Steglujan (Ertugliflozin and Sitagliptin) – Oral: Uses, Side Effects ... - Verywell Health
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What Is Steglujan?
Steglujan (ertugliflozin; sitagliptin) is an orally administered medication used in tandem with diet and exercise to improve blood glucose (blood sugar) levels in adults with type 2 diabetes.
Steglujan contains two medications from two different classes of drugs: ertugliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, and sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor. Steglujan's active ingredients work together to help improve blood sugar control.
SGLT2 inhibitors lower blood sugar levels by causing more sugar to leave the body in the urine. Comparatively, DPP-4 inhibitors decrease blood sugar levels by stimulating insulin release.
Insulin is a hormone that helps sugar move from the blood to inside the cells. DPP-4 inhibitors cause the liver to produce less sugar.
No generic product containing the two active ingredients in Steglijan, ertugliflozin and sitagliptin, is available. Steglujan is a brand-name medication that's available by prescription as an oral (taken by mouth) tablet.
Drug Facts
Generic Name: Ertugliflozin; sitagliptin
Brand Name: Steglujan
Drug Availability: Prescription
Administration Route: Oral
Therapeutic Classification: Hypoglycemic
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Ertugliflozin phosphate; sitagliptin phosphate
Dosage Form: Tablet
What Is Steglujan Used For?
The Food and Drug Administration (FDA) has approved Steglujan to control blood sugar levels in adults with type 2 diabetes. It is used along with a healthy diet and regular exercise.
For context, type 2 diabetes is a condition in which your body fails to use insulin properly, called insulin resistance. As a result, your pancreas generates more insulin to force cells to respond.
Insulin resistance negatively impacts the pancreas, resulting in elevated blood sugar levels. Raised blood sugar levels lead to prediabetes and type 2 diabetes.
High blood sugar can cause serious health problems, such as heart disease, kidney disease, and vision loss.
Steglujan is not used to treat type 1 diabetes (a form of diabetes where the pancreas produces little insulin) due to an increased risk of diabetic ketoacidosis (DKA), a serious complication of diabetes.
Finally, this medication has also not been studied in people with a history of pancreatitis.
How to Take Steglujan
Take Steglujan according to your healthcare provider's instructions. This medication is typically taken once daily in the morning, with or without food.
The recommended starting dose is 5 milligrams of ertugliflozin and 100 milligrams of sitagliptin.
Be sure to swallow the tablets whole. Do not chew or crush the medication.
Storage
Store at room temperature (between 68 and 77 F) away from light. For short periods, you may store it between cool and mildly hot temperatures (59 to 86 F). Keep this medicine in a dry place, and do not store it in your bathroom.
Keep all medications out of reach of children and pets.
Discard all expired or unused drugs. Ask your pharmacist about the best ways to get rid of your medicine. There may be local drug take-back programs in your area.
How Long Does Steglujan Take to Work?
Steglujan starts working right away to lower blood sugar. However, it may take six to 12 weeks of treatment to see an improvement in your hemoglobin A1C (A1C test; exam used to test average levels of blood glucose over the past three months).
In Steguljan's clinical trials, the medication took up to 26 weeks to provide its maximum benefit.
What Are the Side Effects of Steglujan?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
Common side effects associated with the use of Steglujan may include:
Severe Side Effects
The list below includes severe side effects which have been reported with the use of Steglujan.
It is very important to let your provider know immediately if you experience any of these. If you feel the symptoms are life-threatening, call 911 as it might be a medical emergency.
Rarely, severe side effects of Steglujan and their symptoms may include:
- Pancreatitis: Intense pain in the upper abdomen that may reach the back
- Ketoacidosis: Nausea, vomiting, extreme fatigue, or trouble thinking clearly
- Lower limb infection: Sores, ulcers, pain, or tender areas on your legs or feet
- Acute kidney failure: Urinating less than usual, shortness of breath, or swelling in your legs, ankles, or feet
- Dehydration: Sudden cool or pale skin or fast heart rate
- Serious urinary tract problems, such as urosepsis and pyelonephritis: Fever, chills, lower back pain, nausea, or vomiting
- Heart failure: Weakness, trouble breathing, heart palpitations, leg swelling, and rapid weight gain
- Hypoglycemia (low blood sugar) when used with insulin or certain diabetes medicines: Dizziness, sweating, hunger, irritability, shaking, or fainting
- Necrotizing fasciitis of the perineum (Fournier's gangrene): Pain, swelling, or redness in the genital or rectal area along with fever or discomfort
- Allergic reaction: Trouble breathing, swelling under the skin, rash
- Arthralgia: Joint pain that may become severe or disabling
- Pemphigoid: Large blisters or erosions on the skin
Long-Term Side Effects
Most of Steglujan's side effects are temporary.
