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DPP-4 Inhibitors or Gliptins are a group of pills used to treat type 2 diabetes. We call them DPP-4 pills.

There are currently 4 DPP-4 pills available in the United States

  • Januvia or Sitagliptin
  • Onglyza or Saxagliptin 
  • Tradjenta or Linagliptin
  • Nesina or Alogliptin

DPP-4 pills are usually taken once a day by mouth. They can be taken with or without food. If you are taking one in a combination pill with metformin, the total daily dose may be divided in half to be taken two times a day with breakfast and dinner.

When taken alone or in combination with metformin, DPP-4 pills do not cause weight loss or weight gain and have a low risk of low blood sugar or hypoglycemia.

When taken with medications that lower blood sugar, like sulfonylureas or insulin, DPP4s can cause low sugars. If needed, your health care provider can lower the dose of your other diabetes medications to help prevent low blood sugars if a DPP4 is right for you.

Some people should not take DPP-4 pills.  You should not take DPP-4 inhibitors if you have ever had pancreatitis, which is a painful inflammation of your pancreas, have ever had a condition called DKA or diabetic ketoacidosis, if your kidney function is not normal, or if you have CHF – also known as congestive heart failure – your doctor will help you to decide if a DPP-4 pill is right for you.

DPP-4 medications can be taken with insulin and other diabetes pills but not with a group of medications called GLP-1 inhibitors which are a shot that can be given to help control blood sugars in type 2 diabetes.

You should know about the side effects of DPP-4 pills. The most common side effects of DPP-4 inhibitors are:

  • nasal congestion or cold like symptoms
  • headache
  • joint pain
  • upset stomach including nausea or diarrhea

These side effects do not happen very often with DPP4s, but you should know what they are.

Even less common side effects of DPP4 pills are:

  • allergic or skin reactions, such as swelling of the lips or a rash
  • pancreatitis, which is an inflammation of the pancreas, which gives you severe belly pain that may go around into your back and/or severe vomiting 

If you experience any of these things after starting to take a DPP-4, please call your healthcare provider.

If you develop severe belly pain and/or vomiting, call 911 or go to the Emergency Department.