Segluromet
Segluromet is a medication that combines two ingredients: ertugliflozin (a sodium glucose cotransporter 2 inhibitor) and metformin (a biguanide). It helps lower blood sugar levels in adults with Type 2 diabetes. Segluromet works best when you also follow a diabetes-friendly diet and exercise regularly. This medication comes as a tablet that's taken by mouth twice a day with food. Side effects can include diarrhea, stomach upset, and genital yeast infections. Segluromet is only available as a brand-name medication.
What is Segluromet (ertugliflozin / metformin)?
What is Segluromet (ertugliflozin / metformin) used for?
How Segluromet (ertugliflozin / metformin) works
Segluromet (ertugliflozin / metformin) is a combination of two diabetes medications that work together to lower your blood sugar.
Ertugliflozin is a sodium glucose co-transporter 2 inhibitor, or SGLT2 inhibitor for short. It blocks the SGLT2 protein in the kidneys. This prevents sugar from absorbing back into your body in the kidneys. Instead, the sugar goes into your urine. This helps get rid of extra sugar in your blood and lower your blood sugar levels.
Metformin is a biguanide. It works in a few ways to lower blood sugar levels. Metformin lowers the amount of sugar your liver releases into your blood. It also lowers the amount of sugar that's absorbed through your gut from food you eat. And, it helps your body respond better to insulin.
Drug Facts
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What are the side effects of Segluromet (ertugliflozin / metformin)?
Common Side Effects
- Genital fungal infection
- Urinary tract infection
- Headache
- Diarrhea
- Nausea
- Vomiting
- Passing gas
- Stomach discomfort
- Indigestion
- Weakness
- Headache
Other Side Effects
- Back pain
- Common cold symptoms
- Feeling thirsty
- More urination
- Vaginal itching
- Weight loss
Serious Side Effects
- Buildup of lactic acid: confusion, feeling weak or tired, fast heartbeat, rapid breathing, no appetite, nausea, vomiting, feeling cold or clammy
- Serious genital infection: fever; pain, tenderness, redness, or swelling in the genital area
- Ketoacidosis (high ketone levels in the blood): shortness of breath, dry mouth, fruity-smelling breath, feeling very tired, vomiting, stomach pain
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
- Diabetic ketoacidosis (DKA)—increased thirst or amount of urine, dry mouth, fatigue, fruity odor to breath, trouble breathing, stomach pain, nausea, vomiting
- Genital yeast infection—redness, swelling, pain, or itchiness, odor, thick or lumpy discharge
- High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
- Infection or redness, swelling, tenderness, or pain in the genitals, or area from the genitals to the back of the rectum
- Low vitamin B12 level—pain, tingling, or numbness in the hands or feet, muscle weakness, dizziness, confusion, trouble concentrating
- New pain or tenderness, change in skin color, sores or ulcers, infection of the leg or foot
- Urinary tract infection (UTI)—burning when passing urine, passing frequent small amounts of urine, bloody or cloudy urine, pain in the lower back or sides
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Segluromet (ertugliflozin / metformin)
Pros
Two diabetes medications combined into one tablet so there's less pills to take each day
Adjustable dose based on blood sugar levels
Cons
Might make you urinate more
Not for people with Type 1 diabetes
Not recommended during pregnancy or while breastfeeding
Pharmacist tips for Segluromet (ertugliflozin / metformin)
Take Segluromet (ertugliflozin / metformin) twice a day with meals. This helps lower the chance of getting an upset stomach from the medication.
Drink plenty of water while taking Segluromet (ertugliflozin / metformin). This helps prevent dehydration, low blood pressure, and dizziness. These are possible risks of the medication.
Avoid drinking a lot of alcohol while taking Segluromet (ertugliflozin / metformin). This can raise the risk of a serious problem called lactic acidosis (buildup of lactic acid in the blood). Talk to your prescriber about your drinking habits and if this medication is safe for you.
Let your care team know if you notice any signs of urinary or genital infections while taking Segluromet (ertugliflozin / metformin). Look out for a burning feeling when you urinate or pain in the lower stomach area. Also be aware of any pain, tenderness, redness, or swelling in the genital area. Your care team can guide you to the right treatment if you have an infection.