Rarely, certain serious side effects of this medication may continue to affect you even after you stop taking it.
For example, taking Steglujan may increase the risk of a lower leg amputation. It is important to monitor and let your healthcare provider know about any new pain or tenderness, sores or ulcers involving the leg or foot.
Report Side Effects
Steglujan may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Dosage: How Much Steglujan Should I Take?
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For type 2 diabetes:
- Adults—At first, one tablet once a day, in the morning. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 15 milligrams (mg) of ertugliflozin and 100 mg of sitagliptin once a day.
- Children—Use and dose must be determined by your doctor.
- For type 2 diabetes:
Modifications
Treatment or dosage changes may be required for the following cases under the discretion of the healthcare provider. Special caution may need to be used in:
Dose adjustment(s): Steglujan's manufacturer does not offer guidance on whether it is OK to crush or split this medication. So, it is best to swallow each tablet whole. If you have difficulty swallowing the tablet whole, speak to your provider or pharmacist for advice.
Pregnancy: Based on animal data, Steglujan is not recommended during the second and third trimesters of pregnancy. However, the limited available data on ertugliflozin and sitagliptin use during pregnancy are not sufficient to determine a drug-associated risk of negative developmental outcomes. As such, there are risks to the parent and fetus associated with uncontrolled diabetes in pregnancy.
Breastfeeding: Steglujan is not recommended while breastfeeding.
Children: The safety of Steglujan in people under 18 has not been established. Therefore, consult with a healthcare provider to find alternative treatment options.
Adults 65 and older: No dosage adjustment of Stegluajn is recommended based on age. Older adults, however, are more likely to have decreased kidney function. Because kidney function issues can occur after digesting ertugliflozin, and sitagliptin is known to be expelled by the kidneys, kidney function should be assessed more frequently in older adults.
Liver problems: No dosage adjustment of Stegluajn is necessary for people with mild or moderate liver impairment. However, Steglujan has not been studied in people with severe liver impairment and is not recommended for use in this patient population.
Kidney problems: Individuals with a history of kidney issues should consult a healthcare provider before starting treatment. Clinical studies have shown that the use of sitagliptin has led to worsening kidney function, including acute kidney failure, sometimes requiring dialysis.
Missed Dose
If you miss a dose of Steglujan, take it as soon as you remember. You should not double the next dose to make up for a missed dose.
Overdose: What Happens If I Take Too Much Steglujan?
Consuming an excessive amount of Steglujan may cause the following symptoms that maybe indicate a potential overdose:
What Happens If I Overdose on Steglujan?
If you think you or someone else may have overdosed on Steglujan, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Steglujan, call 911 immediately.
Precautions
It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.
Using this medicine during the second and later part of a pregnancy can harm your unborn baby. If you think you have become pregnant while using this medicine, tell your doctor right away.
It is very important to follow carefully any instructions from your doctor about:
- Alcohol—Drinking alcohol may cause severe high blood sugar. Discuss this with your doctor.
- Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
- Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about the changes in the dosing of their diabetes medicine that might occur because of lifestyle changes, such as changes in exercise, diet, and illness. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
- Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
- In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have a sudden and severe stomach pain, chills, constipation, nausea, vomiting, loss of appetite, fever, or lightheadedness.
Dizziness, lightheadedness, or fainting may occur with this medicine. This is more common if you have kidney disease, low blood pressure, or if you are taking a diuretic (water pill). Drinking plenty of fluids each day may help. Drink plenty of water during exercise or in hot weather. Check with your doctor if you have severe nausea, vomiting, or diarrhea that does not stop. This may cause you to lose too much water.
Ketoacidosis (high ketones and acid in the blood) may occur while you are using this medicine. This can be life-threatening and requires immediate medical attention. Your doctor may give you insulin, fluid, and carbohydrate replacement to treat this condition. Tell your doctor right away if you have nausea, vomiting, trouble breathing, increased thirst or urination.
Check with your doctor right away if you have bloody urine, decrease in how much or how often you urinate, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.
This medicine may increase your risk of having urinary tract infections, including pyelonephritis or urosepsis. Check with your doctor right away if you have bladder pain, bloody or cloudy urine, difficult, burning, or painful urination, or lower back or side pain.
This medicine may increase your risk of having lower leg or foot amputation (leg removal surgery). Check with your doctor right away if you have pain, tenderness, sores or ulcers, or infections on your leg or foot.
