COMBINATION DRUGS FOR TYPE 2 DIABETES


In recents years, pharmaceutical companies have been combining various diabetes drugs into one pill in order to increase patient compliance and treatment efficacy.

Combination drugs include metformin and pioglitazone (Actoplus Met ® / Competact®), glimepiride and rosiglitazone (Avandaryl™), Avandamet®, glimepiride and pioglitazone (Duetact® / Tandemact™), metformin and vidagliptin (Eucreas®), metformin and glyburide (Glucovance®), metformin and sitagliptin (Janumet™) and metformin and glipizide (Metaglip™). While most combinations are proprietary, some are also available as generics.

  • glimepiride and pioglitazone (Actos®)

    Tradename(s) Duetact® (US) / Tandemact™ (Europe)
    Company(ies) Takeda
    Available doses 2 mg / 30 mg and 4 mg / 30 mg
    Dose per day once daily
    US patent status  
    US FDA status approved July 2006
    EMEA status approved January 2006
    Indication

    Duetact is indicated as an adjunct to diet and exercise as a once-daily combination therapy to improve glycemic control in patients with type 2 diabetes who are already treated with a combination of pioglitazone and a sulfonylurea or whose diabetes is not adequately controlled with a sulfonylurea alone, or for those patients who have initially responded to pioglitazone alone and require additional glycemic control.

  • glimepiride and rosiglitazone (Avandia®)

    Tradename(s) Avandaryl™ (USA) / Avaglim™ (Europe)
    Company(ies) GlaxoSmithKline
    Available doses 1 mg /4 mg, 2 mg /4 mg, 4 mg / 4 mg, 2mg / 8 mg and 4 mg / 8 mg
    Dose per day once daily
    US patent status expires 2012
    US FDA status approved November 2005
    EMEA status approved June 2006
    Indication
    Avandaryl is indicated as an adjunct to diet and exercise, to improve glycemic control in patients with type 2 diabetes mellitus when treatment with dual rosiglitazone and glimepiride therapy is appropriate.
    Comments
    GlaxoSmithKline reported sales of £42M in 2006 and £50M in 2007.

  • metformin and glipizide

    Tradename(s) Metaglip™ (also available as a generic)
    Company(ies) Bristol-Myers Squibb
    Available doses 250 mg / 2.5 mg, 500 mg / 2.5 mg and 500 mg / 5 mg
    Dose per day with meals
    US patent status  
    US FDA status approved October 2007
    EMEA status  
    Indication
    Metaglip is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

  • metformin and glyburide

    Tradename(s) Glucovance® (also available as a generic)
    Company(ies) Bristol-Myers Squibb
    Available doses 250 mg / 2.5 mg, 250 mg / 2.5 mg and 1,000 mg / 5 mg
    Dose per day once or twice daily
    US patent status  
    US FDA status approved July 2000
    EMEA status  
    Indication

    Glucovane is indicated as initial therapy, as an adjunct to diet and exercise, to improve glycemic control in patients with type 2 diabetes whose hyperglycemia cannot be satisfactorily managed with diet and exercise alone.

    Glucovance is indicated as second-line therapy when diet, exercise, and initial treatment with a sulfonylurea or metformin do not result in adequate glycemic control in patients with type 2 diabetes. For patients requiring additional therapy, a thiazolidinedione may be added to Glucovance to achieve additional glycemic control.

  • metformin and pioglitazone (Actos®)

    Tradename(s) Actoplus Met® (USA) / Competact® (Europe)
    Company(ies) Takeda
    Available doses 500 mg / 15 mg (USA) and 850 mg / 15 mg
    Dose per day with meals
    US patent status  
    US FDA status approved August 2005
    EMEA status approved July 2006
    Indication
    ActoPlus Met is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes who are already treated with a combination of pioglitazone and metformin or whose diabetes is not adequately controlled with metformin alone, or for those patients who have initially responded to pioglitazone alone and require additional glycemic control.

  • metformin and rosiglitazone (Avandia®)

    Tradename(s) Avandamet®
    Company(ies) GlaxoSmithKline
    Available doses 500 mg/ 1 mg, 500 mg/ 2 mg, 500 mg / 4 mg, 1,000 mg / 2 mg, 1,000 mg / 4 mg
    Dose per day twice daily
    US patent status expires 2012
    US FDA status approved October 2002
    EMEA status approved October 2003
    Indication
    Avandamet is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus when treatment with dual rosiglitazone and metformin therapy is appropriate.
    Comments
    GlaxoSmithKline reported sales of £204M in 2006 and £292M in 2007.

  • metformin and sitagliptin (Januvia™)

    Tradename(s) Janumet™ / Efficib™
    Company(ies) Merck & Co.
    Available doses 500 mg / 50 mg and 1,000 mg / 50 mg
    Dose per day twice daily (with meals)
    US patent status 2022
    US FDA status approved March 2007
    EMEA status approved July 2008
    Indication
    Janumet is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both sitagliptin and metformin is appropriate.
    Comments
    Merck & Co. reported sales of $86M in 2007 and $ 351M in 2008.

  • metformin and vidagliptin (Galvus®)

    Tradename(s) Eucreas®
    Company(ies) Novartis Pharma
    Available doses 850 mg / 50 mg and 1,000 mg / 50 mg
    Dose per day twice daily
    US patent status  
    US FDA status not approved
    EMEA status approved November 2007
    Indication
    Eucreas is indicated in the treatment of type 2 diabetes mellitus patients who are unable to achieve sufficient glycaemic control at their maximally tolerated dose of oral metformin alone or who are already treated with the combination of vildagliptin and metformin as separate tablets.