Segluromet

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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).