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Metformin + icosapent ethyl is a combination of two pharmaceutical agents, each with distinct mechanisms and indications. Metformin is an oral antihyperglycemic agent widely used as first-line therapy for type 2 diabetes mellitus; it acts primarily by decreasing hepatic glucose production and improving insulin sensitivity. Icosapent ethyl is the stable, purified ethyl ester form of eicosapentaenoic acid (EPA), an omega-3 fatty acid, indicated as an adjunct to diet or statin therapy to reduce triglyceride levels in adults with severe hypertriglyceridemia or at high cardiovascular risk. Icosapent ethyl reduces triglycerides through multiple mechanisms including inhibition of hepatic VLDL synthesis/secretion, increased beta oxidation, decreased lipogenesis in the liver, and enhanced clearance of triglyceride-rich particles. The combination may be considered in patients with both type 2 diabetes and elevated triglycerides to address both glycemic control and lipid abnormalities[1][5][8].
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