What is the recommended use and dosage of Saxagliptin (DPP-4 inhibitor) in adults with type 2 diabetes?

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From the Guidelines

Saxagliptin should be prescribed with caution in adults with type 2 diabetes, considering its potential increased risk of heart failure hospitalization, and the recommended dose is 2.5 mg or 5 mg once daily, with the 5 mg dose being standard for most patients, as indicated by the most recent study 1.

Key Considerations

  • The Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus – Thrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53) study showed that patients treated with saxagliptin were more likely to be hospitalized for heart failure than those given placebo 1.
  • However, other cardiovascular outcomes trials did not find a significant increase in risk of heart failure hospitalization with DPP-4 inhibitor use compared with placebo 1.
  • The dose of saxagliptin should be adjusted in patients with moderate to severe kidney impairment, with a maximum dose of 2.5 mg daily recommended for patients with an eGFR <15 mL/min/1.73 m2, as indicated by the consensus report 1.

Dosage and Administration

  • The recommended dose of saxagliptin is 2.5 mg or 5 mg once daily, with the 5 mg dose being standard for most patients.
  • The lower 2.5 mg dose is recommended for patients with moderate to severe kidney impairment or those taking strong CYP3A4/5 inhibitors like ketoconazole.
  • Saxagliptin can be taken with or without food at any time of day, and no dose adjustment is needed based on meals.

Safety and Efficacy

  • Saxagliptin works by inhibiting the DPP-4 enzyme, which prolongs the action of incretin hormones that stimulate insulin release and reduce glucagon secretion, ultimately lowering blood glucose levels.
  • Common side effects include upper respiratory tract infections, urinary tract infections, and headache, while hypoglycemia risk is low when used alone but increases when combined with insulin or sulfonylureas.
  • Saxagliptin may be used as monotherapy when metformin is contraindicated or not tolerated, but is more commonly prescribed as an add-on therapy to metformin or other antidiabetic medications when additional glycemic control is needed.

From the FDA Drug Label

Saxagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Recommended dosage is 2.5 mg or 5 mg orally once daily taken regardless of meals. Patients with an eGFR <45 mL/min/1.73 m2 (moderate or severe renal impairment, or end-stage renal disease): Recommended dosage is 2.5 mg once daily regardless of meals. Limit the dosage of saxagliptin tablets to 2.5 mg daily for patients also taking strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitors (e.g., ketoconazole).

The recommended use of Saxagliptin in adults with type 2 diabetes is as an adjunct to diet and exercise to improve glycemic control. The recommended dosage is 2.5 mg or 5 mg orally once daily, taken regardless of meals. However, for patients with:

  • Moderate or severe renal impairment, or end-stage renal disease, the recommended dosage is 2.5 mg once daily.
  • Concomitant use of strong CYP3A4/5 inhibitors, the dosage should be limited to 2.5 mg daily 2 2.

From the Research

Recommended Use of Saxagliptin

  • Saxagliptin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus 3, 4.
  • It can be used alone or in combination with other oral antidiabetic medications, such as metformin, a sulfonylurea, or a thiazolidinedione 3, 4.

Dosage of Saxagliptin

  • The recommended dosage of saxagliptin is 2.5 mg or 5 mg once daily 4.
  • For patients with moderate or severe renal impairment or end-stage renal disease, or patients taking a strong inhibitor of cytochrome P-450 isoenzyme 3A4 or 3A5, the recommended dosage is 2.5 mg once daily 4.

Efficacy and Safety of Saxagliptin

  • Saxagliptin has been shown to improve glycemic control, as reflected by significant decreases in glycated hemoglobin, fasting plasma glucose, and postprandial glucose levels compared with controls 3, 4, 5.
  • It is generally well tolerated, with a low incidence of hypoglycemia and weight-neutral effects 3, 4, 5.
  • Saxagliptin has been found to have clinically neutral effects on body weight, blood pressure, lipid levels, and other markers of cardiovascular risk compared with controls 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Clinical overview of saxagliptin for Type 2 diabetes management.

Expert review of endocrinology & metabolism, 2010

Research

Saxagliptin: a dipeptidyl peptidase-4 inhibitor for the treatment of type 2 diabetes mellitus.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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