Saxagliptin is a medicine used to treat type 2 diabetes. Type 2 diabetes is an illness where the body does not make enough insulin, or the insulin that it makes does not work properly.

This can cause high blood sugar levels (hyperglycaemia).

Saxagliptin is prescribed for people who have high blood sugar even though they have a sensible diet and exercise regularly.

Saxagliptin is only available on prescription.

It comes as tablets that you swallow. It also comes as tablets containing a mixture of saxagliptin and metformin or saxagliptin and dapagliflozin.

Metformin and dapagliflozin are other drugs used to treat diabetes.

• Saxagliptin works by increasing the amount of insulin that your body makes. Insulin is the hormone that controls sugar levels in your blood.
• You take saxagliptin once a day.
• The most common side effects of saxagliptin are diarrhoea or stomach ache.
• This medicine does not usually make you put on weight.
• Saxagliptin is also called by the brand name Onglyza. When combined with metformin it's called Komboglyze, and Qtern when mixed with dapagliflozin.

Saxagliptin can be taken by adults (aged 18 years and older).

Saxagliptin is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have had an allergic reaction to saxagliptin or any other medicines in the past
• have kidney disease or liver disease
• have heart failure
• have (or have previously had) problems with your pancreas
• are at increased risk of infection (after an organ transplant or because of a condition like AIDS)
• are pregnant or breastfeeding, or trying to get pregnant

This medicine is not used to treat type 1 diabetes (when your body does not produce insulin).

Take saxagliptin once a day.

You can take it at any time - for example, in the morning or in the evening. Just try to take it at the same time every day.

Take your tablet with a glass of water. Swallow the tablet whole, without breaking it.

You can take sitagliptin with or without food.

How much will I take?

Saxagliptin comes as 2.5mg or 5mg tablets.

The usual dose is 5mg a day.

Your doctor might give you a lower dose of 2.5mg a day if you:

• have problems with your kidneys
• take other diabetes medicines, such as insulin

What if I take too much?

What if I forget to take it?

Take the missed dose as soon as you remember, unless it's nearly time for your next dose.

In this case, skip the missed dose and take your next dose at the usual time.

Never take 2 doses on the same day.

If you forget doses often, it may help to set an alarm to remind you.

You could ask your pharmacist for advice on other ways to remember to take your medicines.

Like all medicines, saxagliptin can cause side effects in some people.

But many people have no side effects or only minor ones.

Common side effects

These common side effects happen in more than 1 in 100 people.

Talk to your doctor or pharmacist if these side effects bother you or do not go away:

• feeling dizzy or weak
• headaches
• diarrhoea
• stomach pains
• feeling or being sick (nausea or vomiting)
• urinary tract infections (UTIs)
• cold-like symptoms
• mild rash

Serious side effects

It happens rarely, but some people may have serious side effects after taking saxagliptin.

Call your doctor straight away if you have:

• severe stomach pains
• yellowing of your skin or the whites of your eyes turn yellow

Low blood sugar

Saxagliptin does not usually cause low blood sugar (known as hypoglycaemia, or "hypos") when taken on its own.

But hypos can happen when you take saxagliptin with other diabetes medicines, such as insulin or gliclazide.

Early warning signs of low blood sugar include:

• feeling hungry
• trembling or shaking
• sweating
• confusion
• difficulty concentrating

It's also possible for your blood sugar to go too low while you're asleep.

If this happens, it can make you feel sweaty, tired and confused when you wake up.

Low blood sugar may happen if you:

• take too much of some types of diabetes medicines
• eat meals irregularly or skip meals
• are fasting
• do not eat a healthy diet and are not getting enough nutrients
• change what you eat
• increase your physical activity without eating more to compensate
• drink alcohol, especially after skipping a meal
• take some other medicines or herbal medicines at the same time
• have a hormone disorder, such as hypothyroidism
• have kidney or liver problems

To prevent hypos, it's important to have regular meals, including breakfast. Never miss or delay a meal.

If you're planning to exercise more than usual, make sure you eat carbohydrates like bread, pasta or cereals before, during or after exercise.

Always carry a fast-acting carbohydrate with you, like sugar cubes, fruit juice or some sweets, in case your blood sugar level gets low. Artificial sweeteners will not help.

You may also need to eat a starchy carbohydrate, like a sandwich or a biscuit, to maintain your blood sugar for longer.

If taking in sugar does not help or the hypo symptoms come back, contact your doctor or the nearest hospital.

Make sure your friends and family know about your diabetes and the symptoms of low blood sugar levels so they can recognise a hypo if it happens.

Serious allergic reaction

It's possible to have a serious allergic reaction (anaphylaxis) to saxagliptin.

These are not all the side effects of saxagliptin.

For a full list, see the leaflet inside your medicines packet.

What to do about:

• feeling dizzy or weak - stop what you're doing and sit or lie down until you feel better. Do not drive or use tools or machinery if you're feeling dizzy or tired. Do not drink alcohol as it'll make you feel worse.
• headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if they last longer than a week or are severe.
• diarrhoea - drink plenty of water or other fluids to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
• stomach ache - try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your tummy may also help. If you're in a lot of pain, speak to your pharmacist or doctor.
• feeling or being sick (nausea or vomiting) - try taking saxagliptin with or after food to see if that helps. Try to eat smaller, more frequent meals. If you're being sick, try having small, frequent sips of water.
• urinary tract infections (UTIs) - talk to your pharmacist or doctor if you have symptoms of a UTI. These include needing to pee suddenly or more often, pain when peeing, smelly or cloudy pee, or pain in your lower belly. Drink plenty of water and take paracetamol to ease the pain if you need to.
• cold-like symptoms - try taking paracetamol or ibuprofen regularly for a few days. If the symptoms return when you stop taking the painkillers, ask your doctor for advice.
• mild rash - it may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you. If your rash gets worse or lasts for more than a week, make an appointment to see your doctor.

Saxagliptin is generally not recommended in pregnancy or while breastfeeding.

Your doctor will only prescribe saxagliptin while you're pregnant or breastfeeding if the benefits of taking the medicine outweigh the risks.

Saxagliptin and breastfeeding

Small amounts of saxagliptin get into breast milk. But it has not been linked with any side effects in breastfed babies.

Talk to your doctor if you want to breastfeed. They may recommend taking a different medicine.

Some medicines and saxagliptin can interfere with each other. Some can increase your risk of getting side effects.

Tell your doctor if you're taking:

• dexamethasone (a steroid used for many conditions, including arthritis and cancer)
• carbamazepine, phenobarbital or phenytoin (medicines for seizures)
• diltiazem (a medicine for high blood pressure)
• ketoconazole (a medicine for fungal infections)
• rifampicin (an antibiotic used in treating TB and other bacterial infections)
• insulin or any other diabetes medicines, such as gliclazide, glipizide, glibenclamide, glimepiride or tolbutamide

Make sure that your doctor and pharmacist know you're taking saxagliptin before starting or stopping any other medicine.

Mixing saxagliptin with herbal remedies and supplements

There's very little information about taking herbal remedies and supplements with saxagliptin.