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saxagliptin

Generic Onglyza
Used for Diabetes Type 2
Used for Diabetes Type 2

Saxagliptin (Onglyza) is an add-on medication to exercise and a balanced, nutritious diet to improve blood sugar control in adults with Type 2 diabetes. It belongs to the drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors. The saxagliptin (Onglyza) dosage is taken by mouth once daily. Possible side effects include certain infections and headaches. The brand name, Onglyza, is no longer available. But the lower-cost generic version is still available.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on June 24, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesLatest newsReferencesPricesMedicare
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What is Saxagliptin (Onglyza)?

What is Saxagliptin (Onglyza) used for?

How Saxagliptin (Onglyza) works

Saxagliptin (Onglyza) is a dipeptidyl peptidase-4 (DPP-4) inhibitor, or also known as a "gliptin." It works by blocking the action of DPP-4, a protein that breaks down hormones that tell the body to make insulin. By blocking DPP-4, the medication allows insulin to stick around in the body longer to help control your blood sugar levels.

Are you looking for information on sitagliptin (Januvia) instead?

Drug Facts

Common BrandsOnglyza (brand name no longer available)
Drug ClassDPP-4 inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the side effects of Saxagliptin (Onglyza)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Other Side Effects

  • Low blood sugar

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Inflammation of the pancreas: upper belly pain, nausea, vomiting, fever, fast heartbeat, shortness of breath
  • Heart failure: trouble breathing; swelling in your legs, ankles, or feet; rapid weight gain
  • Severe allergic reaction: hives; trouble breathing; swelling of your face, lips, or tongue

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Anxiety

bladder pain

bloating or swelling of the face, arms, hands, lower legs, or feet

bloody or cloudy urine

blurred vision

body aches or pain

chills

cold sweats

confusion

cool, pale skin

cough

depression

difficult, burning, or painful urination

difficulty with breathing

dizziness

ear congestion

fast heartbeat

fever

frequent urge to urinate

headache

increased hunger

loss of voice

lower back or side pain

nasal congestion

nausea

nightmares

rapid weight gain

runny nose

seizures

shakiness

slurred speech

sneezing

sore throat

tingling of the hands or feet

unusual tiredness or weakness

unusual weight gain or loss

Incidence not known

Chest pain

constipation

darkened urine

decreased urine output

difficulty with swallowing

dilated neck veins

extreme fatigue

flaking or peeling of the skin

hives or skin rash

indigestion

irregular breathing

irregular heartbeat

large, hard skin blisters

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

loss of appetite

pains in the stomach, side, or abdomen, possibly radiating to the back

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

severe joint pain

swelling of face, fingers, feet, or lower leg

tightness in the chest

troubled breathing

vomiting

weight gain

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Diarrhea

pain or tenderness around the eyes and cheekbones

redness of the skin

weakness

welts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Saxagliptin (Onglyza)

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Pros

Taken once daily (with or without food)

Less likely to cause weight gain (compared to some other diabetes medications)

Very low risk of causing hypoglycemia (low blood sugar) when it's taken by itself

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Cons

Doesn't lower A1C and blood sugar levels as well as other diabetes medications

Might raise risk of hospitalization due to heart failure in certain people

Not for treating Type 1 diabetes or diabetic ketoacidosis

pharmacist-tips

Pharmacist tips for Saxagliptin (Onglyza)

pharmacist

  • Take saxagliptin (Onglyza) by mouth once daily with or without food. Food won't affect how well the medication works for you.

    • Swallow the saxagliptin (Onglyza) tablets whole. Don't cut or split your tablets. Speak with your prescriber about your options if you have trouble swallowing the saxagliptin (Onglyza) tablets.

      • Speak with your healthcare team about ways to plan balanced and nutritious meals and an exercise routine that works best for you. It's recommended to follow a consistent diet and exercise regimen to help you get the most from your treatment with saxagliptin (Onglyza).

        • Let your healthcare care know about all the medications you're currently taking and planning to take with saxagliptin (Onglyza). Certain medications can interact with saxagliptin (Onglyza), and these interactions can sometimes raise your risk for side effects. Your prescriber might need to adjust the dose of your medications, including saxagliptin (Onglyza), to keep you safe.

          • Stop taking saxagliptin (Onglyza) and contact your prescriber right away if you have severe stomach pain that doesn't go away. This could be a sign of dangerous pancreas inflammation.

