Onglyza (Saxagliptin) - Oral

What Is Onglyza?

Onglyza (saxagliptin) is a prescription drug used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes.

Onglyza is in a drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors. DPP-4 inhibitors are also known as gliptins because the chemical name of every drug in the class ends in gliptin.

Onglyza works by stimulating the production and release of insulin, which helps lower blood sugar levels. It also decreases glucagon. Glucagon is a hormone that helps the liver release glucose (sugar) to raise blood sugar levels. Therefore, decreasing glucagon lowers blood sugar levels.

It is available as an oral tablet, in brand name only. There is no generic available.

Drug Facts

Generic Name: Saxagliptin

Brand Name(s): Onglyza

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Hypoglycemic

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Saxagliptin

Dosage Form(s): Tablet

What Is Onglyza Used For?

The Food and Drug Administration (FDA) approved Onglyza to use along with diet and exercise to improve blood sugar control in adults with type 2 diabetes. It can be used alone or with other drugs for diabetes.

Onglyza cannot be used to treat type 1 diabetes or diabetic ketoacidosis (DKA). DKA is a complication of diabetes that can be life-threatening. It occurs when the body makes high levels of blood acids (ketones). Although DKA is more common in people with type 1 diabetes, it can also occur in people with type 2 diabetes.

How to Take Onglyza

Before taking Onglyza, read the information leaflet that comes with your prescription. Discuss any questions with your healthcare provider.

Take Onglyza by mouth as prescribed by your healthcare provider, usually once daily, with or without food. Swallow the tablet whole; do not split, cut, or chew it. Do not skip any doses or take more or less than instructed.

Here are a few additional considerations while on Onglyza:

  • Tell your healthcare provider if you have a fever, infection, trauma, or upcoming surgeries, as these situations can affect blood sugar.
  • Before and during treatment, your healthcare provider will order lab work to test your kidney function. If you have kidney problems, you may need a lower dose of Onglyza.
  • Follow recommended diet and exercise plans.
  • Follow instructions for checking blood sugar and treating hypoglycemia (low blood sugar).

Be aware of the signs and symptoms of low blood sugar, such as:

  • Hunger
  • Confusion
  • Shakiness
  • Dizziness
  • Blurred vision

Your healthcare provider will tell you how to treat low blood sugar. You may need to eat or drink fast-acting sugar, like glucose tablets or juice. Also, ask about a glucagon prescription, such as Baqsimi nasal spray, which can be used in emergencies to treat severe low blood sugar.

Storage

Store Onglyza at room temperature (68 F to 77 F), away from heat, direct light, and moisture. Do not store Onglyza in the bathroom. Keep the medication in its original labeled container and out of the reach of children and pets. Keep the bottle tightly closed when not in use.

How Long Does Onglyza Take to Work?

After a single dose of Onglyza, the highest level is reached in the body in about two hours. However, it may take a few days or weeks of treatment to see an effect on blood sugar.

What Are the Side Effects of Onglyza?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Onglyza are:

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and symptoms can include the following:

  • Hypersensitivity reaction/anaphylaxis or skin reaction: Symptoms can include rash, hives, red or purple skin rash, blistering or peeling skin, swelling around the lips, tongue, and face, and/or difficulty breathing. These symptoms require emergency medical attention. 
  • Hypoglycemia (low blood sugar): Symptoms include hunger, dizziness, blurred vision, shakiness, and confusion. Your healthcare provider will tell you how and when to treat low blood sugar.  
  • Heart failure: Call your healthcare provider immediately if you have symptoms of swelling, rapid weight gain, or shortness of breath.
  • Pancreatitis: Pancreatitis is an inflamed pancreas, which can be life-threatening. Call your healthcare provider immediately if you have pain in the upper stomach (which may spread to the back), with or without vomiting.
  • Severe joint pain: Call your healthcare provider immediately if you have severe joint pain or joint pain that does not go away.
  • Bullous pemphigoid (a rare skin condition that causes blisters filled with fluid): Call your healthcare provider immediately if you have itching, blisters, or a breakdown of the skin’s outer layer.
  • Rhabdomyolysis (muscle breakdown which can cause kidney damage)

Long-Term Side Effects

While many people tolerate Onglyza, long-term or delayed side effects are possible. Some long-term or delayed side effects, such as upper respiratory or sinus infection, sore throat, or joint pain, can be mild.

