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What is Onglyza (Saxagliptin)?

Onglyza an oral antidiabetic medication that is prescribed alongside a healthy diet and regular exercise to help improve blood sugar levels in adults with type 2 diabetes mellitus. Its chemical, or generic version is called Saxagliptin.

What is it used for?

Onglyza is used to help improve and regulate blood sugar levels in adult patients with type 2 diabetes. It is typically used in combination with the following antidiabetic drugs:

  • Metformin
  • Sulfonylurea
  • Metformin and a sulfonylurea; or
  • Insulin (with or without metformin) when exercise and metformin, diet, sulfonylurea, insulin (with or without metformin), or metformin and a sulfonylurea alone have failed to sufficiently control blood sugar levels

How does this medication work?

Onglyza belongs to a class of antidiabetic medicines called DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors). They help to improve blood sugar levels after a meal and lower blood sugar levels between meals, and they also help decrease the amount of sugar made by your body.

Like all DPP-4 inhibitors, this medication slows down the breakdown of digestive hormones, which increases the overall amount of these hormones in the body. This increased amount of digestive hormones are responsible for the drug’s beneficial effects, which are increased insulin production in response to meals, decreased rate of sugar production in the liver, slower gastric emptying (the rate at which it takes the food to leave the stomach), a reduction in appetite, and improved regeneration of beta cells in the pancreas (the cells that store and produce insulin).

How to take Saxagliptin

Saxagliptin (Onglyza)is only prescribed for type 2 diabetes, and not prescribed for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis. It is recommended to be taken once daily, with or without meals. The tablets must not be split or cut.

Before you take it, your doctor should administer a blood test that measures how well your kidneys are working before and during your treatment. You may need to change your dose if your kidneys are not working well.

Onglyza dosage

Always follow the directions that were given to you by your doctor.

The usual recommended adult dose is 5 mg, taken once daily, with or without food. You might need a lower dose if your kidneys are not working well. When this medication is used together with an insulin secretagogue (e.g., sulfonylurea) or with insulin, a smaller dose of the insulin secretagogue or insulin might be required in order to minimize the risk of low blood sugar (hypoglycemia).

Missed Doses

If you should miss a dose, take it as soon as you remember. If you do not happen to remember until it is almost time for your next dose, skip the missed dose and just go back to your regular schedule. Never take a double dose.

Warnings and Precautions

Before you begin taking Onglyza talk to your doctor if:

  • You have had any allergic reaction to other DPP-4 inhibitors
  • You have or have had any kidney complications
  • You have or have had liver complications
  • You have or have had heart failure
  • You have been told you have a reduced immune system; for example, you have had organ transplantation or have been diagnosed with human immunodeficiency syndrome (HIV/AIDS)
  • You are currently pregnant or are planning to become pregnant
  • You are currently breastfeeding or are planning to breastfeed
  • You have or have had pancreatic problems such as pancreatitis (inflammation of the pancreas)
  • You start or stop taking other medications, including antibiotics, antifungals or HIV/AIDS medications

Onglyza should avoided in patients with end-stage renal disease (ESRD) who require dialysis.

Since lactose monohydrate is one of the non-medicinal ingredients in Onglyza, do not take it if a doctor has told you that you have one of the following hereditary diseases: galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption.

Side effects

Common negative effects may include:

  • Upper respiratory tract infection
  • Urinary tract infection (UTI)
  • Urinary tract infection

Less common negative effects may include:

  • Pancreatitis (inflammation of the pancreas)
  • Heart failure
  • Low blood sugar level (hypoglycemia)
  • Joint Pain
  • Bullous pemphigoid (a skin reaction)
  • Peripheral edema (fluid retention)
  • High blood sugar level (hyperglycemia)

Pancreatitis is a serious condition and can lead to death. Stop taking the medication and contact your doctor immediately if you have symptoms of what might be pancreatitis. These symptoms may include severe and persistent stomach pain. The pain may feel like it is going from the front of your abdomen through to your back. This may occur with or without vomiting.

Contact your doctor immediately if you think you may have any of the following symptoms of heart failure: shortness of breath or trouble breathing, particularly when you are lying down, swelling of the feet, ankles or legs, a rapid increase in weight. You are at a greater risk of heart failure if you currently have or have had:

  • Kidney disease
  • Several risk factors of getting heart disease
  • Heart or blood vessel disease including heart failure or heart attack

When used with certain types of other antidiabetic medicines, such as a sulfonylureas or insulin, the chance of getting low blood sugar (hypoglycemia) is higher.

Symptoms of hypoglycemia may include

  • Hunger
  • Shaking
  • Rapid heartbeat
  • Sweating
  • Headache
  • Changes in mood
  • Changes in vision

Some people who take DPP-4 inhibitors can break out in a skin condition called bullous pemphigoid that may be serious and may require hospital treatment. Tell your doctor immediately if you develop a breakdown of the outer layer of your skin, which would include blisters and hives.

When used alongside a thiazolidinedione (TZD), like pioglitazone or rosiglitazone, fluid retention may become more severe. If you happen to get any symptoms of what you think may be peripheral edema, such as swelling of your feet, ankles or hands, make sure to call your doctor.

Your blood sugar level may also get too high (hyperglycemia) if you have fever, infection, surgery, or trauma (stressful conditions). In these cases, contact your doctor immediately as your medication may need to be changed.

Talk to your health care provider about any side effect that bothers you or does not go away. These are not all the possible negative effects. Call your doctor for medical advice about side effects.

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