What are Sitagliptin and Saxagliptin?

Sitagliptin and Saxagliptin are hypoglycemic medications used for treating type 2 diabetes. The first line of treatment for type 2 diabetes mellitus is composed of metformin (for overweight patients). Sulfonylureas used to be the most popular anti-diabetic treatment in the United States until the introduction of metformin. However, sulfonylureas are associated with hypoglycemia, weight gain, beta cell death, and possible cardiac problems. Beyond metformin, DPP-4 inhibitors are popularly becoming another option for many.

DPP-4 Inhibitor Family – Gliptins

Gliptin is a recently introduced class of anti-hyperglycemic drugs with promising advantages. It works by blocking the action of dipeptidyl peptidase-4 (DPP-4), an enzyme that degrades the hormone incretin.

Incretin hormones helps in controlling the production of insulin and release of glucose; specifically, it stimulates the production of more insulin when it is needed, and moderates the production of glucose from the liver when it is not needed.

Various studies have acknowledged the safety and efficacy of gliptins, without promoting weight gain and with lower risk of hypoglycemia.

Difference between Sitagliptin vs. Saxagliptin

Sitagliptin (Januvia)

Saxagliptin (Onglyza)

Mode of ActionInhibits the action of DPP-4 enzyme that destroys GIP and GLP—hormones that are essential in reducing blood sugar levels.Controls blood sugar levels by reducing the breakdown of incretin hormones by inhibiting the action of DPP4.
ContraindicationsContraindicated in patients with pancreatitis, gallstones, high triglyceride levels, and kidney problems.Increases the risk of heart failure, pancreatitis, and pancreatic cancer.
EfficacyShowed similar glycemic controls, but Saxagliptin demonstrated superiority for FBG (fasting blood glucose) control. Generally, safe and effective with lower risk of hypoglycemia compared to other oral anti-hyperglycemic agents.
Drug CombinationOften prescribed alongside metformin, rosiglitazone, or pioglitazone.Often prescribed alongside Metformin.
Side EffectsHeadaches, abdominal pain, upper respiratory infection, nausea, hypoglycemia, and diarrhea.Headaches, vomiting, gastroenteritis, respiratory infection, urinary tract infection, and hypoglycemia.
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