Onglyza (Saxagliptin Hydrochloride)

(sax' a glip tin)

Saxagliptin is used along with diet and exercise to lower blood sugar levels in patients with type 2 diabetes (condition in which blood sugar is too high because the body does not produce or use insulin normally). Saxagliptin is in a class of medications called dipeptidyl peptidase-4 (DPP-4) inhibitors. It works by increasing the amount of insulin produced by the body after meals when blood sugar is high. Saxagliptin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated). Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

Saxagliptin comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take saxagliptin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take saxagliptin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Saxagliptin controls type 2 diabetes but does not cure it. Continue to take saxagliptin even if you feel well. Do not stop taking saxagliptin without talking to your doctor.

Before taking saxagliptin,
• tell your doctor and pharmacist if you are allergic to saxagliptin, any other medications, or any of the ingredients in saxagliptin tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antifungal medications such as itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral); clarithromycin (Biaxin); certain medications for HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome) such as atazanavir (Reyataz, in Evotaz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); insulin or oral medications for diabetes such as chlorpropamide (Diabinese), glimepiride (Amaryl, in Duetact), glipizide (Glucotrol), glyburide (Diabeta, Glynase, in Glucovance), nateglinide (Starlix), pioglitazone (Actos, in Actoplus Met, in Duetact), repaglinide (Prandin, in Prandimet), rosiglitazone (Avandia), tolazamide, and tolbutamide; nefazodone; and telithromycin (no longer available in the U.S.; Ketek). You doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you drink or have ever drunk large amounts of alcohol, if you have or have ever had pancreatitis (swelling of the pancreas), gallstones, high levels of triglycerides (fatty substances) in your blood, heart failure, diabetic ketoacidosis, or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking saxagliptin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking saxagliptin.
• talk to your doctor about what you should do if you get hurt or if you develop a fever or infection. These conditions may affect your blood sugar and the amount of saxagliptin you may need.

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthy diet, exercise regularly, and lose weight if necessary. This will help to control your diabetes and help saxagliptin work more effectively.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one unless your doctor tells you that you should.

This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms. Saxagliptin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• sore throat
• headache
• joint pain

Some side effects can be serious. If you experience any of these symptoms, stop taking saxagliptin and call your doctor immediately:

• rash
• hives
• skin peeling
• itching
• swelling of the face, lips, tongue or throat
• difficulty breathing or swallowing
• hoarseness
• ongoing pain, that begins in the upper left or middle of the stomach but may spread to the back
• vomiting
• loss of appetite
• excessive tiredness
• shortness of breath, especially when lying down
• swelling of the feet, ankles, or legs
• sudden weight gain

Saxagliptin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will probably order certain laboratory tests before and during your treatment with saxagliptin to check your body's response to it. Your blood sugar and glycosylated hemoglobin (HbA1c) should be checked regularly to determine your response to saxagliptin. Your doctor may also tell you how to check your response to saxagliptin by measuring your blood or urine sugar levels at home. Follow these directions carefully. You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.