Ertugliflozin / Metformin
Ertugliflozin and metformin is a two-ingredient combination used alongside diet and exercise to improve blood sugar control in adults with type 2 diabetes.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 4 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
Segluromet carries a serious boxed warning about lactic acidosis — a dangerous buildup of lactic acid in the blood that can be fatal. This is caused by the metformin in Segluromet. Cases have led to death, dangerously low blood pressure, very low body temperature, and abnormal heart rhythms. Symptoms can be easy to miss at first: feeling unwell, muscle aches, difficulty breathing, unusual sleepiness, or stomach pain. Your risk is higher if you have kidney problems, liver disease, are 65 or older, drink heavily, are having surgery, or are receiving iodinated contrast dye for an imaging scan. If lactic acidosis is suspected, stop Segluromet immediately and go to a hospital — treatment includes supportive care and often hemodialysis (blood-filtering machine). Never ignore these early warning signs.
📖 Ertugliflozin / Metformin: Patient Information Guide
A plain-language walkthrough of Ertugliflozin / Metformin — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Ertugliflozin/metformin is a combination medicine used to improve blood sugar control in adults with type 2 diabetes, always alongside diet and exercise.
- Segluromet (oral tablet) is FDA-approved as an add-on to diet and exercise to improve blood sugar (glycemic) control in adults with type 2 diabetes mellitus
- Segluromet is not indicated for type 1 diabetes — it may increase the risk of diabetic ketoacidosis in those patients
- Segluromet is not for treating diabetic ketoacidosis
⚙️How it works▾
Segluromet works through two separate but complementary pathways. Ertugliflozin blocks a kidney transporter called SGLT2, which is responsible for pulling glucose (sugar) from urine back into the blood. By blocking SGLT2, more sugar is removed through urine instead of staying in the bloodstream. Metformin works in three ways: it reduces the amount of glucose the liver releases into the blood, slows glucose absorption in the intestines, and makes body cells more sensitive to insulin so they take up and use glucose more efficiently. Metformin does not cause the body to release extra insulin, so it rarely causes low blood sugar on its own.
💊How it's taken▾
Segluromet tablets are taken by mouth twice a day, with meals. Taking with food is important — it helps reduce nausea and stomach upset, especially when first starting metformin. Your prescriber will choose a starting strength based on what diabetes medicines you are already taking, and may gradually increase the dose to minimize side effects and optimize blood sugar control.
- Never exceed the maximum daily doses your prescriber sets
- If you miss a dose, take it as soon as you remember — but skip it if it's almost time for the next one, and never double up
- Segluromet should be temporarily stopped before scheduled surgery or prolonged fasting periods (at least 4 days before, if possible) and before certain imaging procedures that use contrast dye
🤒Side effects — in detail▾
The most common side effects of Segluromet include:
- Yeast infections of the vagina or penis (the most frequent side effect from ertugliflozin)
- Diarrhea, nausea, vomiting, gas, stomach discomfort, or indigestion (mainly from metformin)
- Urinary tract infections
- Increased urination
- Headache
- Vaginal itching
- Increased thirst
- Weight loss
Serious reactions requiring prompt medical attention include lactic acidosis (muscle pain, trouble breathing, unusual sleepiness, belly pain), ketoacidosis (nausea, vomiting, stomach pain, shortness of breath), signs of serious urinary or skin infections, foot sores or leg ulcers, and severe dehydration or dizziness. Do not ignore these — get help right away.
⚠️Warnings & precautions▾
- Lactic acidosis (metformin): A rare but potentially fatal buildup of lactic acid in the blood. Risk is highest in people with kidney or liver problems, those 65 and older, heavy drinkers, and anyone dehydrated or undergoing surgery. Early symptoms — muscle aches, fatigue, belly pain, breathing trouble — can be subtle. Stop the medicine and seek emergency care if suspected.
- Ketoacidosis (ertugliflozin): A serious acid buildup that can occur even with near-normal blood sugar levels. Watch for nausea, vomiting, stomach pain, fatigue, and shortness of breath. Stop Segluromet and get immediate care if these occur.
- Lower limb amputation risk (ertugliflozin): Clinical studies showed a small increased rate of toe and foot amputations. Report any new foot sores, infections, or pain to your doctor promptly.
- Fournier's gangrene: A rare but life-threatening infection in the genital or perineal (groin) area. Seek emergency care immediately for pain, swelling, redness, or fever in that area.
- Volume depletion (dehydration): Ertugliflozin causes more urine output, which can lead to dehydration, low blood pressure, and kidney problems — especially in older adults or those on diuretics.
- Serious urinary tract infections: SGLT2 inhibitors increase urinary tract infection risk, including severe infections (pyelonephritis, urosepsis) needing hospitalization.
- Vitamin B12 deficiency (metformin): Long-term metformin use can lower vitamin B12 levels. Annual blood count monitoring is recommended.
