One of the most serious side effects of saxagliptin—sold under the brand name Onglyza and used in the treatment of type-2 diabetes—is an increase in the risk of heart failure. This is also true in a related medicine containing alogliptin as both are part of a grouping of drugs known as class of dipeptidyl peptidase-4 (DPP-4) inhibitor drugs, according to the U.S. Food and Drug Administration (FDA).

This increased risk of heart failure is particularly pronounced in patients who have already presented with signs and symptoms of heart or kidney disease or perhaps both. According to the report, the results of two clinical trials were reviewed by the FDA—one involving saxagliptin and one involving alogliptin.

The saxagliptin trial results revealed that 35 out of 1,000 patient recipients of the drug ended up in the hospital for heart failure as opposed to 28 out of 1,000 placebo takers. The alogliptin trial data indicated that 39 recipients out of 1,000 versus 33 on the placebo were hospitalized. The common element for all trial enrollees was that they had a history of heart failure or kidney trouble.

That said, it is important to note that, according to Everyday Health, the heart failure side effects of saxagliptin and alogliptin were still deemed to fall under what would be considered a “broadly acceptable cardiovascular risk profile”. Purportedly, 14 out of 15 FDA reviewers recommended putting warnings regarding the risk of heart failure on the label, and this was completed.

What Is Heart Failure?

Heart failure doesn’t mean that your heart has stopped, but it does mean that the cardiac muscle has stopped working efficiently enough to meet the current demands of the body. As indicated by the Mayo Clinic, the ventricles which receive deoxygenated blood from the body and fresh oxygenated blood from the lungs may not fill up as needed between beats or empty fully during them. This can have a variety of consequences.

In the case of right-side heart failure, the heart can’t pump enough blood into the lungs to oxygenate the blood. Left-side heart failure occurs when the heart is incapable of pumping oxygenated blood to the rest of the body.

Heart failure can affect only the right side of the heart or both sides of the heart. However, it is far more common for heart failure to affect both sides of the heart, according to the National Institutes of Health’s National Heart, Lung, and Blood Institute.

There are several causes of heart failure, including ischemic heart disease, diabetes, high blood pressure, and other heart conditions. Any of these conditions can damage or overwork the heart, leading to a failure of cardiac muscle. Based on new research, saxagliptin use may also contribute to heart failure.

What Are Symptoms of Heart Failure?

The symptoms of heart failure may be diffuse and include trouble catching your breath, generalized weakness and fatigue, fluid retention in the lower extremities of the feet, ankles, and calves, nausea, and reduced desire to eat, generalized pain the upper torso, or the actual sensation of a rapid or irregular heartbeat. Since some symptoms of heart failure may also signal an actual myocardial infarction (heart attack), any chest pain or weakness and fainting that comes on quickly should be followed up with immediately with medical attention.

How Does Saxagliptin Work?

Saxagliptin is an incretin mimetic, which means the drug stimulates the production of insulin within the pancreas in patients who suffer from type 2 diabetes. When combined with diet and exercise, saxagliptin often helps control blood sugar from going dangerously high, a condition known as hyperglycemia.

According to Onglyza manufacturer AstraZeneca, people with type 2 diabetes may have higher blood sugar readings in the morning because the pancreas often releases too much glucagon, which in turn causes the liver to release a high dose of sugar. Onglyza cuts down on the amount of sugar the liver excretes overnight, which means blood sugar levels in the morning may be within a more normal range rather than too high.

Saxagliptin purportedly also may effectively decrease after-meal blood sugar increases by helping the pancreas produce more insulin after a meal is eaten.

Because Onglyza works directly on the pancreas, one serious side effect may be an inflammation of the pancreas, a condition known as pancreatitis. Severe pain that might feel as if it is going from the abdomen through to the back may or may not be accompanied by vomiting. Pancreatitis may come on suddenly and can lead to death.

Onglyza’s manufacturer also warns that anyone who has kidney problems should allow a doctor to take a blood test to see how well the kidneys work before and after being treated with Onglyza. Patients who have insufficient kidney function may require a lower dose of the medication than originally prescribed.

How Do Serious Allergic Reaction Side Effects of Saxagliptin Present?

As indicated by our Everyday Health resource, a severe allergic reaction to Saxagliptin might present itself with an outbreak of hives or a purplish or red rash that causes blistering and often attacks the mucous membranes of the mouth, tongue, throat, and eyes. Swelling of the throat and breathing problems associated with this may accompany symptoms. In extreme forms, these reactions may be diagnosed as anaphylactic shock or Stevens-Johnson Syndrome.

Stevens-Johnson syndrome is a rare disorder that affects the skin and mucous membranes (eyes, mouth, nose, genitals, etc.). Although the condition is rare and unpredictable, it is almost always caused as a reaction to a medication. Early symptoms may include fever, skin pain all around the body, a sore throat and mouth, fatigue, coughing, and burning eyes. Later, a red or purple skin rash will develop including blisters on the skin or mucous membranes and shedding of the skin after blisters form.

If you developed a significant reaction or heart failure after taking saxagliptin, your health woes may be linked to the drug. In these cases, you may be able to take legal action against the drug manufacturer. This can reward you by holding the manufacturer responsible for failing to warn you about the risks and even monetary compensation if your suit results in a settlement or damages.