Metformin combination drugs list
Pro Research Analysisby 
Searched over 200M research papers
Metformin Combination Drugs for Type 2 Diabetes and Other Conditions
Introduction to Metformin-Based Combination Therapy
Metformin is a cornerstone in the treatment of type 2 diabetes mellitus (T2DM) due to its efficacy in lowering blood glucose levels and its relatively favorable safety profile. However, many patients eventually require additional medications to achieve optimal glycemic control. This article synthesizes the current research on various drugs combined with metformin to treat T2DM and other conditions.
Common Metformin Combinations for Type 2 Diabetes
Sulfonylureas and Metformin
Sulfonylureas are frequently combined with metformin to enhance glycemic control. Studies have shown that this combination is effective in reducing HbA1c levels significantly more than metformin alone1 2 4. However, this combination also increases the risk of hypoglycemia compared to other drug combinations3 4.
Thiazolidinediones and Metformin
Thiazolidinediones, such as pioglitazone and rosiglitazone, are another class of drugs often used in combination with metformin. This combination has been shown to improve insulin sensitivity and reduce HbA1c levels, although it carries risks such as weight gain and increased risk of heart failure2 3 4.
DPP-4 Inhibitors and Metformin
Dipeptidyl peptidase-4 (DPP-4) inhibitors, including sitagliptin and saxagliptin, are commonly added to metformin therapy. This combination is effective in lowering HbA1c levels and has a lower risk of hypoglycemia compared to sulfonylureas1 3 4.
SGLT-2 Inhibitors and Metformin
Sodium-glucose cotransporter 2 (SGLT-2) inhibitors, such as canagliflozin and dapagliflozin, are newer additions to the diabetes treatment arsenal. When combined with metformin, they not only lower blood glucose levels but also offer benefits such as weight loss and reduced blood pressure1 3 4.
GLP-1 Receptor Agonists and Metformin
Glucagon-like peptide-1 (GLP-1) receptor agonists, including exenatide and liraglutide, are another effective combination with metformin. This combination helps in significant HbA1c reduction and weight loss, with a lower risk of hypoglycemia1 3 4.
Metformin Combinations for Other Conditions
Metformin and Spironolactone for PCOS
In women with polycystic ovary syndrome (PCOS), combining metformin with low-dose spironolactone has shown superior efficacy in improving menstrual regularity and reducing androgen levels compared to either drug alone6 10. This combination also improves insulin sensitivity and has a favorable safety profile.
Metformin and Chemotherapeutic Drugs
Metformin has been explored as an adjuvant therapy in cancer treatment. When combined with various chemotherapeutic agents, metformin can enhance the efficacy of these drugs and reduce their toxicity. The mechanisms include activation of the AMPK/mTOR pathway and inhibition of oxidative stress and inflammatory signaling pathways7 8.
Conclusion
Metformin-based combination therapies are essential in managing type 2 diabetes and other conditions like PCOS and cancer. These combinations offer enhanced efficacy in glycemic control and other clinical benefits, although they come with varying risks and side effects. Clinicians should consider individual patient profiles when selecting the most appropriate combination therapy.
Sources and full results
Most relevant research papers on this topic
Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes
This updated systematic review reveals that metformin-based combination therapy is more effective and safer than metformin monotherapy for treating type 2 diabetes in terms of intermediate and long-term outcomes.
Systematic Review
Rigorous Journal
Highly CitedComparison of different drugs as add-on treatments to metformin in type 2 diabetes: a meta-analysis.
Sulphonylureas and alpha-glucosidase inhibitors show similar efficacy on HbA1c when combined with metformin in type 2 diabetic patients failing to respond to metformin monotherapy.
Meta-AnalysisComparative Effectiveness and Safety of Medications for Type 2 Diabetes: An Update Including New Drugs and 2-Drug Combinations
Metformin is a first-line agent for treating type 2 diabetes, with most 2-drug combinations similarly reducing hemoglobin A(1c) levels, but some increase risk for hypoglycemia and bone fractures.
Systematic ReviewHighly CitedMetformin and second- or third-generation sulphonylurea combination therapy for adults with type 2 diabetes mellitus.
Metformin and sulphonylurea combination therapy shows mixed results in reducing all-cause and cardiovascular mortality compared to metformin alone for adults with type 2 diabetes mellitus.
Meta-Analysis
Very Rigorous JournalTherapeutic Comparison of Metformin and Sulfonylurea, Alone and in Various Combinations: A double-blind controlled study
Metformin and sulfonylurea both effectively promote glycemic control in non-insulin-dependent diabetes patients, with high-dose combinations further improving glucose control.
RCTHighly CitedImproved efficacy of low-dose spironolactone and metformin combination than either drug alone in the management of women with polycystic ovary syndrome (PCOS): a six-month, open-label randomized study.
The combination of low-dose spironolactone and metformin is superior to either drug alone in improving clinical benefits and compliance in women with polycystic ovary syndrome (PCOS).
RCTRigorous JournalHighly CitedCombination of metformin with chemotherapeutic drugs via different molecular mechanisms.
Combining metformin with chemotherapeutic drugs can decrease toxicity and attenuate tumor resistance, with diverse molecular mechanisms playing a role in their synergistic effects.
Highly CitedCombinational strategies of metformin and chemotherapy in cancers
Metformin combined with chemotherapy shows potential in improving treatment efficacy and lower doses for various cancers, including digestive, reproductive, and lung cancers.
Rigorous JournalHighly CitedDIABETES MEDICATIONS AS MONOTHERAPY OR METFORMIN - BASED COMBINATION THERAPY FOR TYPE 2 DIABETES : A SYSTEMATIC REVIEW
Early combination therapy with metformin and other drugs may provide better diabetes control, with no significant difference between two or three drug combinations.
Systematic ReviewInsulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.
Metformin improves clinical pregnancy rates and ovulation rates in women with PCOS, but does not significantly affect live birth rates.
Meta-AnalysisVery Rigorous JournalHighly Cited