In those taking sulphonylureas there is an increased risk of low blood sugar. 3 adverse reactions were seen higher in<unk>  vs placebo. Table 1: Adverse Reactions (Regardless of Investigator Assessment of Causality) in Placebo-Controlled Trials* Reported in ≥ 5% of Patients Treated with ONGLYZA<unk>  tablets) 5 mg and More Commonly than in Patients Treated with Placebo. + Number (%) of Patients ONGLYZA 5 mg N=882 Placebo N=799 Upper respiratory tract infection 68 (7.7) 61 (7.6) Urinary tract infection 60 (6.8) 49 (6.1) Headache 57 (6.5) 47 (5.9) * The 5 placebo-controlled trials include two monotherapy trials and one add-on combination therapy trial with each of the following: metformin, thiazolidinedione, or glyburide. Table shows 24-week data regardless of glycemic rescue. In February 2012, Bristol-Myers/Astra Zeneca distributed additional safety information on<unk>  use in South Africa. The package insert is to be edited for South Africa. Contraindications will now include a history of sensitivity to<unk>  (or another DPP4 inhibitor) as well as pancreatitis. Spontaneously-reported adverse events in South Africa have included anaphylaxis, angioedema and acute pancreatitis. In a cardiovascular outcomes trial,<unk>  treatment let to a small increase in the risk of being hospitalized for heart failure.<unk>  may cause joint pain that can be severe and disabling.<unk>  may increase the risk of heart failure. Tolerability Both monotherapy and combination therapy with other agents was generally well tolerated in clinical trials. Pancreatitis and pancreatic cancer An association of the DPP-IV inhibitor class with pancreatic problems has been proposed, mainly based on case reports associated with the DPP-IV inhibitor sitagliptin and several incretin mimetics including exenatide. A 2013 study of the DPP-4 inhibitor sitagliptin reported found "worrisome changes in the pancreases of the rats that could lead to pancreatic cancer". A second paper by the same authors reported an increase in precancerous lesions in the pancreases of organ donors who had taken GLP-1 inhibitors. In response to these reports, the United States FDA and the European Medicines Agency each undertook independent reviews of all clinical and preclinical data related to the possible association of DPP-IV inhibitors with pancreatic cancer. In a joint letter to the New England Journal of Medicines, the agencies stated that "Both agencies agree that assertions concerning a causal association between incretin-based drugs and pancreatitis or pancreatic cancer, as expressed recently in the scientific literature and in the media, are inconsistent with the current data. The FDA and the EMA have not reached a final conclusion at this time regarding such a causal relationship. Although the totality of the data that have been reviewed provides reassurance, pancreatitis will continue to be considered a risk associated with these drugs until more data are available; both agencies continue to investigate this safety signal." Lawsuits have been filed in which plaintiffs who developed pancreatic cancer claim that DPP-IV inhibitors or incretins had a causative role in the development of their cancers.
Saxagliptin
Linagliptin
Sitagliptin
Vildagliptin
Liraglutide
Exenatide
Canagliflozin
Pioglitazone