Tell your prescriber ahead of time if you have a surgery or procedure coming up. They'll tell you if you need to stop taking Segluromet (ertugliflozin / metformin) a few days before and when it's safe to start again. Around the time of your procedure, you might not be able to eat or drink. Taking the medication during that time can raise your risk of lactic acidosis.
Also let your prescriber know if you have any imaging procedures coming up. And tell the imaging team that you're taking Segluromet (ertugliflozin / metformin). Some imaging procedures use contrast dyes that can affect your kidneys. This can raise the risk of lactic acidosis while you're taking this medication. Follow your care team's instructions about when to stop and restart the medication.
Remember to check your feet often for any new pain, sores, or signs of infections. Tell your care team if you notice anything strange. It's important to catch these problems early because they could raise your risk of needing part of your leg or foot removed during treatment.
Frequently asked questions about Segluromet (ertugliflozin / metformin)
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What are the risks and warnings for Segluromet (ertugliflozin / metformin)?
Segluromet (ertugliflozin / metformin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Lactic acidosis
Risk factors: Age 65 years or older | Kidney problems | Liver problems | Imaging procedure using contrast dye | Surgery or procedure that requires fasting | Low oxygen | Drinking a lot of alcohol | Dehydration | Taking certain medications that raise the risk of lactic acidosis
Segluromet has metformin in it, which can cause a rare but serious problem called lactic acidosis. This happens when too much lactic acid builds up in your blood. If it's not untreated, it can lead to dangerous health problems. Tell your prescriber about all your medical conditions and medications. They can check if you're at risk for lactic acidosis.
Get emergency help right away if you have fast breathing, shortness of breath, feel very tired or weak, sleepy, or have a fast heartbeat. These could be signs of too much lactic acid in your blood.
Serious genital infections and urinary tract infections
Risk factors: History of urinary tract infections | History of genital yeast infections | People who are uncircumcised
Segluromet (ertugliflozin / metformin) can raise your risk of getting urinary tract infections (UTIs). It can also make genital infections like yeast infections more likely to happen. And in rare cases, some people have had a serious and dangerous infection in the genital area called Fournier gangrene. Sometimes, these infections can be so serious that you might need to go to the hospital.
Get medical help if you have a fever, pain or burning when you urinate, need to urinate often, or see blood in your urine. These could be signs of a UTI. Also call a healthcare professional if you think you have a genital infection. Look out for fever and itching, pain, tenderness, redness, or swelling in the genital area. You might need to stop Segluromet (ertugliflozin / metformin) so your care team can help treat the problem in the best way.
Low fluids in the body (leading to low blood pressure, dehydration, or kidney problems)
Risk factors: Kidney problems | Age 65 years or older | Low blood pressure | Taking diuretics (water pills)
Segluromet (ertugliflozin / metformin) can cause fluid loss in the body. This can lead to dehydration, low blood pressure, or kidney damage. Make sure to stay hydrated while taking this medication. Let your care team know if you feel dizzy, lightheaded, or tired. Also tell them if you're urinating less than usual, which can be a sign of kidney problems.
Ketoacidosis
Risk factors: Lowering your insulin dose or missing insulin doses | Sudden fever | Lower calorie intake | Ketogenic diet (keto diet) | Surgery | Dehydration | Alcohol use disorder
Some people who take SGLT2 inhibitors, like the ertugliflozin in Segluromet, have had ketoacidosis. It's a serious condition that happens when your body makes too many ketones. It makes your blood too acidic, which can be life-threatening. Your risk is higher if you're sick, eating less than than usual, drinking a lot of alcohol, or just had surgery.
Stop taking Segluromet (ertugliflozin / metformin) and get medical help right away if you notice signs of ketoacidosis. They include dry mouth, fruity-smelling breath, tiredness, vomiting, stomach pain, and trouble breathing.
