What is saxagliptin and metformin used for?

It is used alongside diet and exercise to help adults manage their blood sugar levels in type 2 diabetes.

Can I take saxagliptin and metformin if I have type 1 diabetes?

No, this medication is not recommended for treating type 1 diabetes or diabetic ketoacidosis.

What should I do if I feel severe stomach pain while taking saxagliptin and metformin?

Severe stomach pain can be a sign of pancreatitis; you should stop the medication and contact your doctor immediately.

Is it safe to drink alcohol with saxagliptin and metformin?

You should avoid excessive alcohol intake because it can increase the risk of a serious condition called lactic acidosis.

What are the signs of lactic acidosis?

Signs can include feeling unwell, muscle pain, stomach pain, breathing problems, or feeling very cold.

Can I crush my saxagliptin and metformin tablets?

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

Does saxagliptin and metformin cause low blood sugar?

If you are also taking insulin or other drugs that increase insulin, your blood sugar could drop too low.

What should I do if I experience skin blistering?

If you develop blisters or skin erosions, stop taking the medication and contact your doctor right away.

Saxagliptin Hydrate | CAS 945667-22-1 | AFNTWHMDBNQQPX

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This is a combination of a DPP4 inhibitor (saxagliptin) and a biguanide (metformin).

Saxagliptin and metformin hydrochloride extended-release tablets are used together to help control blood sugar levels in adults with type 2 diabetes. This medication is meant to be used alongside a healthy diet and regular exercise.

How it worksSaxagliptin works by slowing down the breakdown of natural hormones that help your body release insulin and lower blood sugar. Metformin works by reducing the amount of sugar your liver makes, decreasing the amount of sugar your body absorbs from food, and helping your body use insulin more effectively.

Brand names:Saxagliptin and Metformin

Used for

Type 2 diabetes mellitus improvement of glycemic control

Conditions

Type 2 diabetes mellitus

Class

DPP4 inhibitorBiguanideThis is a combination of a DPP4 inhibitor (saxagliptin) and a biguanide (metformin).Endocrine systemMetabolic

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.

The starting dose is chosen by your doctor based on your current treatment. Doctors may adjust the dose over time to find the best amount for you. If you miss a dose, do not take an extra one; just wait for your next scheduled dose.

Missed dose: If a dose is missed, do not take an extra dose. Resume treatment with the next scheduled dose.

Key warnings

There is a serious risk of lactic acidosis, which can be fatal. Symptoms may be subtle, including feeling unwell, muscle pain, stomach pain, or trouble breathing. Risk factors include kidney problems, heavy alcohol use, or being over 65.

·There is a serious risk of lactic acidosis, which can be fatal. Symptoms may be subtle, including feeling unwell, muscle pain, stomach pain, or trouble breathing. Risk factors include kidney problems, heavy alcohol use, or being over 65.
·Lactic acidosis can occur, especially in people with kidney issues.
·Pancreatitis may occur; stop use if you have severe stomach pain.
·Heart failure risk should be considered in patients with known risk factors.
·Serious allergic reactions, including skin peeling or swelling, have been reported.
·Severe joint pain has been reported with this type of medication.
·Skin blistering (bullous pemphigoid) may occur.

Do not use if

·Severe kidney impairment (eGFR below 30 mL/min/1.73 m2).
·Acute or chronic metabolic acidosis, including diabetic ketoacidosis.
·A history of serious allergic reactions to saxagliptin or metformin.

Side effects

Common

HeadacheUpper respiratory tract infectionUrinary tract infectionDiarrheaNauseaVomitingNasopharyngitis

Serious

·Lactic acidosis (a serious buildup of acid in the blood)
·Pancreatitis (inflammation of the pancreas)
·Heart failure
·Severe joint pain (arthralgia)
·Severe allergic reactions (such as swelling of the face or throat)
·Skin blistering (bullous pemphigoid)
·Low vitamin B12 levels

Seek help if

·Unexplained hyperventilation
·Muscle pain
·Malaise
·Unusual sleepiness
·Dizziness
·Slow or irregular heartbeat
·Feeling cold in extremities
·Severe abdominal pain
·Shortness of breath
·Rapid weight gain
·Swelling of feet
·Skin rash or peeling
·Swelling of face, lips, tongue, or throat

Interactions

·Strong CYP3A4/5 inhibitors (like ketoconazole) can increase saxagliptin levels; your doctor may need to lower your dose.
·Carbonic anhydrase inhibitors (like topiramate) may increase the risk of lactic acidosis.
·Drugs that reduce metformin clearance can increase the risk of lactic acidosis.
·Alcohol can increase the risk of lactic acidosis.
·Using insulin or other insulin-stimulating drugs with this medication may cause low blood sugar (hypoglycemia).
·Certain drugs like diuretics, steroids, and some hormone products may affect blood sugar control.

FoodTake the tablets once daily with your evening meal.

AlcoholAvoid excessive alcohol intake while taking this medication, as it can increase the risk of lactic acidosis.

Special populations

PregnancyThere is not enough information to know if saxagliptin and metformin cause major birth defects or miscarriage in humans. Poorly controlled diabetes during pregnancy can increase risks for both the mother and the baby.

BreastfeedingThere is no specific information available regarding whether saxagliptin or metformin passes into human breast milk.

PediatricThe safety and effectiveness of this medication have not been established for children.

GeriatricElderly patients may have decreased kidney function, so doctors should check kidney health more often. Metformin use in older adults requires caution due to the higher risk of lactic acidosis.

Talk to your doctor

Monitor

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

Questions to ask

·Should I monitor my vitamin B12 levels regularly?
·How often should my kidney function be checked?
·Will this interact with my current insulin dose?
·What should I do if I need an imaging procedure with contrast?

Pharmacokinetics

BioavailabilityBioequivalent to coadministration of individual tablets under fed conditions.

MetabolismSaxagliptin is a competitive DPP4 inhibitor; its active metabolite is 5-hydroxy saxagliptin.

ExcretionMetformin is substantially excreted by the kidney. Saxagliptin and its active metabolite are removed by hemodialysis (23% of dose over 4 hours).

Practical

OverdoseIf an overdose is suspected, seek medical help immediately. For saxagliptin, supportive treatment is used. For metformin, hemodialysis may be needed to remove the drug from your system.

Ingredients

Inactive

carbomer homopolymer type Acolloidal silicon dioxidehypromeллоsemagnesium stearatepolyethylene glycolpolyvinyl alcoholpovidonered iron oxidestearic acidtalctitanium dioxideyellow iron oxideammonium hydroxideblack iron oxidepropylene glycolshellac glaze

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