            • If you miss a dose of saxagliptin (Onglyza), take it as soon as you remember. If it's close to the time for your next dose, skip the missed dose and continue taking the medication as usual (take your next dose as usual). Don't double up on doses to make up for the missed dose.

              faqs

              Frequently asked questions about Saxagliptin (Onglyza)

              How long does saxagliptin (Onglyza) take to work?
              A clinical trial showed that saxagliptin (Onglyza) can start to work to lower blood sugar levels soon after you start treatment. But it can take up to a few weeks to months to see the full effects of the medication in lowering your blood sugar and improving your A1C level (average blood sugar level over a few months). This clinical study compared people who took saxagliptin (Onglyza) with metformin and people who took metformin alone. Make sure you continue to follow a nutritious diet and regular exercise routine so that saxagliptin (Onglyza) works as best as possible for you.
              Is saxagliptin (Onglyza) generic?
              Yes. The brand-name version of the medication called Onglyza was discontinued by the manufacturer. But luckily, there are generic versions of the medication available. The first generic saxagliptin (Onglyza) tablets were approved in 2023.
              When is the best time to take saxagliptin (Onglyza)?
              You can generally take the saxagliptin (Onglyza) tablet at any time of day that's convenient for you. You can also take the medication before or after a meal. Once you decide on the general time you would like to take saxagliptin (Onglyza), it's best to continue to take the medication at around the same time each day. Making it a part of your daily routine can help you remember to take the medication.
              Does saxagliptin (Onglyza) cause weight gain?
              In clinical trials, saxagliptin (Onglyza) didn't have a large effect on most people's weight. This is unlike some other diabetes medications that are known to have an effect on weight, such as insulin. Discuss with your prescriber if you notice a change in your weight after you start treatment with saxagliptin (Onglyza).
              Can you drink alcohol with saxagliptin (Onglyza)?
              Talk to your healthcare team about whether you can drink alcohol while you're taking saxagliptin (Onglyza). Alcohol can affect blood glucose levels in people with diabetes. You'll also want to avoid drinking alcohol on an empty stomach or following exercise, as it can put you at risk for having low blood sugar.
              Can you take saxagliptin (Onglyza) and metformin together?
              Yes, it's possible that the healthcare professional who's managing your diabetes might prescribe saxagliptin (Onglyza) and metformin for you to take together. Metformin remains a first-choice medication to control your blood sugar. Your prescriber might add saxagliptin (Onglyza) to your treatment if your A1C is still high with metformin, a balanced and nutritious diet, and regular exercise.
              What is the difference between saxagliptin and alogliptin?
              Saxagliptin (Onglyza) and alogliptin (Nesina) are both DPP-4 inhibitors that are used to treat Type 2 diabetes. They're both once-daily options, are tablets that are taken by mouth, and have a low potential for causing weight gain. Talk with prescriber or healthcare professional who's managing your diabetes about which medication would be best for you.
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              What are the risks and warnings for Saxagliptin (Onglyza)?

              Saxagliptin (Onglyza) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Pancreas problems

              Although rare, some people who took saxagliptin (Onglyza) in clinical studies reported having inflammation in their pancreas (pancreatitis). It's not known whether this medication can raise your risk of pancreatitis if you've had this medical problem before. Some common symptoms of an inflamed pancreas are upper stomach pain, fever, nausea, and vomiting. Contact your prescriber right away if you start to feel any of these symptoms. You might need to stop taking saxagliptin (Onglyza).

              risk-warning

              Heart failure

              • Risk factors: History of heart failure | History of kidney issues

                Clinical trials for saxagliptin (Onglyza) discovered a link between DPP-4 inhibitor treatment and hospitalization for heart failure in people who have or are at risk for heart disease. Be sure your prescriber knows about your medical history to discuss the risks and benefits of treatment with saxagliptin (Onglyza). Get medical help right away if you notice any symptoms related to heart failure, such as shortness of breath, irregular heartbeat, sudden weight gain, and swelling in the feet or ankles, while you're taking saxagliptin (Onglyza).

                risk-warning

                Low blood sugar (hypoglycemia)

                • Risk factors: Changes in diet and exercise | Drinking alcohol | Taking other diabetes medications, especially insulin or sulfonylureas | Over age 65 | Liver or kidney problems

