Patient/caregiver was educated on side effects of Saxagliptin use as follows:
Hypoglycemia
- Normally, incretins stimulate secretion of insulin from the pancreas. The longer incretins stay in circulation, the more the stimulus for insulin secretion.
- Saxagliptin inhibits the breakdown of incretins and contributes to longer lifespan of incretins. This contributes to longer duration of action of incretins, leading to increase in insulin secretion.
- Increased insulin secretion results in increased shifting of blood glucose into the tissues, which lowers the blood sugars and contributes to improved blood sugar control.
- Extreme lowering of blood sugars and hypoglycemia with saxagliptin alone is not a common complaint. Hypoglycemia with saxagliptin can be a serious concern, especially when it is used in combination with other medications for blood sugar control, such as, insulin, glimepiride and glyburide.
- Patients in hypoglycemia can have poor glucose supply to the brain, which is its major source of nutrition. So, poor nutrition supply to brain cells result in severe dizziness, lightheadedness, inability to focus, irritability, headache, and weakness.
- Avoid skipping meals while taking saxagliptin. Observing compliance with timely nutrition intake and recommended calorie consumption can help prevent development of hypoglycemic episodes.
Fluid retention
- Use of saxagliptin can sometimes contribute to significant fluid retention in the body. Retained fluid can add extra load on the heart, especially in individuals with congestive heart failure and can lead to worsening of heart failure symptoms and cardiac function.
- Patients can present with edema, sharp weight gain, progressively increasing shortness of breath, compromised endurance, and worsening fatigue.
- Report to your physician regarding any findings of worsening fluid retention for recommendations on management.
