Dipeptidyl peptidase 4 (DPP-4) Inhibitors

What are dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors)?

Dipeptidyl peptidase 4 (DPP-4) inhibitors are a class of drugs that can be used to treat people who have type 2 diabetes.

A group of hormones called incretins are involved in the process of reducing your blood glucose to normal levels after eating. An incretin hormone that is produced in the intestine called “glucagon-like peptide” (GLP-1) is released after a carbohydrate-containing meal. GLP-1 then binds to a receptor that stimulates the pancreas to release insulin. Insulin then transports glucose out of the bloodstream, lowering the blood glucose.

An enzyme in the body called “dipeptidyl peptidase-4” (DPP-4) stops the incretin GLP-1 from working when it is no longer needed. DPP-4 inhibitor medications work by blocking this enzyme, therefore increasing the level of the incretin GLP-1 in the body and enhancing its effects. This can help to improve blood sugar control in people with type 2 diabetes.

According to AACE guidelines, treatment with DPP-4 inhibitors may be appropriate for people who have:

  • Already tried to control their blood sugar with lifestyle therapy (healthy diet, exercise, and weight loss) but need to add a medication to manage it more effectively
  • Already tried treatment with one or more other medications for type 2 diabetes, but need to try adding on an additional medication to control their blood sugar levels

DPP-4 inhibitor medications are sold under some of the following brand names:

What is Nesina (alogliptin)?

Nesina is a type of DPP-4 inhibitor medication that can be used in combination with a healthy diet and regular exercise to help adults with type 2 diabetes to control their blood sugar. The active ingredient in Nesina is algoliptin.

Nesina is an oral medication that is usually taken in a tablet once per day, with or without food. Be sure to follow your healthcare providers’ advice about how to take Nesina. Before prescribing Nesina, and during treatment, your healthcare provider will probably administer blood tests to check how well your kidneys are working. People who are allergic to any of the ingredients in Nesina (alogliptin) should not take it. Always check with your healthcare professional about any potential drug interactions before starting treatment.

Some of the most common side effects that Nesina can cause include:

  • stuffy or runny nose and sore throat
  • Headache
  • Cold-like symptoms (upper respiratory tract infection)

Nesina can also cause more serious side effects in a small number of people. These include:

  • Pancreatitis
  • Heart failure
  • Hypoglycemia
  • Joint pain
  • Skin reaction
  • Liver problems
  • Allergic reactions

If not treated, these side effects can be very serious or even life-threatening. Your healthcare provider will talk with you about the signs and symptoms of these side effects. If you experience side effects from Nesina or any other medication, be sure to inform your healthcare provider.

What is Januvia (sitagliptin)?

Januvia is a medication that may be prescribed for adults with type 2 diabetes, in combination with lifestyle management (healthy diet and regular exercise) to help control their blood sugar. Januvia contains an active ingredient called sitagliptin, which is a DPP-4 inhibitor which increases the effects of incretin hormones.

Januvia is taken once a day by mouth in a tablet, with or without food. Always follow your healthcare provider’s advice about how to take Januvia. Your healthcare provider will probably test your kidney function before and during treatment with Januvia. People who are allergic to any of the ingredients in Januvia (sitagliptin) should not take it. Always check with your healthcare professional about any potential drug interactions before starting treatment.

Some of the most common side effects that treatment with Januvia can cause include:

  • Upper respiratory infection
  • Stuffy or runny nose and sore throat
  • Headache
  • Hypoglycemia

In some people, taking Januvia can cause very serious side effects:

  • Pancreatitis
  • Kidney problems
  • Joint pain
  • Skin reactions

If not treated, these side effects can be very serious or even life-threatening. Your healthcare provider will talk with you about the signs and symptoms of these side effects. If you experience side effects from Januva or any other medication, be sure to inform your healthcare provider.

What is Onglyza (saxagliptin)?

Onglyza is a treatment option for some adults with type 2 diabetes, which should be used in combination with diet and exercise. The active ingredient in Onglyza is saxagliptin, a DPP-4 inhibitor that enhances the effect of the hormone incretin to control blood sugar levels.

Onglyza is usually taken by mouth once daily, with or without food, but be sure to follow your healthcare provider’s advice about how to take it. You will need to have your kidney function checked before and during treatment with Onglyza. People who are allergic to any of the ingredients in Onglyza (saxagliptin) should not take it. Always check with your healthcare professional about any potential drug interactions before starting treatment.

Some of the most common side effects experienced by people taking Onglyza are:

  • Upper respiratory tract infection
  • Urinary tract infection
  • Headache
  • Hypoglycemia
  • Edema

Taking Onglyza can also cause more serious and potentially dangerous side effects:

  • Pancreatitis
  • Joint pain
  • Allergic reaction
  • Skin reaction
  • Swelling in the hands, feet, or ankles

Contact your healthcare provider if you experience any side effects from this or any other medication. Your healthcare provider will talk to you about how to recognize the signs and symptoms of the side effects that treatment with Onglyza can cause.

What is Tradjenta (linagliptin)?

Tradjenta, a DPP-4 inhibitor medication, can be used to treat certain adults with type 2 diabetes when combined with a healthy diet and regular exercise. Linagliptin is the active ingredient in Tradjenta, and it works by increasing the hormone incretin in the body which helps lower blood sugar levels.

Tradjenta is an oral medication typically taken once a day in a tablet, with or without food. Be sure to follow your healthcare provider’s instructions exactly for taking Tradjenta. People who are allergic to any of the ingredients in Tradjenta (linagliptin) should not take it. Always check with your healthcare professional about any potential drug interactions before starting treatment.

Some of the most common side effects from taking Tradjenta are:

  • Runny/stuffy nose and sore throat
  • Hypoglycemia
  • Cough
  • Diarrhea

Tradjenta can also cause more serious side effects in some people. These include:

  • Pancreatitis
  • Joint pain
  • Skin reaction
  • Allergic reaction

Your healthcare providers will talk with you about the signs of these side effects, and be sure to let them know if you experience side effects from taking Tradjenta or any other medication.

Written by: Anna Nicholson | Last reviewed: April 2017
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