Dapagliflozin/Saxagliptin is a combination medication designed to help manage diabetes mellitus, a chronic condition that affects how the body handles glucose (sugar). This medication combines two active ingredients, dapagliflozin/Saxagliptin, to address different aspects of diabetes control. Dapagliflozin/Saxagliptin sold under the brand name Qtern.^[2][3] It is a combination of dapagliflozin and saxagliptin.^[2][3] It is taken by mouth.^[2][3]

The most common side effects include upper respiratory tract infection (such as nose and throat infections) and, when used with a sulphonylurea, hypoglycaemia (low blood glucose levels).^[3]

Dapagliflozin/saxagliptin was approved for medical use in the European Union in July 2016, and in the United States in February 2017.^[3][4]

Synergistic Mechanism of Action

Dual-Action Approach: The combination of dapagliflozin and saxagliptin provides a dual-action approach to diabetes management. Dapagliflozin addresses excess glucose in the urine, reducing blood glucose levels independently of insulin, while saxagliptin fine-tunes glycemic control by modulating incretin dynamics.

Comprehensive Glycemic Control: By targeting different pathways involved in glucose regulation, the combination aims to achieve comprehensive glycemic control. This is particularly beneficial for individuals with type 2 diabetes who may have varying degrees of insulin resistance and impaired incretin function.

Potential Cardiovascular and Renal Benefits: Beyond glycemic control, both dapagliflozin and saxagliptin have shown potential cardiovascular and renal benefits in clinical studies. The combination's dual mechanism may contribute to these additional positive outcomes, providing a holistic approach to diabetes care.

Medical uses

In the United States dapagliflozin/saxagliptin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.^[2]

In the European Union it is indicated in adults aged 18 years and older with type 2 diabetes mellitus:

• to improve glycemic control when metformin with or without sulphonylurea (SU) and either saxagliptin or dapagliflozin does not provide adequate glycemic control.^[3]
• when already being treated with saxagliptin and dapagliflozin.^[3]

Adverse effects

• Hypoglycemia (low blood sugar): While less common with dapagliflozin alone, it can occur, especially if used in conjunction with other antidiabetic medications.
• Dehydration: Excessive loss of fluids through increased urine output may lead to dehydration, particularly if fluid intake is insufficient.
• Genital Infections: There may be an increased risk of genital yeast infections in both men and women.
• Pancreatitis: In rare cases, saxagliptin has been associated with inflammation of the pancreas (pancreatitis).
• Allergic Reactions: Some individuals may experience allergic reactions, such as rash or swelling.
• Hypoglycemia: The risk of hypoglycemia may be present, especially if the combination is used with other antidiabetic medications.
• Renal Function Changes: Both dapagliflozin and saxagliptin may affect kidney function, and regular monitoring is recommended.

Use in Pregnancy

• When it comes to combination therapy with dapagliflozin and saxagliptin, the cumulative effects on pregnancy and fetal development need careful consideration.
• The safety of using this combination during pregnancy has not been extensively studied, and therefore, caution is advised.