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saxagliptin

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Brand names: Onglyza

DPP-4 Inhibitor Rx

QTERN is a drug that combines two medicines to help lower blood sugar in adults with type 2 diabetes. It should be used with diet and exercise.

Drug Pricing (NADAC)

Brand Price

$15.51/unit

Generic Price

$4.39/unit

Generic Savings

72%

Generic Available

Yes (5 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

QTERN helps adults with type 2 diabetes control their blood sugar levels.

Common side effects

Upper respiratory tract infection, Urinary tract infection, High cholesterol

Key warnings

QTERN can cause a serious condition called diabetic ketoacidosis, especially if you have type 1 diabetes.

How It Works

QTERN contains two medicines that work in different ways to lower blood sugar. One medicine helps your kidneys remove sugar from your blood through your urine. The other medicine helps your body release more insulin after you eat.

How to Take It

Take QTERN once a day in the morning. You can take it with or without food. If you are not already taking dapagliflozin, the usual starting dose is one 5mg/5mg tablet daily. Your doctor may increase your dose to one 10mg/5mg tablet daily if needed.

Pregnancy & Breastfeeding

QTERN may harm your unborn baby, especially during the second and third trimesters. It is not recommended to use QTERN while breastfeeding.

Missed Dose

If you miss a dose of QTERN, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.

Storage

Store QTERN at room temperature, between 68°F and 77°F.

Side Effects (from patient reports)

Based on 3,280 FDA adverse event reports.

Congestive heart failure
428
Increased blood sugar
401
Heart failure
400
Feeling sick to your stomach
372
Medicine not working
333
Loose stools
328
Feeling tired
261
Feeling lightheaded
260
Head pain
253
Weight loss
244

FDA Adverse Event Report Analysis

Detailed analysis of 8,141 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2007–2025.

Total Reports

8,141

Death-Related Reports

648

Hospitalization Reports

2,815

Top Indication

Type 2 Diabetes Mellitus

Gender Distribution

Female 3,751 (51%)
Male 3,610 (49%)

Age Distribution

0–17 111
18–44 208
45–64 1,860
65–74 1,503
75+ 1,177

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 CARDIAC FAILURE CONGESTIVE 428
2 BLOOD GLUCOSE INCREASED 401
3 CARDIAC FAILURE 400
4 NAUSEA 372
5 DRUG INEFFECTIVE 333
6 DIARRHOEA 328
7 FATIGUE 261
8 DIZZINESS 260
9 HEADACHE 253
10 WEIGHT DECREASED 244
11 DEATH 233
12 VOMITING 227
13 RASH 217
14 ACUTE KIDNEY INJURY 213
15 DYSPNOEA 204

Reactions in Death Reports

DEATH 233
CARDIAC FAILURE CONGESTIVE 66
CARDIAC FAILURE 58
PNEUMONIA 41
PANCREATIC CARCINOMA 39
ACUTE KIDNEY INJURY 27
RENAL FAILURE 22
SEPSIS 21
CHRONIC KIDNEY DISEASE 19
PANCREATIC CARCINOMA METASTATIC 19

Reactions in Hospitalization Reports

CARDIAC FAILURE CONGESTIVE 208
CARDIAC FAILURE 183
PNEUMONIA 139
NAUSEA 137
VOMITING 133
ACUTE KIDNEY INJURY 124
DIARRHOEA 123
DYSPNOEA 118
DEHYDRATION 108
PANCREATITIS 106

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

QTERN can cause a serious condition called diabetic ketoacidosis, especially if you have type 1 diabetes. Symptoms include trouble breathing, nausea, vomiting, belly pain, confusion, and unusual fatigue. If you have these symptoms, get medical help right away. QTERN may also increase your risk of heart failure. Tell your doctor if you have any heart problems.

Known Drug Interactions

7 DRUG INTERACTIONS Table 3: Clinically Relevant Interactions with QTERN Strong Inhibitors of CYP3A4/5 Enzymes Clinical Impact Ketoconazole significantly increased saxagliptin exposure. • Strong CYP3A4/5 Inhibitors (e.g., Ketoconazole): Do not coadminister QTERN with strong cytochrome P450 3A4/5 inhibitors.

Mechanism: Ketoconazole blocks the enzymes that clear saxagliptin from your body, which significantly increases the amount of drug in your blood.

