Metformin Hydrochloride and Siponimod Fumarate

• Generic Name: metformin
• Dosage Forms: n.a.
• Other Brand Names: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet, Glumetza. Riomet

Used as an adjunct to diet and exercise for the management of type 2 diabetes mellitus.

May be used in combination with a sulfonylurea, repaglinide, a thiazolidinedione antidiabetic agent, a dipeptidyl peptidase-4 [DPP-4] inhibitor, a glucagon-like peptide-1 (GLP-1) agonist, or a sodium-glucose cotransporter-2 [SGLT2] inhibitor for the management of type 2 diabetes mellitus in patients who do not achieve adequate glycemic control on monotherapy with metformin or any of these drugs. Also used concomitantly with nateglinide.

May be used with insulin to improve glycemic control and/or decrease the required dosage of insulin.

Commercially available in fixed combination with glyburide or glipizide for use as an adjunct to diet and exercise in adults with type 2 diabetes mellitus. May add a thiazolidinedione antidiabetic agent if patient has inadequate glycemic control with fixed-combination metformin/glyburide therapy.

Commercially available in fixed combination with rosiglitazone for use when treatment with both rosiglitazone and metformin is appropriate.

Commercially available in fixed combination with pioglitazone (as immediate- or extended-release tablets) for use as an adjunct to diet and exercise in patients with type 2 diabetes mellitus who have inadequate glycemic control with pioglitazone or metformin monotherapy or in those who are already receiving pioglitazone and metformin concurrently as separate components.

Commercially available in fixed combination with repaglinide for use as an adjunct to diet and exercise in patients with type 2 diabetes mellitus who are already receiving repaglinide and metformin concurrently as separate components or in those who have inadequate glycemic control with repaglinide or metformin monotherapy.

Commercially available in fixed combination with the DPP-4 inhibitors alogliptin, linagliptin, saxagliptin, or sitagliptin for use as an adjunct to diet and exercise when treatment with both drug components is appropriate.

Commercially available in fixed combinations with the SGLT2 inhibitors canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin for use when treatment with both drugs components is appropriate.

Metformin generally is the preferred initial oral antidiabetic agent for patients with type 2 diabetes mellitus. Potential advantages of metformin compared with sulfonylureas or insulin include minimal risk of hypoglycemia, more favorable effects on serum lipids, reduction of hyperinsulinemia, and weight loss or lack of weight gain.

Not effective as sole therapy in patients with diabetes mellitus complicated by acidosis, ketosis, or coma.

Has been used in the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome.

• Generic Name: siponimod
• Dosage Forms: n.a.
• Other Brand Names: Mayzent, Mayzent Starter Pack

Siponimod fumarate is a sphingosine 1-phosphate receptor modulator indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.