steglujan (ertugliflozin/sitagliptin), and tell your provider before surgery or a fasting procedure, since it should be stopped beforehand. Combining it with insulin or sulfonylureas increases the risk of low blood sugar, and lithium levels need closer monitoring during treatment.
No, not with significant kidney impairment. Steglujan is contraindicated with an eGFR below 30 mL/min/1.73m2, end-stage renal disease, or dialysis, because the ertugliflozin component depends on kidney function and becomes unsafe as kidney function falls. Your provider checks this before prescribing.
Use caution. The sitagliptin component in Steglujan has been linked to acute pancreatitis, so tell your provider about any past pancreatitis before starting. Stop Steglujan and seek care immediately for severe stomach pain that spreads to the back, with or without vomiting.
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