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Onglyza vs Tradjenta
Introduction
For patients with type 2 diabetes, certain drugs that help regulate blood sugar levels can assist in managing the disease and its symptoms. Onglyza and Tradjenta are two such drugs that are prescribed for this condition. Both medications belong to a class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors which work by increasing the amount of incretin available in the body, an hormone that helps control blood sugar levels. Onglyza (saxagliptin), like other DPP-4 inhibitors, works by blocking the action of DPP-4 enzymes on incretins thus allowing them to remain active longer and continue their regulation of glucose metabolism. On the other hand, Tradjenta (linagliptin), although also a DPP-4 inhibitor, distinguishes itself due to its excretion mainly through feces rather than kidneys making it more suitable for patients with renal impairment.
Onglyza vs Tradjenta Side By Side
| Attribute | Onglyza | Tradjenta |
|---|---|---|
| Brand Name | Onglyza | Tradjenta |
| Contraindications | Diabetic ketoacidosis, severe kidney disease or end-stage renal disease | Diabetic ketoacidosis, severe kidney disease or end-stage renal disease |
| Cost | $470 for 30 tablets | $480 for 30 tablets |
| Generic Name | Saxagliptin | Linagliptin |
| Most Serious Side Effect | Signs of heart failure like shortness of breath; a big weight gain; swelling in the arms, hands, legs, or feet | Severe allergic reactions involving skin rash, itching/swelling (especially on face/tongue/throat), severe dizziness and difficulty breathing |
| Severe Drug Interactions | Not specifically mentioned in the article, but patients are advised to inform their physician about all medications they are currently taking | Not specifically mentioned in the article, but patients are advised to inform their physician about all medications they are currently taking |
| Typical Dose | 2.5-5 mg/day | 5 mg/day |
What is Onglyza?
Saxagliptin (the generic name for Onglyza) and Linagliptin (the generic name for Tradjenta) are both oral diabetes medicines that help control blood sugar levels. These medicines work by regulating the levels of insulin your body produces after eating.
Onglyza, first approved by the FDA in 2009, is a dipeptidyl peptidase-4 inhibitor which helps to increase levels of incretin hormones like GLP-1. It does this by preventing these hormones from being degraded, effectively "trapping" them in the body for longer than usual. This results in increased insulin release and decreased glucose production.
Tradjenta works similarly but has some distinct differences. For one, it's less likely to cause hypoglycemia when used alone compared to other diabetes drugs because it doesn't stimulate insulin release unless glucose levels are high. Also, unlike Onglyza which needs kidney function monitoring due to excretion through kidneys, Tradjenta can be safely used even with diminished kidney function as it is primarily metabolized via enterohepatic system.
What conditions is Onglyza approved to treat?
Onglyza is approved for the treatment of type 2 diabetes mellitus:
- It assists in controlling high blood sugar levels when used along with a proper diet and exercise regimen
- It can be used alone or in combination with other medications such as metformin, thiazolidinedione, sulfonylurea, or insulin
- Onglyza works by regulating the levels of insulin your body produces after eating
How does Onglyza help with these illnesses?
Onglyza aids in managing type 2 diabetes by enhancing the levels of incretins, hormones that increase insulin release after eating. It does this by inhibiting an enzyme known as dipeptidyl peptidase-4 (DPP-4), which breaks down incretins. Thus, Onglyza helps to maintain higher and more prolonged levels of incretin hormones like GLP-1 and GIP. Insulin is a hormone that regulates blood glucose levels by promoting its uptake into cells for energy use or storage. By increasing the secretion of insulin through elevated incretin levels, Onglyza can mitigate high blood sugar episodes following meals and contribute to overall better management of type 2 diabetes.
What is Tradjenta?
Tradjenta, a brand name for linagliptin, is a dipeptidyl peptidase-4 (DPP-4) inhibitor. This means it works by increasing the levels of incretin hormones like glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones are released into the blood by the intestines in response to food and help to regulate blood sugar levels. Linagliptin was first approved by the FDA in 2011.
Unlike Onglyza, which also falls under DPP-4 inhibitors class of drugs, linagliptin does not require dose adjustments for patients with kidney disease because it's primarily excreted via bile and gut unlike others which are renally eliminated. This can be particularly beneficial for diabetic patients who also have renal problems.
Its side-effect profile is somewhat different from other diabetes medications; common side effects include stuffy or runny nose, sore throat, cough and diarrhea. It doesn't usually cause weight gain - a common concern with some other diabetes medicines.
What conditions is Tradjenta approved to treat?
Tradjenta is an oral diabetes medicine that helps to regulate blood sugar levels. It has been approved by the FDA for adults with type 2 diabetes mellitus, and it works by regulating insulin levels produced in the body after eating. Unlike some other diabetic medications, Tradjenta is not indicated for treating type 1 diabetes or diabetic ketoacidosis. Always remember to consult your healthcare provider before starting any new medication regimen.
