Saxagliptin

Key facts

• Saxagliptin (sold as Onglyza) is a DPP-4 inhibitor. It boosts your body's own insulin response after meals and reduces the sugar your liver releases.
• You take it once a day, with or without food, usually alongside diet and exercise or other diabetes medicines such as metformin.
• Saxagliptin has been linked to a higher rate of hospitalization for heart failure. Tell your doctor promptly about new or worsening shortness of breath, swelling in the legs or ankles, or sudden weight gain.
• Seek urgent care for severe, persistent abdominal pain, which can signal pancreatitis.

What saxagliptin treats

Saxagliptin treats type 2 diabetes, helping to lower blood glucose when diet and exercise alone are not enough. It is often combined with metformin or other diabetes medicines. It is not used for type 1 diabetes or diabetic ketoacidosis.

How saxagliptin works

After meals, your gut releases hormones called incretins that tell the pancreas to release insulin and tell the liver to release less sugar. An enzyme called DPP-4 quickly breaks these hormones down. Saxagliptin blocks DPP-4, so the incretin hormones last longer and blood sugar control improves, mainly around meals.

Before you take it

• Tell your prescriber if you have heart failure or a history of it. Saxagliptin is linked to a higher risk of hospitalization for heart failure, and your doctor may choose a different medicine if you already have heart failure.
• Tell your prescriber about any history of pancreatitis or gallstones, since DPP-4 inhibitors carry a small risk of pancreatitis.
• Saxagliptin does not usually cause low blood sugar on its own, but combining it with insulin or a sulfonylurea increases that risk, and your doctor may lower those doses.
• Kidney function affects your dose; tell your prescriber about any kidney problems.

Side effects

Common effects include upper respiratory infections, headache, and urinary tract infections.

Stop and seek urgent medical care for any of these:

• Severe, persistent abdominal pain, sometimes spreading to the back, possibly with nausea and vomiting.
• Swelling of the face, lips, tongue or throat, or a widespread blistering rash.
• New or worsening shortness of breath, swelling in the legs or ankles, or rapid weight gain.

Safety essentials

• Saxagliptin carries a recognized risk of heart failure hospitalization. Report breathlessness, swelling or sudden weight gain to your doctor without delay, especially if you have existing heart disease.
• Stop the medicine and seek care immediately for severe abdominal pain, since rare cases of acute pancreatitis have occurred.
• Continue routine blood-sugar monitoring and attend follow-up appointments so your dose and combination therapy can be adjusted safely.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.