Experiences with
Saxagliptin

Saxagliptin is a medicine used to treat type 2 diabetes.

Type 2 diabetes is a condition 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 usually prescribed when a healthy diet and exercise alone have not been enough to control your blood sugar levels.

It works by increasing the amount of insulin that your body makes. Insulin is the hormone that controls sugar levels in your blood.

Saxagliptin is only available on prescription.

It comes as tablets. It also comes as tablets containing a mixture of saxagliptin and another medicine called metformin or saxagliptin mixed with dapagliflozin. When combined with metformin it's known by the brand name Komboglyze, and Qtern when mixed with dapagliflozin.

Who can take saxagliptin

Most adults aged 18 years and older can take saxagliptin.

Who may not be able to take saxagliptin

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

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

have ever had an allergic reaction to saxagliptin or any other medicine
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

Dosage and strength

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

How to take it

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 drink of water. Swallow the tablet whole, without breaking it.

You can take saxagliptin with or without food.

How long to take it for

Saxagliptin helps keep your blood sugar level as normal as possible to prevent health problems.

You'll probably have to take it for a long time, even for the rest of your life.

Over time it gets harder to control blood sugar levels, so your doctor might eventually recommend stopping saxagliptin and trying a different treatment.

Do not stop taking saxagliptin without speaking to your doctor.

If you 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.

Do not take 2 doses to make up for a forgotten dose.

If you often forget doses, 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.

If you take too much

you take more than your prescribed dose of saxagliptin and:

you have stomach pains
you are feeling or being sick (nausea or vomiting)
you feel dizzy
you are worried

Go to 111.nhs.uk or call 111

Common side effects

These common side effects of saxagliptin happen in more than 1 in 100 people. There are things you can do to help cope with them:

Stop what you're doing and sit or lie down until you feel better. Do not drive, cycle or use tools or machinery if you're feeling dizzy or tired. Do not drink alcohol as it will make you feel worse.

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 the headaches last longer than a week or are severe.

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.

If you take the combined contraceptive pill or progestogen-only pill and you have severe diarrhoea for more than 24 hours , your contraception may not protect you from pregnancy. Check the pill packet for advice.

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 stomach may also help.

If you're in a lot of pain, speak to your pharmacist or doctor.

Try taking saxagliptin with or after food to see if that helps. Try to eat smaller, more frequent meals. Drink plenty of fluids such as water or squash. If you're being sick, try having small, frequent sips of water.

If you take contraceptive pills and saxagliptin makes you sick (vomit) your contraception may not protect you from pregnancy. Look on the pill packet to find out what to do.

Contact your 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 tummy. Drink plenty of water and take paracetamol to ease the pain if you need to.

If you get symptoms such as a sore throat or sinus infection, make sure you rest and drink plenty of fluids. 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.

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.

Talk to your doctor or pharmacist if the advice on how to cope does not help and these side effects bother you or do not go away.

Serious side effects

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

Call your doctor or call 111 straight away if:

you get severe stomach pains
the whites of your eyes turn yellow, or your skin turns yellow, although this may be less obvious on brown or black skin – this can be a sign of liver problems

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
exercise too much without eating enough carbohydrates
drink alcohol, especially after skipping a meal
take some other medicines or herbal medicines at the same time
have a hormone disorder, such as an underactive thyroid (hypothyroidism)
have kidney or liver problems

Preventing hypos

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.

Call your doctor or contact 111 if taking in sugar does not help or the hypo symptoms come back.

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.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of saxagliptin. For a full list, see the leaflet inside your medicine packet.

Saxagliptin and pregnancy

Saxagliptin is not recommended as there's not much information about its safety during pregnancy. Other medicines used to treat diabetes, such as insulin and metformin, are safe to use while pregnant.

If you are pregnant or thinking of getting pregnant, talk to your doctor as they will need to review your treatment. They will be able to suggest a different medicine that is safer for you to take in pregnancy.

Saxagliptin and breastfeeding

Saxagliptin is not usually recommended while breastfeeding. We do not know how much saxagliptin passes into breast milk, but it is possible it could lower your baby's blood sugar level.

If you are breastfeeding, or planning to breastfeed, talk to your doctor about what's best for you and your baby. They will need to review your treatment and may be able to suggest a different medicine for you, particularly if you're breastfeeding a newborn or premature baby.

If your doctor says it's OK to keep taking saxagliptin while breastfeeding, contact your health visitor, midwife, pharmacist or doctor as soon as possible if:

your baby is not feeding as well as usual
your baby seems unusually sleepy or drowsy
your baby seems unusually restless or irritable
your baby is paler, or more sweaty, than usual
your baby seems hungrier than usual
your baby is peeing more
you have any other concerns about your baby

Saxagliptin and fertility

There's no evidence to suggest that taking saxagliptin reduces fertility in either men or women.

Speak to a pharmacist or your doctor if you're trying to get pregnant. They may want to review your treatment.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

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

Tell your doctor or pharmacist if you're taking:

carbamazepine, phenobarbital or phenytoin – medicines for seizures
diltiazem – a medicine for high blood pressure
rifampicin – an antibiotic used in treating tuberculosis (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 not enough information to say that herbal remedies or supplements are safe to take with saxagliptin. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Some herbal remedies might increase your chance of getting low blood sugar with saxagliptin.

Meds New IA (H2) - Cautions with other medicines alert