Onglyza (saxagliptin) is one of the most commonly prescribed oral medications for type-2 diabetes. Last year in 2014, sales for the drug were at $820 million just 5 years after receiving FDA approval.

Onglyza is classified as a DPP-IV inhibitor. DPP-IV is an enzyme that rapidly degrades glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

Both GLP-1 and GIP facilitate the release of insulin from the pancreas and increase insulin synthesis by way of inhibiting glucagon, a substance that raises glucose levels. Together this increase of insulin and decrease of glucagon lowers blood glucose levels.

As a form of monotherapy, Onglyza can be used on its own to treat diabetes. Other times, it is used in combination with other oral diabetes medications such as Actos or Avandia.

Research studies have shown that Onglyza significantly reduces HbA1c, which is elevated in diabetic patients. It also lowers postprandial (after meal) glucose levels.

Common Side Effects of Onglyza Use

As with all prescription medications, Onglyza carries a risk of common side effects. Onglyza’s most often reported mild side effects include:

• Upper respiratory infections
• Headache
• Nausea
• Mild skin rash and itching
• Cough
• Abdominal pain

Serious Onglyza Side Effects

As Onglyza works by affecting the pancreas, the location of insulin production, and sometimes very serious side effects involving that organ occur. Onglyza has been associated with both pancreatitis and pancreatic cancer.

Pancreatitis is the inflammation of the pancreas. Since Onglyza works to stimulate the cells of the pancreas, sometimes this causes inflammation in that organ. Pancreatitis can be serious and lead to death.

Pancreatic cancer is one of the most deadly forms of cancer. It is typically not diagnosed until the cancer has progressed to a later stage because the symptoms may be overlooked or attributed to other causes.

Jaundice, a yellowing of the skin and eyes, back or abdomen pain, unintentional weight loss and fatigue are common, non-specific symptoms of pancreatic cancer.

In general, individuals with diabetes are more likely to develop pancreatic cancer. Other risk factors include obesity, smoking and pancreatitis (the other pancreas-related side effect of Onglyza).

The prognosis of pancreatic cancer is very grim. Fewer than five percent of individuals who are diagnosed with the disease live more than five years beyond their diagnosis.

FDA Warnings About Onglyza

In April 2015, the Food and Drug Administration (FDA) issued a statement that Onglyza carried an increased risk of heart failure.   This warning was the result of a study that found that patients who were taking Onglyza had a 27 percent greater risk of being hospitalized from heart failure than those who did not take Onglyza. Also, there was an overall increased mortality rate for all causes of death combined. The label for Onglyza was updated to include the heart failure warning.