Combination medicines for type 2 diabetes

For some people with type 2 diabetes, a single medicine — like metformin — may control blood glucose levels initially. But this may change as the condition progresses or circumstances change. At some point, more than one medicine — for example, metformin and a sulfonylurea — may be necessary to control blood glucose levels adequately.

It is important to tell your health professional about all the medicines you are taking — including prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) — as they may interact with diabetes medicines and affect your blood glucose levels. This may mean that your doctor will need to adjust your dose, or make changes to your other medicines.

What are the benefits of taking combination medicines for type 2 diabetes?

More than one type of medicine may be necessary to control blood glucose levels adequately in people with type 2 diabetes. For example, metformin may be combined with a sulfonylurea (glibenclamide), a gliptin (alogliptin, sitagliptin, saxagliptin, linagliptin or vildagliptin), a glitazone (rosiglitazone) or an SGLT2 inhibitor (dapagliflozin).

Combinations of metformin with many other medicines are available in Australia as a single tablet in varying dose combinations of the two active ingredients. For example, for people who are already taking metformin and vildagliptin, a single fixed-dose combination tablet may be prescribed at the dose of each medicine that was used separately.

Note about medicine names

Most medicines have two names: the active ingredient and the brand name. The active ingredient is the chemical in the medicine that makes it work. The brand name is the name given to the medicine by its manufacturer. There may be several brands that contain the same active ingredient. This website uses active ingredient names, with brand names in brackets. We also discuss medicines in groups or ‘classes’, when their effects or actions are very similar.

If you are prescribed one of these combination tablets, it is very important that you stop taking any of the same medicines as individual tablets. Always talk to your pharmacist or health professional about this.

Table 1. PBS-listed non-insulin medicines for treatment of type 2 diabetes

Medicine class Active ingredient(s) Brand name(s)
Biguanides Metformin Diaformin, Formet, Glucobete, Glucophage, Diabex
Metformin XR Diaformin XR, Metex XR, Diabex XR
Sulfonylureas Glibenclamide Glimel, Daonil
Gliclazide Glyade, Nidem
Gliclazide MR Glyade MR, Oziclide MR, Diamicron MR
Glimepiride Aylide, Diapride, Dimirel, Amaryl
Glipizide Melizide, Minidiab
DPP-4 inhibitors Alogliptin Nesina
Linagliptin Trajenta
Saxagliptin1 Onglyza
Sitagliptin2 Januvia
Vildagliptin Galvus
GLP-1 analogues Exenatide Byetta
SGLT2 inhibitors Dapagliflozin Forxiga
Empagliflozin Jardiance
Thiazolidinediones Pioglitazone Acpio, Actos, Pizaccord, Prioten, Vexazone
Rosiglitazone Avandia
Acarbose Acarbose Glucobay
FDC products
Sulfonylurea/metformin Glibenclamide/metformin Glucovance
DPP 4 inhibitor/metformin Alogliptin/metformin Nesina Met
DPP 4 inhibitor/metformin Linagliptin/metformin Trajentamet
DPP 4 inhibitor/metformin Saxagliptin/metformin XR3 Kombiglyze XR
DPP 4 inhibitor/metformin Sitagliptin/metformin2 Janumet
DPP 4 inhibitor/metformin Sitagliptin/metformin XR2 Janumet XR
DPP 4 inhibitor/metformin Vildagliptin/metformin Galvumet
SGLT2/metformin Dapagliflozin/metformin XR4 Xigduo XR
Thiazolidinedione/metformin Rosiglitazone/metformin Avandamet

XR: extended release    MR: modified release

Source: NPS Radar December 2015

  1. Australian Government Department of Health. Public Summary Document - Saxagliptin 2015. [PBS] (accessed 3 November 2015).
  2. Australian Government Department of Health. Public Summary Document - Sitagliptin; sitagliptin and metformin; sitagliptin and metformin XR. 2015. [PBS] (accessed 3 November 2015).
  3. Australian Government Department of Health. Public Summary Document - Saxagliptin and metformin XR. 2015. [PBS] (accessed 3 November 2015).
  4. Australian Government Department of Health. Public Summary Document - Dapagliflozin and metformin XR. 2015. [PBS] (accessed 3 November 2015).

What are the side effects of combination medicines?

The side effects of the combination medicines will generally be the same as the side effects of both medicines if they were taken individually.

Who can I ask about side effects?

If you’re concerned that you or someone in your care may have had side effects related to a medicine, seek medical advice. People with questions about their medicines or seeking general information about side effects can also call the NPS Medicines Line on 1300 633 424 (Monday-Friday, 9am-5pm).To report possible side effects call the Adverse Medicine Events (AME) line on 1300 134 237 from anywhere in Australia (Monday–Friday, 9am–5pm AEST).

Interactions

Some medicines are known to affect blood glucose levels. Click on the following links to view tables that list some of these medicines:

The interactions of the combination medicines will generally be the same as those for both medicines as when they are taken individually.

Phone for medicines information

Call Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, 'natural', vitamins and mineral supplements) from a pharmacist. Your call will be answered by healthdirect Australia.