Check with your doctor right away if you have chest pain or tightness, decreased urine output, dilated neck veins, extreme fatigue, irregular breathing, irregular heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain. These may be symptoms of heart failure.
This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with other diabetes medicines (eg, insulin, glipizide, or glyburide). Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms of low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Talk to your doctor about the best way to treat low blood sugar.
Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your diabetes medicine, overeat or do not follow your diet plan, have a fever or infection, or do not exercise as much as usual. Some symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed and dry skin, a fruit-like breath odor, increased frequency and amount of urination, ketones in the urine, loss of appetite, nausea or vomiting, rapid and deep breathing, tiredness, or unusual thirst. If symptoms of high blood sugar occur, check your blood sugar level and call your doctor for instructions.
This medicine may cause vaginal yeast infections in women and yeast infections of the penis in men. This is more common in patients who have a history of genital yeast infections or in men who are not circumcised. Women may have a vaginal discharge, itching, or odor. Men may have redness, itching, swelling, or pain around the penis, or a discharge with a strong odor from the penis. Check with your doctor right away if you have any of these symptoms.
This medicine may cause a rare but serious bacterial infection, called necrotizing fasciitis of the perineum or Fournier's gangrene, which can cause damage to the skin tissue in the area between and around the anus and genitals (perineum). Fournier's gangrene may lead to hospitalization, multiple surgeries, or death. Check with your doctor right away if you have fever, unusual tiredness or weakness, or pain, tenderness, redness, or swelling of the area between and around your anus and genitals.
This medicine may cause serious allergic reactions, including anaphylaxis, angioedema, or certain skin conditions (Stevens-Johnson syndrome), which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a blistering, peeling, or loosening of the skin. chills, cough, diarrhea, joint or muscle pain. red irritated eyes, red skin lesions, often with a purple center, rash, sore throat, sores, ulcers, or white spots in the mouth or on the lips, , trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.
This medicine may cause severe and disabling joint pain. Call your doctor right away if you have severe joint pain while using this medicine.
This medicine may cause bullous pemphigoid. Tell your doctor if you have large, hard skin blisters while using this medicine.
Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests (eg, urine glucose tests may not be accurate).
Limit the amount of alcohol you drink while you are using this medicine. Heavy alcohol use or binge drinking can increase your chances of serious side effects.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
What Are Reasons I Shouldn't Take Steglujan?
Steglujan may not be safe for everyone. You should not take this medication if:
Additionally, this medication is not intended to treat type 1 diabetes due to an increased risk of DKA. Steglujan may not be safe for people with a history of pancreatitis.
What Other Medications Interact With Steglujan?
Steglujan interacts with several medications.
The following list includes some of the most important interactions to know about but does not include all possible interactions.
It is very important to tell your provider and pharmacist about everything you take, including prescription drugs, over-the-counter (OTC) medications, vitamins, dietary supplements, and herbal products.
Examples of drugs that can interact with Steglujan, along with their interaction risks, are:
- Insulin: Increases the risk of low blood sugar with Steglujan
- Certain diabetes medicines, such as sulfonylureas: Increases the risk of low blood sugar with Steglujan
- Digoxin: May increase the blood levels of digoxin, raising the risk of digoxin's side effects
- Chloroquine: Increases the risk of low blood sugar with Steglujan
What Medications Are Similar to Steglujan?
Steglujan conveniently combines two diabetes medications in one pill: ertugliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, and sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor.
Ertugliflozin is available as the single-ingredient drug Steglatro.
Other SGLT2 inhibitors that are similar to ertugliflozin include:
Other DPP-4 inhibitors that are similar to sitagliptin include:
Other combinational medications that contain an SGLT2 and DPP-4 inhibitor include:
Note that Steglujan is not meant to be taken in addition to any of the medications listed above. Many other diabetes treatment options are also available.
Talk to your healthcare provider if you are interested in an alternative to Steglujan.
How Can I Stay Healthy While Taking Steglujan?
Getting control over your blood sugar levels can help prevent diabetes complications.
You can get optimal results from Steglujan by taking it every day and adopting a healthy lifestyle.
This includes eating healthy food and exercising regularly. For some people, losing weight can even reverse type 2 diabetes. The key is getting into a routine that works for you.
Remember that managing a chronic disease like diabetes is a marathon—not a sprint. Start by making one small change at a time, such as drinking water instead of a sugary beverage with lunch.
Building healthy habits into your daily routine is more sustainable than following fad diets that cause rapid but temporary weight loss.
One of the best ways to live well with diabetes is to share the journey with your support system. For example, prepare healthy meals with family members or exercise with a friend.
Medical Disclaimer
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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