Moderate long-term or delayed side effects can include swelling of the extremities, low white blood cell counts, or low platelet counts.

Severe long-term or delayed side effects may include:

  • Kidney failure
  • Inflamed pancreas
  • Severe skin reactions
  • Bone fractures
  • Heart failure
  • Muscle breakdown (which can also lead to kidney damage)

Report Side Effects

Onglyza may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Onglyza Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For Type 2 diabetes:
      • Adults—2.5 or 5 milligrams (mg) once a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, it is important for users to be aware of the following when taking Onglyza.

Children: Onglyza is not approved for use in children under 18. 

Pregnant or breastfeeding people: There is limited data on people who are pregnant or nursing and taking Onglyza. Consult your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. If you already take Onglyza and find out you are pregnant, consult your healthcare provider for advice.  

Older adults: Adults 65 and older may be more sensitive to Onglyza, especially if they also have heart or kidney problems, which can increase the risk for heart failure or kidney disease. Older adults should be monitored for symptoms of heart failure. If heart failure develops, the drug may have to be stopped. In this case, your healthcare provider may select another drug. Older adults with kidney problems may need a lower dose, as well as regular kidney function monitoring. 

People with kidney problems: People with kidney problems may need a lower dose, and regular monitoring will be necessary.

People with liver problems: A dosage adjustment is not required for people with liver problems.

Missed Dose

If you miss a dose of Onglyza, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Do not take two doses together unless your healthcare provider tells you to do so.

Overdose: What Happens If I Take Too Much Onglyza?

Taking too much Onglyza can cause symptoms of low blood sugar such as:

  • Weakness
  • Confusion
  • Tremors
  • Excessive sweating
  • Trouble speaking
  • Nausea or vomiting
  • Fast heart rate and breathing
  • Fainting
  • Seizure

What Happens If I Overdose on Onglyza?

If you think you or someone else may have overdosed on Onglyza, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Onglyza, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Pancreatitis (swelling and inflammation of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

If you are rapidly gaining weight, having trouble breathing, chest pain, extreme tiredness or weakness, irregular breathing, irregular heartbeat, or excessive swelling of the hands, wrist, ankles, or feet, check with your doctor immediately. These may be symptoms of a heart problem.

This medicine may cause serious allergic reactions, including anaphylaxis, angioedema, and serious skin reactions. These conditions may be life-threatening and require immediate medical attention. Check with your doctor right away if you have a rash, itching, a large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, skin flaking or peeling, trouble with breathing, or chest tightness while you are using this medicine.

This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms of low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Talk to your doctor about the best way to treat low blood sugar.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar.

This medicine may cause severe joint pain. Call your doctor right away if you have severe joint pain with this medicine.

This medicine may cause bullous pemphigoid. Tell your doctor if you have large, hard skin blisters while using this medicine.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Onglyza?

Onglyza is not appropriate for everyone. Some people should not take Onglyza. For example, you should not take this medication if you are allergic to saxagliptin, any drug in the DPP-4 inhibitor class of drugs, or any inactive ingredients in Onglyza. It also should not be used to treat people with type 1 diabetes or diabetic ketoacidosis. 

Onglyza may be prescribed with caution in some people only if the healthcare provider determines it is safe. These populations include people with kidney problems and those with a risk of heart failure or pancreatitis.

What Other Medications May Interact With Onglyza?

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter (OTC) medicines, and vitamins or supplements.

