PMID- 30068236
OWN - NLM
STAT- MEDLINE
DCOM- 20180824
LR  - 20191210
IS  - 1744-764X (Electronic)
IS  - 1474-0338 (Linking)
VI  - 17
IP  - 8
DP  - 2018 Aug
TI  - The safety of empagliflozin plus metformin for the treatment of type 2 diabetes.
PG  - 837-848
LID - 10.1080/14740338.2018.1497159 [doi]
AB  - Metformin is the first-line glucose-lowering medication in type 2 diabetes 
      mellitus (T2DM), but it generally requires soon or later the addition of a 
      second-line therapy, among which a sodium-glucose cotransporter type 2 (SGLT-2) 
      inhibitor, to reach and maintain adequate glucose control. Areas covered: This 
      narrative review provides an analysis of both efficacy and safety of a dual 
      therapy combining metformin and empagliflozin, a SGLT-2 inhibitor that has proven 
      its' potential to reduce major cardiovascular (CV) events, mortality, and renal 
      outcomes in patients with T2DM and established CV disease. Pharmacokinetic 
      studies showed the absence of drug-drug interactions and demonstrate 
      bioequivalence between fixed-dose combination (FDC) and individual tablets of 
      empagliflozin and metformin. Focus will be put on the use of this dual therapy in 
      special populations. Expert opinion: The addition of empagliflozin to metformin 
      therapy improves glucose control, with a minimal risk of hypoglycemia, while 
      reducing body weight and arterial blood pressure. EMPA-REG OUTCOME showed that 
      this combined therapy may be used in patients with established CV disease or 
      heart failure. However, caution may be required in fragile elderly patients and 
      in patients with severe impaired renal function. Further post-marketing 
      surveillance is recommended to demonstrate long-term safety. FDC may improve 
      adherence.
FAU - Scheen, Andre J
AU  - Scheen AJ
AD  - a Division of Diabetes Nutrition and Metabolic Disorders, Department of Medicine, 
      (B35) , University of Liege, CHU Sart Tilman , Liege , Belgium.
AD  - b Division of Clinical Pharmacology, Center for Interdisciplinary Research on 
      Medicines (CIRM) , University of Liege, CHU Sart Tilman , Liege , Belgium.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180801
PL  - England
TA  - Expert Opin Drug Saf
JT  - Expert opinion on drug safety
JID - 101163027
RN  - 0 (Benzhydryl Compounds)
RN  - 0 (Blood Glucose)
RN  - 0 (Drug Combinations)
RN  - 0 (Glucosides)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (SLC5A2 protein, human)
RN  - 0 (Sodium-Glucose Transporter 2)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 9100L32L2N (Metformin)
RN  - HDC1R2M35U (empagliflozin)
SB  - IM
MH  - Aged
MH  - Benzhydryl Compounds/*administration & dosage/adverse effects/pharmacokinetics
MH  - Blood Glucose/drug effects
MH  - Blood Pressure/drug effects
MH  - Body Weight/drug effects
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Drug Combinations
MH  - Drug Therapy, Combination
MH  - Glucosides/*administration & dosage/adverse effects/pharmacokinetics
MH  - Humans
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/administration & dosage/adverse effects/pharmacokinetics
MH  - Metformin/*administration & dosage/adverse effects/pharmacokinetics
MH  - Sodium-Glucose Transporter 2
MH  - Sodium-Glucose Transporter 2 Inhibitors
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - SGLT-2 inhibitor
OT  - chronic kidney disease
OT  - combined therapy
OT  - fixed-dose combination
OT  - type 2 diabetes mellitus
EDAT- 2018/08/03 06:00
MHDA- 2018/08/25 06:00
CRDT- 2018/08/03 06:00
PHST- 2018/08/03 06:00 [pubmed]
PHST- 2018/08/25 06:00 [medline]
PHST- 2018/08/03 06:00 [entrez]
AID - 10.1080/14740338.2018.1497159 [doi]
PST - ppublish
SO  - Expert Opin Drug Saf. 2018 Aug;17(8):837-848. doi: 10.1080/14740338.2018.1497159. 
      Epub 2018 Aug 1.