                  Taking saxagliptin (Onglyza) by itself, but more likely together with certain other diabetes medications like insulin, can cause low blood sugar. Very low blood sugar can sometimes be life-threatening. Symptoms of low blood sugar include feeling shaky, weak, or very hungry; being nervous or confused; having fast heartbeat or body chills; sweating; and feeling sleepy. Talk to your prescriber or pharmacist if you're concerned about having low blood sugar levels during treatment.

                  risk-warning

                  Joint pain

                  Although rare, DPP-4 inhibitors like saxagliptin (Onglyza) can cause severe and disabling joint pain. This joint pain can occur within one day to years after starting the medication. Talk to your prescriber right away if you experience any discomfort in your joints.

                  risk-warning

                  Large blisters

                  There have been some reports of people who developed large, fluid-filled blisters (bullous pemphigoid) after they took DPP-4 inhibitors like saxagliptin (Onglyza). These blisters usually go away with appropriate treatment and once you stop taking saxagliptin (Onglyza). Contact your prescriber right away if you develop blisters or sores on the skin. You might need to stop taking saxagliptin (Onglyza) and get referred to a dermatologist for treatment.

                  risk-warning

                  Risk of allergic reaction

                  • Risk factors: Allergy to Yellow No. 5 dye | Allergy to aspirin | Allergy to other DPP-4 inhibitors

                    Although rare, it's possible for you to develop an allergic reaction from taking saxagliptin (Onglyza). Allergic reactions to the medication can be due to the dye colorings that are in the saxagliptin (Onglyza) tablets. People who have an allergy to aspirin might be at risk for allergic reactions to the dye colorings. Make sure your prescriber knows about all of your allergies before you start this medication.

                    Allergic reactions can include swelling of the face, a blistering rash, and anaphylaxis. Reports of allergic reactions to saxagliptin (Onglyza) happened within the first 3 months of treatment. Stop taking saxagliptin (Onglyza) and get emergency medical help right away if you have an allergic reaction to the medication.

                    dosage

                    Saxagliptin (Onglyza) dosage forms

                    The average cost for 30 tablets of 5mg of Saxagliptin (Onglyza) is $54.72 with a free GoodRx coupon. This is 84.66% off the average retail price of $356.77.
                    tablet
                    Tablet
                    DosageQuantityPrice as low asPrice per unit
                    2.5mg30 tablets$127.29$4.24
                    5mg30 tablets$54.72$1.82

                    Typical dosing for Saxagliptin (Onglyza)

                    The typical dose is 2.5 mg or 5 mg by mouth once daily.

                    interactions

                    Interactions between Saxagliptin (Onglyza) and other drugs

                    Saxagliptin (Onglyza) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Saxagliptin (Onglyza). Please note that only the generic name of each medication is listed below.

                    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                    drug-cost

                    How much does Saxagliptin (Onglyza) cost?

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                    Saxagliptin (Onglyza) (generic)
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                    alternatives

                    What are alternatives to Saxagliptin (Onglyza)?

                    There are a number of medications that your doctor can prescribe in place of Saxagliptin (Onglyza). Compare a few possible alternatives below.
                    Saxagliptin (Onglyza)
                    Used for:
                    $54.72 Lowest GoodRx priceView Prices
                    Januvia (sitagliptin)
                    Used for:

                    • Type 2 diabetes in adults

                    $335.54 Lowest GoodRx priceView Prices
                    Glyburide
                    Used for:

                    • Type 2 diabetes

                    $23.93 Lowest GoodRx priceView Prices

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                    References

                    Best studies we found

                    American Diabetes Association Professional Practice Committee. (2024). 9. Pharmacologic approaches to glycemic treatment: Standards of Care in Diabetes–2024. Diabetes Care.

                    Aurobindo Pharma Limited. (2024). Saxagliptin tablet, film coated [package insert]. DailyMed.

                    Drugs@FDA: FDA-Approved Drugs. (n.d.). Onglyza. U.S. Food and Drug Administration.

                    View All References (4)

                    Gastelli, G. (2024). Should metformin continue as first-line pharmacotherapy for patients with type 2 diabetes? Yes: Metformin is still the best choice. American Family Physician.

                    Scirica, B. M., et al. (2013). Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. The New England Journal of Medicine.

                    U.S. Food and Drug Administration. (2024). 2023 first generic drug approvals.

                    You and Your Hormones. (2021). Insulin.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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