DPP-4 inhibitor
Saxagliptin
Brand names: Onglyza
Adult dose
Dose: 5mg PO OD (2.5mg if eGFR <50)
Route: PO
Frequency: OD
Dose adjustments
Renal
Reduce to 2.5mg if eGFR <50
Clinical pearls
- T2DM 2nd-line per NICE NG28; weight-neutral
- Avoid in HFrEF where possible
Contraindications
- Type 1 DM
- DKA
- Severe hypersensitivity
- Pancreatitis history
- Severe hepatic impairment
Side effects
- URTI
- Pancreatitis
- Hypersensitivity
- Severe arthralgia
- Hypoglycaemia (with sulfonylurea/insulin)
- HF hospitalisation (signal in SAVOR-TIMI)
Interactions
- Strong CYP3A4 inducers
- Insulin/sulfonylureas (hypoglycaemia)
Monitoring
- HbA1c
- Renal function
- Pancreatic enzymes if symptomatic
Reference: BNF; NICE NG28; https://bnf.nice.org.uk/drugs/saxagliptin/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016