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DPP-IV Inhibitors

Brand Name (Generic Name)

Januvia (sitagliptin phosphate)

Onglyza (saxagliptin)

DPP-IV Inhibitors are responsible for increasing beta-cell insulin production and decreasing glucagons production in response to blood glucose levels, (i.e when blood glucose levels are high, insulin production is boosted and glucose production by the liver drops off). They amplify the response and reaction of a "normal" pancreas to high blood sugar levels. This mechanism does not work when your blood sugar is low so hypoglycemia is unlikely.

Sitagliptin phosphate has shown weight loss benefits in clinical trials. It also appears to preserve beta cell function.

How often should I take sitagliptin phosphate?

Once a day, as your doctor may suggest. Your doctor may also prescribe this medication in conjunction with metformin, Actos, or Avandia.

When should I take sitagliptin phosphate?

Sitagliptin phosphate can be taken with or without food. You doctor should tell you what will work best for you.

What are possible side effects?

• Upper respiratory infection
• Stuffy or runny nose and sore throat
• Headache
• Stomach discomfort
• Diarrhea

Onglyza (saxagliptin)

What is saxagliptin?

Saxagliptin is an oral prescription medicine used along with diet and exercise to control high blood sugar in adults with type 2 diabetes. Onglyza works by enhancing the body's natural ability to control high blood sugar; it lowers blood sugar by helping the body increase the level of insulin after meals. Onglyza is unlikely to cause your blood sugar to be lowered to a dangerous level (hypoglycemia) because it does not work well when your blood sugar is low. It can be used alone or together with one of several common oral diabetes medicines, such as metformin, a thiazolidinedione (TZD), or a sulfonylurea.

Who can take saxagliptin?

Type 2 diabetes patients can use this prescription medicine.

Who can not take saxagliptin?

• People with type 1 diabetes.
• People who want to treat diabetic ketoacidosis (dangerously high levels of certain acids, known as ketones, in the blood or urine).
• People who are pregnant or plan to become pregnant.

What dosage can I take and how should I take it?

Take saxagliptin by mouth one time each day exactly as directed by your doctor; it can be taken with or without food.

What are the side effects?

Common side effects of saxagliptin include upper respiratory tract infection, urinary tract infection, and headache.

Tradjenta (linagliptin)

What is linagliptin?

Linagliptin is a prescription medicine that is used along with diet and exercise to lower blood sugar in adults with type 2 diabetes. It lowers blood sugar in a glucose-dependent manner by increasing incretin levels, which increase insulin levels after meals and throughout the day. It can be taken alone or in combination with other commonly prescribed medications for type 2 diabetes, such as metformin, sulfonylurea, or pioglitazone. It is not known if linagliptin is safe and effective when used with insulin.

Who can take linagliptin?

Type 2 diabetes patients can use this prescription medicine.

Who can not take linagliptin?

Linagliptin is not for people with type 1 diabetes or for people with diabetic ketoacidosis (increased ketones in the blood or urine).

Do not take linagliptin if you are allergic to linagliptin or any of the ingredients in Tradjenta. Symptoms of a serious allergic reaction to linagliptin are rash, raised red patches on your skin (hives), swelling of your face, lips, and throat that may cause difficulty breathing or swallowing. If you have any symptoms of a serious allergic reaction, stop taking Tradjenta and call your doctor right away.

What should I tell my doctor before taking linagliptin?

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you take other medicines that can lower your blood sugar, such as a sulfonylurea or insulin. If you take linagliptin with another medicine that can cause low blood sugar (hypoglycemia), your risk of getting low blood sugar is higher. The dose of your sulfonylurea medicine of insulin may need to be lowered while you take linagliptin. Signs and symptoms of low blood sugar may include headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heart beat, sweating, or feeling jittery.

Also tell your doctor if you take rifampin (Rifadin, Rimactane, Rifater, Rifamate), an antibiotic that is used to treat tuberculosis.

Linagliptin may affect the way other medicines work, and other medicines may affect how linagliptin works.

Tell your doctor if you are pregnant or planning to become pregnant or are breastfeeding or plan to breastfeed.

What are the side effects?

The most common side effects of linagliptin include stuffy or runny nose and sore throat.

Reviewed by Francine Kaufman, MD.