Onglyza can interact with drugs that inhibit certain enzymes called CYP3A4 and CYP3A5. These enzymes process certain medications in the body. Onglyza levels may be increased in the body if taken with any of these drugs. You may need a lower Onglyza dose if you take any of the following:

  • Biaxin XL (clarithromycin)
  • Nizoral (ketoconazole)
  • Norvir (ritonavir) and combination drugs that contain ritonavir
  • Reyataz (atazanavir) and combination drugs that contain atazanavir
  • Sporanox (itraconazole)
  • Viracept (nelfinavir)

Other drug interactions may occur with Onglyza. Consult your healthcare provider for a full list of drug interactions.

What Medications Are Similar?

Onglyza contains the ingredient saxagliptin and is a DPP-4 inhibitor. Other drugs in this class include:

The ingredient in Onglyza, saxagliptin, is also available as part of a combination product in the following drugs:

Other oral medications are available to help control blood sugar in adults with type 2 diabetes. They include:

Some people with type 2 diabetes use injectable medications that are not insulin, but help control blood sugar. These are known as glucagon-like peptide-1 (GLP-1) agonists. Examples include:

People with type 2 diabetes may also need injectable insulin to help control blood sugar levels. There are various types of long-acting and short-acting insulin products. Examples of short-acting insulin include Humalog (insulin lispro) and Novolog (insulin aspart), and examples of long-acting insulin include Lantus (insulin glargine) and Levemir (insulin detemir).

This is a list of drugs also prescribed for type 2 diabetes. It is not necessarily a list of drugs recommended to take with Onglyza, although some may be prescribed together. Talk to your healthcare provider or pharmacist if you have any questions about your treatment regimen.

Frequently Asked Questions

  • What is Onglyza used for?

    Onglyza is used in combination with diet and exercise to improve blood sugar control in adults with type 2 diabetes.

  • How does Onglyza work?

    Onglyza helps increase the production and release of insulin and decreases glucagon in the body. Insulin and glucagon are hormones involved in regulating glucose (sugar) levels in the blood. This allows it to lower blood sugar effectively.

  • What drugs should not be taken with Onglyza?

    Onglyza interacts with various drugs. Interactions may require a different medication or a dosage adjustment. Some examples include the antibiotic Biaxin XL (clarithromycin) and the antifungal Sporanox (itraconazole). Before taking Onglyza, check with your healthcare provider to ensure that Onglyza is safe to take with other medications.

  • How long does it take Onglyza to work?

    A dose of Onglyza reaches its highest levels in the body in about two hours. It may take a few days or a few weeks of treatment to see an effect on blood sugar.

  • What are the side effects of Onglyza?

    The most common side effects of Onglyza are infections (e.g., respiratory, urinary tract), headache, low blood sugar, vomiting, stomach pain or virus, kidney problems, and swelling of the extremities (hands or lower legs).

    Get emergency medical help immediately if you have symptoms of an allergic reaction, such as hives, difficulty breathing, or swelling around the face. Severe skin reactions such as red or purple rash or blistering and peeling skin also require immediate medical attention.

How Can I Stay Healthy While Taking Onglyza?

Before taking Onglyza, discuss your medical history, prescription, and OTC drug use with your healthcare provider.

Managing type 2 diabetes can be overwhelming. You can take steps to prepare if you experience a medical emergency. Prepare a diabetes supply kit to have on hand and include items such as:

  • A blood glucose testing meter and extra supplies (e.g., strips, lancing device, lancets, alcohol wipes, extra batteries for the meter)
  • Emergency contact information
  • Glucagon (injection or nasal Baqsimi) for emergency use
  • Low blood sugar treatments (e.g., glucose tablets and juice boxes)

Wear a medical alert bracelet or necklace to alert emergency responders that you have type 2 diabetes.

Onglyza should be used along with diet and exercise. Ask your healthcare provider what diet and exercise regimen to follow. Monitor your blood sugar as directed.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.