🔀What it interacts with▾
Segluromet can interact with several medicines and substances — always tell your prescriber and pharmacist everything you take:
- Insulin or sulfonylureas (e.g., glipizide, glimepiride): raise the risk of low blood sugar when combined with Segluromet; dose adjustments may be needed
- Carbonic anhydrase inhibitors (e.g., topiramate, zonisamide, acetazolamide): increase lactic acidosis risk by affecting acid-base balance; closer monitoring is needed
- Drugs that reduce metformin clearance (e.g., ranolazine, vandetanib, dolutegravir, cimetidine): slow kidney removal of metformin, raising its blood levels and lactic acidosis risk
- Alcohol: amplifies metformin's effect on lactic acid metabolism — excessive drinking should be avoided
- Iodinated contrast agents (used in CT scans and other imaging): can acutely impair kidney function, increasing lactic acidosis risk; Segluromet may need to be paused before and after these procedures
- Lithium: Segluromet may lower lithium blood levels; more frequent monitoring is recommended
- Drugs that raise blood sugar (e.g., thiazide diuretics, corticosteroids, estrogens, oral contraceptives, phenytoin, nicotinic acid, certain blood pressure medicines): can reduce the blood sugar-lowering effect of Segluromet; closer monitoring of blood sugar is needed
- Urine glucose tests and 1,5-AG assay: ertugliflozin causes glucose to spill into urine, making urine glucose tests unreliable for monitoring diabetes control; the 1,5-AG blood test is also unreliable — use HbA1c or other methods instead
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Severe kidney disease or dialysis: Segluromet is contraindicated (must not be used) if eGFR is below 30 mL/min/1.73 m² or you are on dialysis; not recommended if eGFR is below 45
- Liver disease: Avoid Segluromet — metformin can cause lactic acidosis in people with impaired liver function
- Metabolic acidosis or diabetic ketoacidosis: Segluromet is contraindicated in these conditions
- Allergy: Do not take if you have had a serious allergic reaction (such as anaphylaxis or angioedema) to ertugliflozin, metformin, or any ingredient in Segluromet
- Type 1 diabetes: Segluromet is not indicated and may increase ketoacidosis risk
- Pregnancy (second and third trimesters): Not recommended — animal studies showed kidney harm to the developing fetus from ertugliflozin
- Breastfeeding: Not recommended — potential risk to the infant's developing kidneys
- Premenopausal women: Metformin may trigger ovulation in some women who don't normally ovulate, potentially leading to unintended pregnancy
- Adults 65 and older: Higher risk of dehydration and kidney side effects; renal function should be checked more frequently
- Children under 18: Safety and effectiveness have not been established
- Upcoming surgery or imaging: Tell your doctor — Segluromet may need to be temporarily stopped
- Heavy alcohol use: Raises lactic acidosis risk with metformin; discuss with your doctor
🚑If you take too much▾
If you or someone else takes too much Segluromet, call Poison Control at 1-800-222-1222 or seek emergency care right away. Metformin overdose has been associated with lactic acidosis in about 32% of reported cases — a medical emergency. Hemodialysis (a blood-filtering machine) can help remove metformin from the body and is recommended when metformin overdose is suspected.
📡Pharmacodynamics — effects in the body▾
Ertugliflozin causes the kidneys to excrete more glucose in the urine by blocking the SGLT2 transporter, and this effect also increases urine volume. Studies confirm that ertugliflozin does not meaningfully affect the heart's electrical activity (QTc interval) at therapeutic doses. Metformin lowers blood sugar both between and after meals without triggering extra insulin release, and does not typically cause low blood sugar on its own.
🔬Pharmacokinetics — how your body processes it▾
When taken as a Segluromet tablet, food does not meaningfully change the total amount of ertugliflozin or metformin absorbed, though peak blood levels may be somewhat lower with a high-fat meal. Ertugliflozin is nearly completely absorbed and reaches peak blood levels within about an hour on an empty stomach; steady blood levels are reached after 4–6 days of once-daily use. Metformin is about 50–60% absorbed on an empty stomach; food modestly lowers and delays its absorption. Ertugliflozin is about 94% bound to proteins in the blood and is mainly broken down in the liver, while metformin is not significantly protein-bound and is cleared almost entirely by the kidneys unchanged.
📦How to store it▾
Store at 20°C-25°C (68°F-77°F), excursions permitted between 15°C-30°C (between 59°F-86°F) . Protect from moisture. Store in a dry place.
