The US Food and Drug Administration (FDA) recently approved the first pill to combine three type 2 diabetes medications: Trijardy XR (extended release). The triple-combination pill is marketed through a partnership of Boehringer Ingelheim and Eli Lilly and includes the following medications:
■ the SGLT-2 inhibitor empagliflozin,
■ the DPP-IV inhibitor linagliptin, and
■ metformin hydrochloride extended release formulation (ER).
Empagliflozin (brand name Jardiance), and linagliptin (Tradjenta) are each manufactured and sold through a partnership between Boehringer Ingelheim (Ridgefield, CT) and Eli Lilly (Indianapolis, IN).
Metformin hydrochloride ER has been available since 1995 in the United States and is sold under brand names (e.g., Glucophage) and generic formulations. It is the most commonly prescribed oral treatment for type 2 diabetes (1).
Multiple medications may be needed to treat type 2 diabetes. The triple combination pill simplifies patient management of their diabetes.
“Many adults living with type 2 diabetes who are already on a treatment plan including multiple medications still struggle to keep their blood sugar under control, and may require additional agents to reach their A1C targets,” said Ralph DeFronzo, MD, professor and diabetes division chief at University of Texas Health in San Antonio. “Adding new medicines to an individual’s plan can be challenging for some, which is why new treatment options that can help improve blood sugar without the burden of an increased pill count are important…. Having three different diabetes medications in a single tablet is an important advance in diabetes treatment.”
The side effects list for Trijardy XR incorporates effects of the individual drugs involved, according to a media release from Boehringer Ingelheim. Common side effects include upper respiratory tract infection, urinary tract infections, stuffy or runny nose and sore throat, constipation, headache, and gastroenteritis.
Among the serious side effects of the new triple-combination drug are lactic acidosis; pancreatitis; heart failure; a rare but serious bacterial infection of the perineum, necrotizing fasciitis; acute kidney injury; serious urinary tract infections; ketoacidosis; dehydration; and hypoglycemia.
Fischer, J Analogue-based Drug Discovery II. https://books.google.com/books?id=h2Kd8ci4Ln8C&pg=PA49#v=onepage&q&f=false. Hoboken, NJ: John Wiley & Sons, 2010; 49. ISBN 978-3-527-63212-1. Accessed February 18, 2020.