Leg and foot amputations
Risk factors: History of amputation | Lower limb infection | Peripheral arterial disease (narrowed blood vessels) | Other problems with blood circulation | Diabetic foot ulcers | Male | High A1C | Taking diuretics (water pills) or insulin
In rare cases, Segluromet (ertugliflozin / metformin) might raise the risk of needing an amputation in the lower legs. In studies of people who took ertugliflozin by itself, the need for amputations of a toe or foot was most common. The most common reasons for amputation were leg infections, damaged leg tissue, and diabetic foot ulcers.
Pay close attention to your legs and feet while taking Segluromet (ertugliflozin / metformin). Let your care team know if you have any new pain, tenderness, sores, ulcers, or infections on your legs or feet. You might need to stop taking this medication. The care team can also recommend ways to manage these foot problems or treat them before they get worse. Be sure to follow up with your care team for foot exams.
Low blood sugar (hypoglycemia) when taken with certain diabetes medications
Risk factors: Older adults | Changes in diet or exercise | Taking other medications for diabetes, especially insulin or sulfonylureas (like glipizide)
You're at risk of low blood sugar if you take Segluromet (ertugliflozin / metformin) with insulins or sulfonylureas (such as glipizide). Your prescriber might need to change your doses to help prevent your blood sugar from dropping too low.
Make sure you know the signs of low blood sugar. These can include feeling shaky, very hungry, confused, weak, nervous, sweaty, and a fast heartbeat. If you have low blood sugar, treat it right away. Talk to your care team if you're worried about low blood sugar while taking this medication.
Low vitamin B12 levels
Risk factors: Low vitamin B12 or calcium intake | Problems with vitamin B12 or calcium absorption
Taking Segluromet (ertugliflozin / metformin) can sometimes lower your vitamin B12 levels. This might lead to vitamin B12 deficiency, which can raise your risk of anemia. It might be more likely to happen if you take this medication for several months or more.
Your prescriber might check your vitamin B12 levels and blood cell counts during treatment. Tell your care team if you feel very tired, dizzy, short of breath, or have tingling or numbness in your hands or feet. These could be signs of low vitamin B12 or anemia.
If your levels are too low, your prescriber might suggest taking vitamin B12 supplements to help. Your vitamin B12 levels also usually go back to normal after stopping Segluromet (ertugliflozin / metformin).
Segluromet (ertugliflozin / metformin) dosage forms
Typical dosing for Segluromet (ertugliflozin / metformin)
Take Segluromet by mouth twice a day with meals.
The Segluromet dose is based on how much ertugliflozin and metformin you were taking before as separate medications. Your prescriber might slowly adjust your dose. These adjustments depend on how well the medication is working and if you have any side effects.
Don't take more than 7.5 mg/1,000 mg (ertugliflozin/metformin) twice a day.
How much does Segluromet (ertugliflozin / metformin) cost?
Segluromet (ertugliflozin / metformin) contraindications
Severe kidney problems
End stage kidney disease
On dialysis
High amount of acid in the blood (metabolic acidosis), including from diabetic ketoacidosis
Allergy to Steglatro (ertugliflozin) or metformin
What are alternatives to Segluromet (ertugliflozin / metformin)?
Type 2 diabetes
To lower the risk of major heart events (e.g., heart attack, stroke) in adults with Type 2 diabetes and heart disease
To lower the risk of hospitalization for heart failure, death due to heart problems, and worsening of kidney problems in certain adults with Type 2 diabetes and diabetic kidney disease
Lowering the risk of death due to heart problems in adults with Type 2 diabetes and heart disease
Lowering the risk of hospitalization and death due to heart problems in adults with Type 2 diabetes and heart failure
Lowering the risk of worsening kidney problems, hospitalization, and death due to heart problems in adults with Type 2 diabetes and chronic kidney disease (CKD)
What is the latest news about Segluromet (ertugliflozin / metformin)?
Segluromet (ertugliflozin / metformin) images
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References
Best studies we foundGallo, S., et al. (2019). Long-term efficacy and safety of ertugliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: 104-week VERTIS MET trial. Diabetes, Obesity & Metabolism.
Leslie, S. W., et al. (2025). Fournier gangrene. StatPearls.
Merck Sharp & Dohme LLC. (2024). Segluromet- ertugliflozin and metformin hydrochloride tablet, film coated [package insert]. DailyMed.
You and Your Hormones. (2021). Insulin.
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