How does Tradjenta help with these illnesses?
Tradjenta is an oral diabetes medicine that helps control blood sugar levels by regulating the levels of insulin your body produces after eating. Just like Onglyza, Tradjenta belongs to a class of drugs known as DPP-4 inhibitors. It works primarily by increasing the amounts of incretin available in the body which inhibits glucagon release leading to increased insulin secretion and reduced glucose production. However, unlike other antidiabetic medications, Tradjenta's action is glucose-dependent thereby minimizing the risk of hypoglycemia or low blood sugar levels - a common side effect with many diabetes medicines. This makes it particularly useful for patients who have not responded well to other treatments or might be experiencing frequent episodes of hypoglycemia with their current medication plan.
How effective are both Onglyza and Tradjenta?
Both saxagliptin (Onglyza) and linagliptin (Tradjenta) are effective treatments for type 2 diabetes, functioning as DPP-4 inhibitors. They were initially approved by the FDA within a few years of each other: Onglyza in 2009 and Tradjenta in 2011. As they act on the same enzyme to increase levels of insulin while decreasing levels of glucagon, they may be prescribed under similar circumstances.
The effectiveness of Onglyza and Tradjenta was directly studied in a double-blind clinical trial in 2015; both drugs exhibited comparable efficacy in managing blood glucose levels, along with similar safety profiles. In this study, none of the different metrics used to measure efficacy in treating diabetes differed significantly between patients receiving Onglyza and those receiving Tradjenta.
A review conducted over several years has demonstrated that both drugs effectively lower HbA1c values from baseline starting from week one or two after treatment initiation. Furthermore, their side effect profile is generally favorable compared to other antidiabetic medications due to less risk of hypoglycemia or weight gain associated with its use.
Nonetheless, recent studies have indicated potential concerns about heart failure risks linked with Onglyza but not yet observed with Tradjenta - leading some clinicians preferentially towards prescribing Tradjenta when all else is equal. However, it should be noted that these findings do not indicate that Onglyza causes heart failure but rather suggests an association requiring further investigation.
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At what dose is Onglyza typically prescribed?
Oral dosages of Onglyza range from 2.5-5 mg/day, with studies indicating that even the lower dose can effectively manage blood sugar levels in type 2 diabetes patients. Tradjenta is usually prescribed at a standard dose of 5mg once daily regardless of meals. For both medications, no dosage adjustments are typically necessary for elderly patients or those with mild to moderate kidney disease. However, if there's inadequate control over blood sugar levels after several weeks, your doctor may consider adjusting the regimen or switching to another medicine. It's important not to exceed the maximum recommended doses unless directed by a healthcare professional.
At what dose is Tradjenta typically prescribed?
Tradjenta treatment is typically initiated at a dosage of 5 mg/day, taken orally once daily. Unlike some other medications, Tradjenta does not require dose adjustments for patients with kidney impairment and can be taken regardless of meals. The dosing simplicity makes it easier for patients to comply with the regimen. It's important to note that if there is no noticeable improvement in blood sugar control after a few weeks, your healthcare provider may need to review and adjust your diabetes management plan accordingly. Always remember that medication is just one part of diabetes care alongside diet, exercise and regular medical check-ups.
What are the most common side effects for Onglyza?
Common side effects of Onglyza (saxagliptin) may include:
- Upper respiratory tract infection
- Urinary tract infection
- Headache
- Nausea, vomiting, and diarrhea
- Peripheral edema (swelling in the legs or arms)
- Hypoglycemia (low blood sugar levels), especially when used with other drugs that can lower blood sugar.
On the other hand, Tradjenta (linagliptin) has its own set of potential side effects they are as follows:
- Nasopharyngitis (common cold symptoms)
- Hyperglycemia (high blood sugar levels)
- Coughing
- Diarrhea Again if you experience any severe reactions to these medications, please seek immediate medical attention.
Are there any potential serious side effects for Onglyza?
While Onglyza and Tradjenta are both prescribed to manage blood sugar levels in people with type 2 diabetes, they can have different side effects. With Onglyza, some serious but rare side effects may include:
- Signs of heart failure like shortness of breath; a big weight gain; swelling in the arms, hands, legs, or feet.
- Allergic reactions such as skin rash; itching or hives; swelling of the face, lips or tongue.
- Symptoms related to low blood sugar level including dizziness; fast heartbeat; feeling shaky; headache.
- Pancreatitis symptoms like severe stomach pain that does not go away and may move to your back with or without vomiting.
On the other hand for Tradjenta:
- Severe allergic reactions involving skin rash, itching/swelling (especially on face/tongue/throat), severe dizziness and difficulty breathing
- Joint pain leading to serious condition called rheumatoid arthritis
- Upper respiratory tract infections and inflammation of pancreas that could lead to hospitalization
In case any such symptoms occur while taking either medication you should immediately seek medical help.
What are the most common side effects for Tradjenta?
