What is Saxagliptin and metformin used for?

It is used as an add-on to diet and exercise to help control blood sugar in adults with type 2 diabetes.

Can I crush or chew Saxagliptin and metformin tablets?

No, you must swallow the tablets whole. Never crush, cut, or chew them.

What are the signs of lactic acidosis with this medication?

Symptoms can be subtle and include malaise, muscle pain, breathing problems, sleepiness, or abdominal pain.

Is Saxagliptin safe for people with kidney disease?

It should not be used if you have severe kidney impairment (eGFR below 30), and doses may need adjustment if kidney function is lower.

Can Saxagliptin cause pancreatitis?

Yes, there have been reports of acute pancreatitis, so you should stop use and contact a doctor if you suspect it.

Will Saxagliptin affect my vitamin B12 levels?

Yes, metformin may lower your vitamin B12 levels, so your doctor may check your levels annually.

Can I take Saxagliptin if I am pregnant?

There isn't enough data to determine the risk of major birth defects, so you must talk to your doctor.

What should I do if I experience severe joint pain while taking Saxagliptin?

Severe joint pain has been reported with this class of drugs; you should discuss this with your doctor.

Saxagliptin | CAS 361442-04-8 | QGJUIPDUBHWZPV

Loading compound...

Antihyperglycemic (diabetes medication)

Saxagliptin and metformin hydrochloride extended-release tablets are a combination medication used alongside diet and exercise to help manage blood sugar levels in adults with type 2 diabetes. It contains two active ingredients: saxagliptin, which helps increase insulin levels, and metformin, which helps control how the body uses sugar.

How it worksSaxagliptin works by blocking an enzyme called DPP4, which helps keep natural hormones in your body active to stimulate insulin release. Metformin works to improve how your body responds to insulin and reduces the amount of sugar your liver makes.

Brand names:ONGLYZA

Used for

Improving blood sugar control in adults with type 2 diabetes mellitus

Conditions

Type 2 diabetes mellitus

Class

DPP4 inhibitorBiguanideAntihyperglycemic (diabetes medication)Endocrine systemMetabolic system

How to take

FormsExtended-release tablets

RoutesOral

Take once daily with your evening meal. Do not crush, cut, or chew the tablets; swallow them whole.

Dosage is individualized by a doctor based on your current treatment and kidney function. If you take strong CYP3A4/5 inhibitors, your saxagliptin dose may need to be limited.

Key warnings

Metformin can cause lactic acidosis, a rare but life-threatening condition. Symptoms may include feeling unwell, muscle pain, breathing problems, sleepiness, or stomach pain.

·Metformin can cause lactic acidosis, a rare but life-threatening condition. Symptoms may include feeling unwell, muscle pain, breathing problems, sleepiness, or stomach pain.
·Pancreatitis: Stop use and contact a doctor if you suspect pancreatitis.
·Heart Failure: Monitor for signs and symptoms if you have risk factors for heart failure.
·Vitamin B12: Metformin may lower your vitamin B12 levels; annual testing is recommended.
·Hypoglycemia: Risk increases if used with insulin or other insulin-stimulating drugs.
·Severe Joint Pain: Some people taking DPP4 inhibitors experience severe joint pain.
·Skin Reactions: Watch for serious allergic reactions or skin blistering.

Do not use if

·Severe kidney impairment (eGFR below 30 mL/min/1.73 m2)
·Acute or chronic metabolic acidosis, including diabetic ketoacidosis
·History of serious allergic reactions to any ingredients in this medicine

Side effects

Common

DiarrheaNauseaVomitingHeadacheUpper respiratory tract infectionUrinary tract infectionNasopharyngitis

Serious

·Lactic acidosis (a dangerous buildup of acid in the blood)
·Pancreatitis (inflammation of the pancreas)
·Heart failure
·Low vitamin B12 levels
·Severe allergic reactions (anaphylaxis, swelling)
·Severe joint pain (arthralgia)
·Skin blistering conditions (bullous pemphigoid)
·Low blood sugar (hypoglycemia)

Seek help if

·Lactic acidosis symptoms
·Signs of pancreatitis
·Severe allergic reactions
·Signs of heart failure

Interactions

·Strong CYP3A4/5 inhibitors (like ketoconazole) can increase saxagliptin levels in your body.
·Carbonic anhydrase inhibitors may increase the risk of lactic acidosis.
·Other drugs that reduce how metformin is cleared from your body may increase the risk of lactic acidosis.
·Using this with insulin or insulin secretagogues may increase the risk of low blood sugar.

FoodTake once daily with the evening meal.

Special populations

PregnancyThere is limited data on the risks of using saxagliptin and metformin in pregnant women. While some studies on metformin haven't shown a clear link to major birth defects, you should discuss the risks and benefits with your doctor.

PediatricThe safety and effectiveness of this medication for children with type 2 diabetes have not been established.

GeriatricOlder adults are more likely to have decreased kidney function. Your doctor should check your kidney function more frequently.

Talk to your doctor

Monitor

·Kidney function (eGFR)
·Vitamin B12 levels
·Blood glucose levels
·Signs of pancreatitis
·Signs of heart failure

Questions to ask

·Is my kidney function healthy enough for this medication?
·Should I monitor my vitamin B12 levels?
·How will this interact with my other medications?
·What should I do if I feel sudden muscle pain or shortness of breath?

Pharmacokinetics

BioavailabilitySaxagliptin and metformin combination tablets are bioequivalent to taking individual tablets under fed conditions.

MetabolismSaxagliptin is a competitive DPP4 inhibitor.

ExcretionSaxagliptin and its active metabolite are removed by hemodialysis (23% of dose over 4 hours).

Practical

OverdoseIn case of overdose, seek medical help immediately. For saxagliptin, supportive treatment is needed based on the patient's condition. Hemodialysis can remove some of the drug from the body.

Ingredients

Inactive

AmmoniaFerrosoferric oxideCarbomer homopolymer type ASilicon dioxideHypromellose 2208Magnesium stearatePolyethylene glycol 3350Polyvinyl alcoholPovidone K90Propylene glycolFerric oxide redShellacStearic acidTalcTitanium dioxide

Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-25.