Home Drug Guide Saxagliptin

Drug Guide

Generic Name

Saxagliptin

Brand Names Onglyza

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Dipeptidyl peptidase-4 (DPP-4) inhibitor

FDA Approved Indications

  • Type 2 diabetes mellitus as an adjunct to diet and exercise

Mechanism of Action

Saxagliptin inhibits the enzyme DPP-4, which prolongs the activity of incretin hormones, increasing insulin release and decreasing glucagon levels in a glucose-dependent manner.

Dosage and Administration

Adult: Initially 2.5 mg once daily, may be increased to 5 mg or decreased to 2.5 mg based on clinical response and tolerability.

Pediatric: Not approved for use in pediatric patients.

Geriatric: No specific dose adjustment necessary, but monitor renal function.

Renal Impairment: Reduce dose in patients with moderate to severe renal impairment (eGFR < 50 mL/min/1.73 m²).

Hepatic Impairment: No specific adjustment necessary.

Pharmacokinetics

Absorption: Well absorbed following oral administration.

Distribution: Volume of distribution approximately 300 L.

Metabolism: Primarily metabolized via CYP3A4/5 to inactive metabolites.

Excretion: Excreted mainly in feces and urine.

Half Life: Approximately 2.5 hours.

Contraindications

  • Hypersensitivity to saxagliptin or any component of the formulation.

Precautions

  • Use with caution in patients with renal impairment, history of pancreatitis, or on other medications affecting glucose levels.

Adverse Reactions - Common

  • Infections (nasopharyngitis, urinary tract infections) (Common)
  • Headache (Common)
  • Hypoglycemia (when used with insulin or sulfonylureas) (Common)

Adverse Reactions - Serious

  • Pancreatitis (Rare)
  • Hypersensitivity reactions, including anaphylaxis (Rare)

Drug-Drug Interactions

  • Thiazolidinediones, Sulfonylureas (may increase hypoglycemia risk)
  • CYP3A4 inhibitors (may increase saxagliptin levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly, renal function, and pancreatic enzymes.

Diagnoses:

  • Risk for unstable blood glucose levels
  • Risk for pancreatitis

Implementation: Administer once daily, with or without food. Educate patient on symptoms of hypoglycemia and pancreatitis.

Evaluation: Assess for reduction in blood glucose levels and any adverse effects or signs of pancreatitis.

Patient/Family Teaching

  • Take medication as prescribed daily.
  • Monitor blood sugar as directed.
  • Report any symptoms of pancreatitis (severe abdominal pain, persistent nausea/vomiting).
  • Maintain a healthy diet and exercise routine.

Special Considerations

Black Box Warnings:

  • Risk of heart failure with the 5 mg dose in patients with established cardiovascular disease or risk factors.

Genetic Factors: No specific genetic testing required.

Lab Test Interference: May affect certain lab tests; consult laboratory for specifics.

Overdose Management

Signs/Symptoms: Severe hypoglycemia, hypotension.

Treatment: Supportive care; glucose administration if hypoglycemia occurs; no specific antidote.

Storage and Handling

Storage: Store at room temperature between 20°C and 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions for at least 2 years.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.