KOMBIGLYZE™ XR
(saxagliptin and metformin HCI
extended-release) tablets

For US Healthcare Professionals

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How Onglyza® (saxagliptin) Works

Onglyza Inhibits DPP-4 Enzyme Activity for a 24-hour Period


Onglyza Prolongs the Action of Naturally Secreted Incretins

Incretin Action in Type 2 Diabetes Mellitus Onglyza Inhibits DPP-4 to Sustain Incretin Action

Incretins, such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), increase insulin production from pancreatic β-cells. Additionally, GLP-1 decreases glucagon production from pancreatic α-cells.

Incretins are rapidly inactivated by the dipeptidyl peptidase-4 (DPP-4) enzyme within minutes.

Onglyza Enhances the Natural Response to Food

Contraindications

  • History of a serious hypersensitivity reaction to ONGLYZA® (saxagliptin) (eg, anaphylaxis, angioedema, or exfoliative skin conditions)

Warnings and Precautions

  • Pancreatitis: There have been postmarketing reports of acute pancreatitis in patients taking ONGLYZA® (saxagliptin). After initiating ONGLYZA® (saxagliptin), observe patients carefully for signs and symptoms of pancreatitis. If pancreatitis is suspected, promptly discontinue ONGLYZA® (saxagliptin) and initiate appropriate management. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while using ONGLYZA® (saxagliptin).
  • Hypoglycemia with Concomitant Use of Sulfonylurea or Insulin: When ONGLYZA® (saxagliptin) was used in combination with a sulfonylurea or with insulin, medications known to cause hypoglycemia, the incidence of confirmed hypoglycemia was increased over that of placebo used in combination with a sulfonylurea or with insulin. Therefore, a lower dose of the insulin secretagogue or insulin may be required to minimize the risk of hypoglycemia when used in combination with ONGLYZA® (saxagliptin).
  • Hypersensitivity Reactions: There have been postmarketing reports of serious hypersensitivity reactions in patients treated with ONGLYZA® (saxagliptin), including anaphylaxis, angioedema, and exfoliative skin conditions. Onset of these reactions occurred within the first 3 months after initiation of treatment with ONGLYZA® (saxagliptin), with some reports occurring after the first dose. If a serious hypersensitivity reaction is suspected, discontinue ONGLYZA® (saxagliptin), assess for other potential causes for the event, and institute alternative treatment for diabetes. Use caution in patients with a history of angioedema to another DPP-4 inhibitor as it is unknown whether they will be predisposed to angioedema with ONGLYZA® (saxagliptin).
  • Macrovascular Outcomes: There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with ONGLYZA® (saxagliptin) or any other antidiabetic drug.

Most Common Adverse Reactions

  • Most common adverse reactions reported in ≥5% of patients treated with ONGLYZA® (saxagliptin) and more commonly than in patients treated with control were upper respiratory tract infection (7.7%, 7.6%), headache (7.5%, 5.2%), nasopharyngitis (6.9%, 4.0%) and urinary tract infection (6.8%, 6.1%).
  • When used as add-on combination therapy with a thiazolidinedione, the incidence of peripheral edema for ONGLYZA® (saxagliptin) 2.5 mg, 5 mg, and placebo was 3.1%, 8.1% and 4.3%, respectively.
  • Confirmed hypoglycemia was reported more commonly in patients treated with ONGLYZA® (saxagliptin) 2.5 mg and ONGLYZA® (saxagliptin) 5 mg compared to placebo in the add-on to glyburide trial (2.4%, 0.8% and 0.7%, respectively), with ONGLYZA® (saxagliptin) 5 mg compared to placebo in the add-on to insulin (with or without metformin) trial (5.3% and 3.3%, respectively),with ONGLYZA® (saxagliptin) 2.5 mg compared to placebo in the renal impairment trial (4.7% and 3.5%, respectively), and with ONGLYZA® (saxagliptin) 5 mg compared to placebo in the add-on to metformin plus sulfonylurea trial (1.6% and 0.0%, respectively).

Drug Interactions

Because ketoconazole, a strong CYP3A4/5 inhibitor, increased saxagliptin exposure, the dose of ONGLYZA® (saxagliptin) should be limited to 2.5 mg when coadministered with a strong CYP3A4/5 inhibitor (eg, atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin).

Use in Specific Populations

  • Patients with Renal Impairment: The dose of ONGLYZA® (saxagliptin) is 2.5 mg once daily for patients with moderate or severe renal impairment, or with end-stage renal disease requiring hemodialysis (creatinine clearance [CrCl] ≤50 mL/min). ONGLYZA® (saxagliptin) should be administered following hemodialysis. ONGLYZA® (saxagliptin) has not been studied in patients undergoing peritoneal dialysis. Assessment of renal function is recommended prior to initiation of ONGLYZA® (saxagliptin) and periodically thereafter.
  • Pregnant and Nursing Women: There are no adequate and well-controlled studies in pregnant women. ONGLYZA® (saxagliptin), like other antidiabetic medications, should be used during pregnancy only if clearly needed. It is not known whether saxagliptin is secreted in human milk. Because many drugs are secreted in human milk, caution should be exercised when ONGLYZA® (saxagliptin) is administered to a nursing woman.
  • Pediatric Patients: Safety and effectiveness of ONGLYZA® (saxagliptin) in pediatric patients have not been established.

ONGLYZA® (saxagliptin) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus in multiple clinical settings.

ONGLYZA® (saxagliptin) should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis. ONGLYZA® (saxagliptin) has not been studied in patients with a history of pancreatitis.


Please click here for US Full Prescribing Information and Medication Guide for ONGLYZA® (saxagliptin)

   
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