Short answer: Both pair an SGLT2 inhibitor with a DPP-4 inhibitor in one daily morning tablet.12 Steglujan uses ertugliflozin and sitagliptin; Glyxambi uses empagliflozin and linagliptin. Glyxambi also carries a heart-death use and is not recommended below an eGFR of 30; Steglujan is not recommended below 45 and is held 4 days before surgery, vs 3 for Glyxambi. Neither has a boxed warning.
| Steglujan | Glyxambi | |
|---|---|---|
| What is in it | Ertugliflozin (SGLT2) and sitagliptin (DPP-4)1 | Empagliflozin (SGLT2) and linagliptin (DPP-4)2 |
| Approved for | Blood sugar control in adults with type 2 diabetes1 | Blood sugar control in adults with type 2 diabetes; the empagliflozin part also lowers heart death in adults with established heart disease2 |
| Dose | 5 mg/100 mg once each morning; may go to 15 mg/100 mg1 | 10 mg/5 mg once each morning; may go to 25 mg/5 mg2 |
| Kidney limits | Not recommended with an eGFR below 45; not used below 30 or on dialysis1 | Not recommended with an eGFR below 302 |
| Before surgery | Held at least 4 days, if possible1 | Held at least 3 days, if possible2 |
| Side effects in label trials | Pooled ertugliflozin trials: female genital yeast infection 9.1% and 12.2% vs 3.0% on placebo1 | Pooled trials without placebo: urinary tract infection 12.5% and 11.4%2 |
| Low blood sugar on metformin | 5.3% and 9.0% in a 26-week study with sitagliptin1 | 2.2% and 3.6% over 52 weeks2 |
| Missed dose | Take as soon as possible; do not double1 | Take as soon as possible; do not double2 |
| Boxed warning | None1 | None2 |
The warnings are close because the drug classes match: ketoacidosis even with blood sugar below 250 mg/dL, pancreatitis, fluid loss, urinary and genital infections including Fournier's gangrene, lower limb amputation, low blood sugar with insulin or a sulfonylurea, allergic reactions, severe joint pain, bullous pemphigoid and heart failure seen with two other DPP-4 inhibitors.12 The Steglujan label also lists acute kidney failure reported with sitagliptin.1 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Which, if either, fits is for your prescriber. More detail: Steglujan side effects, Glyxambi side effects, the Steglujan and Glyxambi dosing schedules and Steglatro vs Jardiance: how do the two SGLT2 tablets differ?.