| Diabetes Mellitus, Non-Insulin-Dependent
Cycloset vs Segluromet
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Cycloset vs Segluromet with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsSegluromet has a higher rate of injection site reactions vs Cycloset based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Segluromet but not Cycloset, including UnitedHealthcare
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Category
Cycloset
Segluromet
At A Glance
Oral
Daily
Dopamine D2 receptor agonist
Oral
Twice daily
SGLT2 inhibitor/biguanide
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Diabetes Mellitus, Non-Insulin-Dependent 1.6 mg to 4.8 mg once daily within 2 hours after waking in the morning with food; initiate at 0.8 mg, increase by one tablet per week to maximal tolerated dose; limit to 1.6 mg daily with moderate CYP3A4 inhibitors; avoid with strong CYP3A4 inhibitors.
Diabetes Mellitus, Non-Insulin-Dependent Individualize starting dosage; take orally twice daily with meals; maximum recommended dosage is 7.5 mg ertugliflozin/1,000 mg metformin HCl per dose (15 mg/2,000 mg daily); not recommended if eGFR <45 mL/min/1.73 m2; contraindicated if eGFR <30 mL/min/1.73 m2, ESRD, or dialysis.
Contraindications
- Known hypersensitivity to bromocriptine, ergot-related drugs, or any excipient in CYCLOSET
- Syncopal migraine
- Postpartum patients
- Lactating patients
- Hypersensitivity to ertugliflozin, metformin, or any excipient in SEGLUROMET
- Severe renal impairment (eGFR less than 30 mL/min/1.73 m2), end stage-renal disease (ESRD), or dialysis
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
Adverse Reactions
Most common (>=5%) Nausea, fatigue, vomiting, headache, dizziness, rhinitis, constipation, sinusitis, diarrhea, asthenia, somnolence, dyspepsia, amblyopia, anorexia
Serious Hypotension, psychotic disorders, somnolence, syncope, fibrotic-related complications, cardiovascular events (myocardial infarction, stroke)
Postmarketing Hallucinations, retroperitoneal fibrosis, pulmonary fibrosis, pleural effusion, pericarditis, pericardial effusions, cardiac valvulopathy, psychotic and psychiatric disorders, impulse control/compulsive behaviors, neuroleptic-like malignant syndrome
Most common (>=2%) Female genital mycotic infections, male genital mycotic infections, urinary tract infections, headache, vaginal pruritus, increased urination, nasopharyngitis, back pain, weight decreased, thirst
Most common (>=5%, metformin) Diarrhea, nausea, vomiting, flatulence, abdominal discomfort, indigestion, asthenia, headache
Serious Lactic acidosis, diabetic ketoacidosis, lower limb amputation, volume depletion, urosepsis and pyelonephritis, hypoglycemia, Fournier's Gangrene, vitamin B12 deficiency
Postmarketing Necrotizing fasciitis of the perineum (Fournier's Gangrene), angioedema, rash (ertugliflozin); cholestatic, hepatocellular, and mixed hepatocellular liver injury (metformin)
Pharmacology
CYCLOSET (bromocriptine mesylate) is a sympatholytic dopamine D2 receptor agonist; timed morning administration in type 2 diabetes is associated with increased insulin sensitivity and glucose disposal and reduced fasting and postprandial hyperglycemia without raising plasma insulin levels.
Ertugliflozin is an SGLT2 inhibitor that reduces renal glucose reabsorption and lowers the renal threshold for glucose, increasing urinary glucose excretion; metformin HCl is a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity.
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Most Common Insurance
Anthem BCBS
Cycloset
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (2/12) · Qty limit (6/12)
Segluromet
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Cycloset
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Segluromet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (1/8)
Humana
Cycloset
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (2/3) · Qty limit (2/3)
Segluromet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Cycloset.
No savings programs available for Segluromet.
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CyclosetView full Cycloset profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.