Home Drug Guide Saxagliptin Hydrochloride

Drug Guide

Generic Name

Saxagliptin Hydrochloride

Brand Names Onglyza

Classification

Therapeutic: Antidiabetic agents, DPP-4 inhibitors

Pharmacological: Inhibitor of dipeptidyl peptidase-4 (DPP-4) enzyme

FDA Approved Indications

  • Improvement of glycemic control in adults with type 2 diabetes mellitus

Mechanism of Action

Saxagliptin inhibits the DPP-4 enzyme, prolonging the activity of incretin hormones, which increase insulin synthesis and release from pancreatic beta cells and decrease glucagon levels, thereby lowering blood glucose levels.

Dosage and Administration

Adult: 5 mg once daily, with or without food

Pediatric: Not approved for pediatric use

Geriatric: Start at 5 mg daily; no specific adjustment required but monitor elderly patients closely

Renal Impairment: Adjust dose to 2.5 mg daily in moderate impairment (eGFR 30-59 mL/min); use not recommended in severe impairment or dialysis

Hepatic Impairment: No dosage adjustment needed

Pharmacokinetics

Absorption: Quick absorption with peak plasma concentrations at approximately 1-2 hours

Distribution: Moderate protein binding (~40-50%)

Metabolism: Primarily metabolized by CYP3A4/5 to an inactive metabolite

Excretion: Excreted mainly via the kidneys; minor fecal excretion

Half Life: 2.5 hours (approximate)

Contraindications

  • Hypersensitivity to saxagliptin or any component

Precautions

  • Use with caution in patients with history of pancreatitis; assess kidney function before initiation and periodically thereafter

Adverse Reactions - Common

  • Infections (such as nasopharyngitis) (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Pancreatitis (Uncommon)
  • Hypersensitivity reactions including anaphylaxis and angioedema (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors (e.g., ketoconazole) may increase saxagliptin levels, adjust dose accordingly

Drug-Food Interactions

  • No significant food interactions

Drug-Herb Interactions

  • Limited data, caution advised with herbal supplements

Nursing Implications

Assessment: Monitor blood glucose levels regularly; assess for signs of pancreatitis including persistent severe abdominal pain

Diagnoses:

  • Risk for unstable blood glucose levels
  • Risk for pancreatitis

Implementation: Administer once daily at the same time each day; educate patient on recognizing symptoms of hypoglycemia and pancreatitis

Evaluation: Evaluate glycemic control and adherence; monitor for adverse effects

Patient/Family Teaching

  • Take medication exactly as prescribed, once daily
  • Report symptoms of pancreatitis such as severe abdominal pain, nausea, vomiting
  • Maintain a balanced diet and monitor blood glucose levels regularly
  • Inform healthcare provider of all medications and herbal supplements being taken

Special Considerations

Black Box Warnings:

  • None specified for saxagliptin

Genetic Factors: No known genetic factors affecting efficacy or safety

Lab Test Interference: No significant interference reported

Overdose Management

Signs/Symptoms: Potential hypoglycemia or adverse effects from overdose

Treatment: Symptomatic and supportive care; hemodialysis may be considered as saxagliptin is renally excreted

Storage and Handling

Storage: Store at room temperature between 20°C and 25°C (68°F to 77°F); protect from moisture

Stability: Stable when stored properly; discard expired medication

🛡️ 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.