Names and pronunciation
(sax-a-glip′tin) Onglyza
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Individual generic drug information
Extracted information for SAXagliptin only.
(sax-a-glip′tin) Onglyza
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Func. class.: Antidiabetic, oral
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Chem. class.: Dipeptidyl-peptidase-4 inhibitor (DPP-4 inhibitor)
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Do not confuse: SAXagliptin/SITaGLIPtin
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ACTION: Slows the inactivation of incretin hormones; improves glucose homeostasis, improves glucose-depen- dent insulin synthesis, lowers glucagon secretions, and slows gastric emptying time
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USES: In adults, type 2 diabetes mel- litus as monotherapy or in combination with other antidiabetic agents
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Extracted information for SAXagliptin only.
CONTRAINDICATIONS: Hyper- sensitivity, angioedema, serious rash, type 1 diabetes, ketoacidosis Precautions: Pregnancy, geriatric patients, GI obstruction, surgery, thyroid/ renal/hepatic disease, trauma, diabetic, heart failure
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SIDE EFFECTS CNS: Headache ENDO: Hypoglycemia (renal impairment) GI: Nausea, vomiting, abdominal pain, pancreatitis INTEG: Urticaria, angioedema, anaphylaxis CV: Edema, HF EENT: Sinusitis
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INTERACTIONS Increase: hypoglycemia—androgens, insu- lins, β-blockers, cimetidine, corticoste- roids, salicylates, MAOIs, fibric acid deriva- tives, FLUoxetine, insulin, sulfonylureas, ACE inhibitors; strong CYP3A4/5 inhibitors; dosage reduction may be needed Drug/Herb Increase: antidiabetic effect—garlic, horse chestnut Drug/Lab Test Decrease: lymphocytes, glucose
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Extracted information for SAXagliptin only.
DOSAGE AND ROUTES • Adult: PO 2.5-5 mg; may use with other antidiabetic agents other than insu- lin; if used with insulin, a lower dose may be needed; max 2.5 mg with strong 3A4-5 inhibitors Renal dose • Adult: PO CCr ≤50 mL/min, 2.5 mg daily; hemodialysis: 2.5 mg/day after hemodialysis
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Available forms: Tabs 2.5, 5 mg
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Administer: PO route • May be taken with/without food • Do not break or cut tabs • Conversion from other antidiabetic agents; change may be made with grad- ual dosage change • Store in tight containers at room tem- perature
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Extracted information for SAXagliptin only.
Assess: • Hypoglycemic reactions (sweating, weakness, dizziness, anxiety, tremors, hunger); monitor blood glucose, HbA1c • Renal studies: BUN, creatinine during treatment • Heart failure: history of risk factors for heart failure; use cautiously in these patients; assess daily weight, edema, dyspnea, crackles, tachycardia/brady- cardia • Pancreatitis: abdominal pain, nausea; discontinue product immediately; previ- ous pancreatitis may be a contributing factor • Pregnancy/breastfeeding: use only if clearly needed, usually insulin is used in S pregnancy; cautious use in breastfeeding, excretion unknown
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Evaluate: • Therapeutic response: decrease in polyuria, polydipsia, polyphagia; clear sensorium; absence of dizziness; stable gait, blood glucose at normal level
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To perform regular self-monitoring of blood glucose using blood-glucose meter • About the symptoms of hypo/hypergly- cemia; what to do about each • That product must be continued on daily basis; about consequences of dis- continuing product abruptly • To avoid OTC medications, alcohol, digoxin, exenatide, insulins, nateglinide, repaglinide, and other products that lower blood glucose unless approved by prescriber • That diabetes is lifelong; that this prod- uct is not a cure, only controls symptoms • That all food included in diet plan must be eaten to prevent hypo/hypergly- cemia • To carry emergency ID • To take product without regard to food • To notify prescriber when surgery, trauma, stress occurs because dose may need to be adjusted or insulin used • Pancreatitis: to immediately report and stop product if severe abdominal pain with vomiting occurs • Hypersensitivity: to immediately get medical assistance and stop product if itching; rash; swelling of face, tongue oc- curs
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Extracted information for SAXagliptin only.
PHARMACOKINETICS Rapidly absorbed, metabolized by liver— CYP3A4, excreted by the kidneys (unchanged 24%), half-life 2.5 hr, 3.1 hr metabolite, peak 2 hr, duration 24 hr
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Filter the extracted dose blocks for this individual drug.
• Adult: PO 2.5-5 mg; may use with other antidiabetic agents other than insu- lin; if used with insulin, a lower dose may be needed; max 2.5 mg with strong 3A4-5 inhibitors Renal dose
Candidate age grouping · source page 1195
• Adult: PO CCr ≤50 mL/min, 2.5 mg daily; hemodialysis: 2.5 mg/day after hemodialysis
Candidate age grouping · source page 1195