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The kuriously named Kombiglyze XR, a combination of Onglyza (saxagliptin) and the old reliable metformin, has arrived at pharmacies and is available by prescription to people with type 2 diabetes. It's similar to Janumet, an older medication that's a combination of Januvia (sitagliptin) and metformin.
Both sitagliptin and saxagliptin are DPP-4 inhibitors, which means that they inhibit, or temporarily prevent, the enzyme DPP-4 from destroying a helpful hormone called GLP-1. GLP-1, which is released by the gut when food arrives there from the stomach, lowers blood sugar by causing the release of insulin, reducing the secretion of glucagon, and slowing stomach emptying and nutrient absorption. Unfortunately, GLP-1 is broken down by DPP-4 after only about a minute of beneficial action. Because GLP-1 could lower blood sugar longer if DPP-4 weren't so efficient at destroying it, DPP-4 inhibitors like sitagliptin and saxagliptin come in very handy for people with type 2 diabetes.
When DPP-4 inhibitors are combined with metformin, patients who need both medicines get the convenience of one, rather than two, pills. Apparently it's convenience that is going to be Kombiglyze XR's special forte, as it is taken only once a day, while Janumet is taken twice a day. That may change soon, however, as a New Drug Application (NDA) for an XR form of Janumet has just been accepted for review by the FDA.
Kombiglyze XR, which is made by Bristol-Myers Squibb and AstraZeneca, was approved by the FDA in November 2010. Janumet is made by Merck and was approved in April 2007.
Merck, Bristol-Myers Squibb, and AstraZeneca
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