| Diabetes Mellitus, Non-Insulin-Dependent
Kombiglyze XR vs Welchol
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Kombiglyze vs Welchol 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 signalsWelchol has a higher rate of injection site reactions vs Kombiglyze based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Welchol but not Kombiglyze, including UnitedHealthcare
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Category
Kombiglyze
Welchol
At A Glance
Oral
Once daily
DPP4 inhibitor + biguanide
Oral
Daily
Bile acid sequestrant
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Familial hyperlipidemia
- Familial hypercholesterolemia - heterozygous
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Diabetes Mellitus, Non-Insulin-Dependent Administer once daily with the evening meal; individualize starting dose based on current regimen; max 5 mg saxagliptin/2,000 mg metformin HCl extended-release once daily; limit saxagliptin to 2.5 mg daily with strong CYP3A4/5 inhibitors; swallow tablets whole.
Familial hyperlipidemia, Familial hypercholesterolemia - heterozygous 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Diabetes Mellitus, Non-Insulin-Dependent 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Contraindications
- Severe renal impairment (eGFR below 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- History of serious hypersensitivity reaction to saxagliptin, metformin HCl, or any ingredient in KOMBIGLYZE XR, including anaphylaxis, angioedema, or exfoliative skin conditions
- Serum TG concentrations >500 mg/dL
- History of hypertriglyceridemia-induced pancreatitis
- History of bowel obstruction
Adverse Reactions
Most common (>=5%) Upper respiratory tract infection, urinary tract infection, headache (saxagliptin); diarrhea, nausea/vomiting (metformin)
Serious Lactic acidosis, pancreatitis, heart failure, hypoglycemia with insulin or insulin secretagogues, hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid, vitamin B12 decrease
Postmarketing Pancreatitis, anaphylaxis, angioedema, exfoliative skin conditions, rhabdomyolysis, bullous pemphigoid, cholestatic and hepatocellular liver injury
Most common (>=2%) Constipation, dyspepsia, nausea, asthenia, pharyngitis, myalgia (primary hyperlipidemia); constipation, dyspepsia, nausea, hypertension, back pain (type 2 diabetes)
Serious Hypertriglyceridemia, pancreatitis, gastrointestinal obstruction, vitamin K and fat-soluble vitamin deficiencies
Postmarketing Bowel obstruction, dysphagia, esophageal obstruction, fecal impaction, pancreatitis, hypertriglyceridemia, increased transaminases
Pharmacology
Kombiglyze XR combines saxagliptin, a competitive DPP4 inhibitor that slows incretin hormone (GLP-1, GIP) inactivation to enhance glucose-dependent insulin release and suppress glucagon, and metformin HCl, a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity.
Colesevelam hydrochloride is a non-absorbed bile acid sequestrant that binds bile acids in the intestine, depletes the bile acid pool, upregulates hepatic cholesterol 7-alpha-hydroxylase, increases LDL receptor expression, and thereby lowers serum LDL-C; the mechanism by which it improves glycemic control in type 2 diabetes is unknown.
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Most Common Insurance
Anthem BCBS
Kombiglyze
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
Welchol
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Kombiglyze
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (7/8)
Welchol
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Kombiglyze
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Welchol
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Kombiglyze.
No savings programs available for Welchol.
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KombiglyzeView full Kombiglyze profile
WelcholView full Welchol profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.