📄 Written from Ertugliflozin / Metformin’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Ertugliflozin / Metformin — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly does Segluromet do for my diabetes? ▾
Is there anything I should watch out for that would mean I need to call a doctor right away? ▾
Should I take Segluromet with food or on an empty stomach? ▾
I also take insulin — is there anything I need to know? ▾
Can I drink alcohol while taking Segluromet? ▾
Do I need to stop Segluromet before surgery or a scan with contrast dye? ▾
Is Ertugliflozin / Metformin available over the counter? ▾
When was Ertugliflozin / Metformin first available? ▾
Who makes Ertugliflozin / Metformin? ▾
💬 Answers drafted from Ertugliflozin / Metformin’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Ertugliflozin / Metformin comes
Ertugliflozin / Metformin is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Tablet
How this form is used
- Segluromet is used alongside diet and exercise to improve blood sugar control in adults with type 2 diabetes
- Segluromet is not for type 1 diabetes or diabetic ketoacidosis
- Segluromet tablets are taken by mouth twice daily with meals
- Segluromet doses are gradually increased when starting metformin to reduce stomach side effects
- If a dose of Segluromet is missed, take it as soon as possible — do not double the next dose
- Segluromet should be stopped at least 4 days before scheduled surgery or procedures that involve prolonged fasting, if possible
📊 Ertugliflozin / Metformin across the U.S. market
How Ertugliflozin / Metformin appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Ertugliflozin / Metformin is used
A general measure of how commonly Ertugliflozin / Metformin is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Ertugliflozin / Metformin is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Ertugliflozin / Metformin prescribed? Of the 1,596 medications we measure, Ertugliflozin / Metformin ranks #920 by Medicaid prescriptions — more than 42% of them.
Utilization by Ertugliflozin / Metformin product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
ertugliflozin 7.5 MG / metformin hydrochloride 1000 MG Oral Tablet Most dispensed
Summed across the 1 of 7 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1992698
ertugliflozin 2.5 MG / metformin hydrochloride 1000 MG Oral Tablet
Summed across the 1 of 7 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1992685
ertugliflozin 7.5 MG / metformin hydrochloride 500 MG Oral Tablet
Summed across the 1 of 4 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1992701
ertugliflozin 2.5 MG / metformin hydrochloride 500 MG Oral Tablet
Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1992693
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Ertugliflozin / Metformin, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 4 of 23 listed Ertugliflozin / Metformin NDCs with Medicaid activity.
🔍 Compare Ertugliflozin / Metformin products
A representative set of FDA-listed product records for Ertugliflozin / Metformin — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Tablet | ||||
| 2.5; 500 mg/1; mg | Oral | A-S Medication Solutions | NDA | View NDC → |
| 2.5; 1000 mg/1; mg | Oral | A-S Medication Solutions | NDA | View NDC → |
| 7.5; 1000 mg/1; mg | Oral | A-S Medication Solutions | NDA | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 2.5 mg/1; METFORMIN HYDROCHLORIDE 500 mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 2.5 mg/1; METFORMIN HYDROCHLORIDE 1000 mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 7.5 mg/1; METFORMIN HYDROCHLORIDE 500 mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 7.5 mg/1; METFORMIN HYDROCHLORIDE 1000 mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| 2.5; 500 mg/1; mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| 2.5; 1000 mg/1; mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| 7.5; 500 mg/1; mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| 7.5; 1000 mg/1; mg | Oral | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 2.5 mg/1; METFORMIN HYDROCHLORIDE 500 mg | — | MSD International GmbH (Puerto Rico Branch) LLC | DRUG FOR FURTHER PROCESSING | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 2.5 mg/1; METFORMIN HYDROCHLORIDE 1000 mg | — | MSD International GmbH (Puerto Rico Branch) LLC | DRUG FOR FURTHER PROCESSING | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 7.5 mg/1; METFORMIN HYDROCHLORIDE 500 mg | — | MSD International GmbH (Puerto Rico Branch) LLC | DRUG FOR FURTHER PROCESSING | View NDC → |
| ERTUGLIFLOZIN PIDOLATE 7.5 mg/1; METFORMIN HYDROCHLORIDE 1000 mg | — | MSD International GmbH (Puerto Rico Branch) LLC | DRUG FOR FURTHER PROCESSING | View NDC → |
Showing 23 of 23 products — FDA National Drug Code Directory. See every product, package size and price: browse all 23 Ertugliflozin / Metformin NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Ertugliflozin / Metformin — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Ertugliflozin / Metformin in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Ertugliflozin / Metformin went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.
RxCUI 1992684 1 dose form · 4 strengths
-
Dose form (SCDF) Oral Tablet RxCUI 1992683In current FDA listingsClinical drug / strength (SCD) ertugliflozin 2.5 MG / metformin hydrochloride 1000 MGRxCUI 1992685ertugliflozin 2.5 MG / metformin hydrochloride 500 MGRxCUI 1992693ertugliflozin 7.5 MG / metformin hydrochloride 1000 MGRxCUI 1992698ertugliflozin 7.5 MG / metformin hydrochloride 500 MGRxCUI 1992701
Look up RxCUI 1992684 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Ertugliflozin / Metformin is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Ertugliflozin / Metformin belongs to the Sodium-glucose co-transporter 2 (SGLT2) inhibitors class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 4 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Merck Sharp & Dohme LLC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.