Qtern

Though rare, people who took saxagliptin have reported inflammation of the pancreas (pancreatitis). It's not known if saxagliptin can raise your risk of pancreatitis if you've had this problem before. Some common symptoms of an inflamed pancreas are upper stomach pain, fever, nausea, and vomiting. If you start to feel any of these symptoms, contact your provider right away. You might need to stop taking Qtern (dapagliflozin / saxagliptin).

• Risk factors: Not eating for a long period of time | After surgery | Sudden fever | Pancreatic problems | Stopping or lowering dose of insulin | Drinking higher amounts of alcohol

Dapagliflozin in Qtern (dapagliflozin / saxagliptin) can cause a rare but serious medical condition called diabetic ketoacidosis (DKA). This condition happens when you don't have enough insulin to help your body use blood sugar as a source for energy. When this occurs, your body gets energy another way by breaking down fat into a type of acid called ketone. But it can be dangerous when too many acidic ketones build up in the blood. It's possible to experience DKA after taking Qtern (dapagliflozin / saxagliptin) even if your blood sugar levels aren't too high, like when you have a fever or when you're recovering from surgery. Seek medical attention right away if you notice signs and symptoms of ketoacidosis, such as trouble breathing, vomiting, belly pain, dry skin and mouth, feeling very tired, and fruity-smelling breath.

• Risk factors: People age 65 years and older | History of kidney problems | Taking certain water pills | Low salt (sodium) diet

Qtern (dapagliflozin / saxagliptin) can cause low levels of fluids in the body because it might cause you to urinate more. This can lead to dehydration, low blood pressure, or sudden kidney injury. Sometimes, the kidney problems can require hospitalization or dialysis. You might be at higher risk for low fluid levels and their complications (e.g., low blood pressure) if you have kidney problems, are taking a loop diuretic, or are of older age. If you have any risk factors for low fluid levels, talk with your provider about how you can safely take Qtern (dapagliflozin / saxagliptin). You might need to get blood and urine tests done before or during treatment so your provider can check your kidney health. Speak with your provider if you feel dizzy, confused, chest pain, or notice you're urinating less than usual while taking Qtern (dapagliflozin / saxagliptin).

• Risk factors: History of urinary tract infections (UTIs) or genital yeast infections

Qtern (dapagliflozin / saxagliptin) might raise your risk of genital and urinary tract infections. These infections can include infections affecting the kidneys and yeast infections. Your risk of a yeast infection is higher if you've had frequent or long-term genital yeast infections in the past. In rare cases, these genital infections can be serious and life-threatening, and they might require hospitalization or surgery. Let your provider know if you have genital itching, pain while urinating, cloudy urine, or back pain. These can be signs of a genital yeast infection or kidney infection. Get medical attention right away if you have symptoms of a more serious infection, like pain, swelling, or redness in the genital area, along with fever and weakness.

• Risk factors: History of allergy to DPP-4 inhibitors (or "gliptins") | History of allergy to SGLT2 inhibitors

Though not common, Qtern (dapagliflozin / saxagliptin) can cause serious allergic reactions, such as rash, peeling or blistering skin, swelling, trouble breathing, and dizziness. These reactions are most common within the first 3 months of starting this medication. Watch out for allergic reactions if you've had a reaction to a different DPP-4 inhibitor (also known as gliptins), like Januvia (sitagliptin). Before taking Qtern (dapagliflozin / saxagliptin), make sure to let your provider know about your medical history.

Rarely, some people taking saxagliptin have experienced an itchy, blistering rash or severe skin infections. Typically, these blisters or sores go away once you stop taking the medication and get treatment for the rash. But if you develop a skin infection, you might need surgery.

If you experience an allergic reaction to Qtern (dapagliflozin / saxagliptin) or you experience itching skin, rash with blisters, or sores, stop the medication and get medical care right away.

Few people who took DPP-4 inhibitors, such as saxagliptin in Qtern (dapagliflozin / saxagliptin), have reported severe joint pain. This can happen anytime from a day to many years after starting this medication. For most people, the pain goes away after stopping the medication. If you experience any discomfort in your joints, speak to your provider right away.

• Risk factors: Heart failure | Heart problems | Kidney problems

If you've recently had a heart or kidney problem, let your provider know before starting Qtern (dapagliflozin / saxagliptin). Some studies show that there might be a chance that taking certain DPP-4 inhibitors might raise the risk for heart failure, especially if you're at high risk of a heart-related event (e.g., heart attack) or heart disease. But other studies seem to show conflicting evidence. More research is needed to fully understand the risk. Let your provider know right away if you experience any symptoms of heart failure, such as trouble breathing, tiredness, swelling in your body, or sudden weight gain. Your provider might recommend that you go to the hospital and that you stop taking Qtern (dapagliflozin / saxagliptin).

• Risk factors: Changes in diet and exercise | Drinking alcohol | Taking other diabetes medications

Qtern (dapagliflozin / saxagliptin) can raise the risk of dangerously low blood sugar when taken together with other diabetes medications, such as insulin and glipizide (Glucotrol). You might also be at risk of having low blood sugar if you've recently changed your diet, exercise, and drinking habits. Very low blood sugar can be life-threatening. Symptoms of low blood sugar include feeling shaky; feeling nervous, anxious, or confused; sweating; and having a fast heartbeat, chills, low energy, and hunger. Make sure you know how to check your blood sugar if you get these symptoms and what to do if you have low blood sugar. Talk to your provider or pharmacist about your risk for low blood sugar.