What to do: Do not take these two medications at the same time.

minor lithium

Lithium Clinical Impact Concomitant use of an SGLT2 inhibitor with lithium may decrease serum lithium concentrations. Intervention Monitor serum lithium concentration more frequently during QTERN initiation and dosage changes.

Mechanism: This medication can cause your body to get rid of lithium more quickly, leading to lower levels in your blood.

What to do: Your doctor should check your lithium blood levels more frequently when you start or change your dose of this medicine.

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin).

Mechanism: Clarithromycin stops the body from breaking down saxagliptin, which can lead to higher levels of the drug in your system.

What to do: Your doctor may need to adjust your dose or watch you more closely for side effects while taking both drugs.

Antidiabetic Drugs Repaglinide a Saxagliptin Monitor for adverse reactions.

Mechanism: Itraconazole blocks the enzymes that process saxagliptin, which can make the diabetes medicine stay in your system longer.

What to do: Watch for signs of low blood sugar and talk to your doctor about whether your dose needs to be adjusted.

Dipeptidyl peptidase 4 (DPP4) inhibitors saxagliptin ↑ saxagliptin Dosage adjustment of saxagliptin is recommended. Refer to the saxagliptin product label for more information.

Mechanism: Ritonavir slows down the body's ability to clear saxagliptin, which causes the drug levels to rise.

What to do: Your doctor may need to lower your dose of saxagliptin while you are taking this medication.

Common Questions

What should I do if I experience severe joint pain while taking QTERN?
Tell your doctor right away if you develop severe joint pain. They may want to stop your QTERN treatment.
Can QTERN be used to treat type 1 diabetes?
No, QTERN is not recommended for use in patients with type 1 diabetes.
What should I do before having surgery?
If possible, stop taking QTERN at least 3 days before major surgery.
What if I have kidney problems?
QTERN is not recommended if your kidneys do not work well.
Can QTERN cause low blood sugar?
Yes, especially if you are also taking insulin or other diabetes medicines.
What are the symptoms of a genital yeast infection?
Symptoms include itching, redness, and discharge.
What should I do if I think I have a serious allergic reaction to QTERN?
Stop taking QTERN and get medical help right away.
Will QTERN affect urine glucose tests?
Yes, QTERN can cause a positive urine glucose test. Use other methods to check your blood sugar.
Can I cut or crush the QTERN tablet?
No, swallow the tablet whole. Do not crush, cut, or chew it.
What should I do if I develop blisters while taking QTERN?
Tell your doctor right away if you develop blisters or skin sores.
What are the common side effects of saxagliptin?
The most commonly reported side effects of saxagliptin include Upper respiratory tract infection, Urinary tract infection, High cholesterol. Based on 3,280 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does saxagliptin interact with other medications?
Yes, saxagliptin has 5 known drug interactions. Notable interactions include ketoconazole, lithium, clarithromycin. Always inform your doctor about all medications you are taking.
What drug class is saxagliptin?
saxagliptin belongs to the DPP-4 Inhibitor drug class. It requires a prescription (Rx). QTERN helps adults with type 2 diabetes control their blood sugar levels.
Is there a generic version of saxagliptin?
Yes, generic saxagliptin is available from 5 manufacturers. The generic costs $4.39 per unit compared to $15.51 for the brand version, saving approximately 72%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is saxagliptin safe during pregnancy?
QTERN may harm your unborn baby, especially during the second and third trimesters. It is not recommended to use QTERN while breastfeeding. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has saxagliptin been recalled?
There are 2 recalls associated with saxagliptin products. CGMP Deviations. Check the recalls section below for full details and affected products.

Active Recalls

Class II March 13, 2025

CGMP Deviations

Glenmark Pharmaceuticals Inc., USA

Class II March 13, 2025

CGMP Deviations

Glenmark Pharmaceuticals Inc., USA

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What the FDA Data Shows for saxagliptin

The FDA label for saxagliptin (sold under brand names such as Onglyza) classifies it as a prescription-only medication in the DPP-4 Inhibitor class. QTERN helps adults with type 2 diabetes control their blood sugar levels. Official labeling lists 3 commonly reported side effects, including Upper respiratory tract infection, Urinary tract infection, High cholesterol.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 3,280 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $4.39 versus $15.51 for the brand — a 72% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 2 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: November 13, 2024

All federal data sources used on this page