Authors

  1. Dalal, Kavitha S. PharmD
  2. Bridgeman, Mary Barna PharmD, BCPS, BCGP

Article Content

Can you identify these medications for diabetes mellitus? To find out, match each brand name in Section I with its generic name in Section II.

 

Section I.

______ 1. Steglatro (Merck Sharp & Dohme Corp.)

 

______ 2. Tresiba (Novo Nordisk)

 

______ 3. Ozempic (Novo Nordisk)

 

Section II

a. Semaglutide. This glucagon-like peptide-1 receptor agonist is indicated, along with diet and exercise, to improve glycemic control in adults with type 2 diabetes mellitus; its use is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or patients with multiple endocrine neoplasia type 2. Semaglutide is initiated as a 0.25 mg subcutaneous injection administered once weekly for 4 weeks; the dose is then increased to 0.5 mg once weekly, to a maximum weekly dose of 1 mg.1 It should be administered once weekly, on the same day each week, at any time of the day, with or without meals. Starting treatment with a lower dose helps to reduce gastrointestinal symptoms, including abdominal pain, nausea, diarrhea, vomiting, and constipation. This medication may cause weight loss and reduce the risk of major adverse cardiovascular events, including cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.

 

b. Insulin degludec. This long-acting basal insulin is indicated for improving glycemic control in patients 1 year of age and older with diabetes mellitus. This insulin formulation can be used with mealtime or rapid-acting insulin or, for patients with type 2 diabetes, in combination with oral or injectable noninsulin medications. Insulin degludec is a clear, colorless solution that should be administered via subcutaneous injection once daily in the thigh, upper arm, or abdomen; injection sites should be rotated within the same region to reduce lipodystrophy. It is available in two concentrations (U-100 and U-200, with 100 units/mL and 200 units/mL, respectively), and in vials and pens for administration; the U-200 concentration is only available in pen form.2

 

c. Ertugliflozin. This medication works by inhibiting the sodium-glucose co-transporter 2 in the kidneys to increase urinary glucose excretion, thereby lowering blood glucose levels. Ertugliflozin is indicated for improving glycemic control in adults with type 2 diabetes, in conjunction with diet and exercise. It is available in 5-mg and 15-mg tablets for oral administration. When initiating treatment, insulin doses, as well as doses of insulin secretagogues, may need to be decreased to reduce the risk of hypoglycemia, and volume depletion should be corrected to prevent acute kidney injury. The starting dose of ertugliflozin is 5 mg once daily, which can be increased to 15 mg once daily if the dose is tolerated. Ertugliflozin is contraindicated in patients on dialysis.3 This medication should be taken in the morning with or without food. Urinary tract infections have been reported with its use.

 

Answers: 1. C, 2. B, 3. A

 

REFERENCES

 

1. Semaglutide injection prescribing information. Novo Nordisk Inc., Plainsboro, New Jersey. 2022. http://www.novo-pi.com/ozempic.pdf. [Context Link]

 

2. Insulin degludec injection prescribing information. Novo Nordisk Inc., Plainsboro, New Jersey. 2019. http://www.novo-pi.com/tresiba.pdf. [Context Link]

 

3. Ertugliflozin prescribing information. Merck & Co., Inc., Rahway, New Jersey. 2022. http://www.merck.com/product/usa/pi_circulars/s/steglatro/steglatro_pi.pdf. [Context Link]