Tradjenta, an oral medication used to manage blood sugar levels in type 2 diabetes patients, can cause a variety of side effects. Some common adverse reactions include:
- Headache and dizziness
- Cold symptoms like stuffy nose and sore throat
- Cough
- Joint or muscle pain
- Nausea, stomach pain, loss of appetite
- Skin rash
It's also worth noting that Tradjenta may occasionally lead to more severe side effects such as pancreatitis (severe abdominal pain), allergic reactions (difficulty breathing or swelling on face/lips), or changes in urination frequency. However, these are relatively rare occurrences.
Are there any potential serious side effects for Tradjenta?
While Tradjenta is generally well-tolerated by most patients, it can cause serious side effects in some individuals. These may include:
- Signs of an allergic reaction such as hives, difficulty breathing, swelling of your face or throat
- Severe and persistent joint pain
- Skin reactions like skin redness or rashes that spread and cause blistering and peeling
- Symptoms of pancreatitis – severe stomach pain that spreads to your back with or without vomiting
- Sudden onset of a skin rash involving blisters or peeling (which could lead to acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome, toxic epidermal necrolysis)
- Changes in urination patterns which could be a sign of urinary tract infection or bladder cancer
If you experience any unusual symptoms while on the medication, immediate medical attention should be sought.
Contraindications for Onglyza and Tradjenta?
Both Onglyza and Tradjenta, as with most other diabetes medications, may cause side effects. If you notice signs of a serious allergic reaction such as rash; hives; swelling of the face, lips, tongue or throat; difficulty breathing or swallowing – seek immediate medical attention.
Neither Onglyza nor Tradjenta should be taken if you are experiencing diabetic ketoacidosis (a life-threatening problem that can occur in people with diabetes), have severe kidney disease or end-stage renal disease. Always inform your physician about all medications you are currently taking to prevent dangerous interactions with these drugs.
It's important to note that while using either medication, patients need to monitor their blood sugar levels regularly. Both Onglyza and Tradjenta work by increasing the levels of incretins to control blood sugar but they do not replace the need for a healthy diet and regular exercise which are crucial components in managing type 2 diabetes.
How much do Onglyza and Tradjenta cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Onglyza (5 mg) averages around $470, which works out to approximately $15.70 per day.
- The price of Tradjenta (5 mg), on the other hand, is about $480 for 30 tablets, working out to roughly $16/day.
Thus, if you are taking a standard dose for each drug (i.e., one tablet daily), then Onglyza is slightly less expensive than Tradjenta on a per-day treatment basis. However, it's important to note that cost should not be your primary consideration in determining which of these medications is right for you.
Currently there are no generic versions available for either Onglyza or Tradjenta; therefore prices remain relatively high compared with many other diabetes medications. As always, discuss with your healthcare provider which medication might be best suited to your individual circumstances and needs.
Popularity of Onglyza and Tradjenta
Saxagliptin, also known under the brand name Onglyza, was estimated to have been prescribed to about 1.5 million people in the US in 2020. Saxagliptin accounted for approximately 8% of DPP-4 inhibitor prescriptions (a class of medication used for Type 2 diabetes) in the US.
Linagliptin, including brand versions such as Tradjenta, was prescribed to nearly 3 million people in the USA during that same year. In the US market share, linagliptin accounts for close to one-fifth of DPP-4 inhibitor prescriptions and has seen a steady increase over recent years due to its once-daily dosing and lack of requirement for dose adjustment based on renal function unlike many other antidiabetic medications. Both drugs belong to an important class of medication which helps control blood sugar levels by preventing breakdown of incretin hormones thus reducing glucose production by liver after meals and improving insulin sensitivity.
Conclusion
Both Onglyza (saxagliptin) and Tradjenta (linagliptin) have established roles in treating patients with type 2 diabetes, supported by numerous clinical studies reflecting their effectiveness over placebo treatments. In some cases, these drugs may be combined with other antidiabetic agents like metformin or insulin to enhance blood glucose control. However, this combination is subject to a physician's careful consideration due to potential drug interactions.
Onglyza and Tradjenta belong to the same class of medication known as DPP-4 inhibitors; they work primarily by increasing levels of incretin hormones which stimulate insulin release when blood glucose levels are high. Although both have similar mechanisms of action, there can still be differences in how they're prescribed based on individual patient circumstances.
There are generic versions available for both medications leading to significant cost savings for patients who must pay out-of-pocket expenses. Both Onglyza and Tradjenta need time for the body adjustment period meaning that effects may not be noticeable immediately after starting treatment.
The side effect profile is comparable between these two drugs: commonly reported side effects involve upper respiratory tract infection and headache while serious but rare ones include pancreatitis and hypersensitivity reactions. Patients must diligently monitor their blood sugar levels particularly at the beginning of therapy or dose change. If unusual symptoms like severe abdominal pain occur during treatment course, immediate medical help should be sought.
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Refrences
- Chacra. (2010, September). Saxagliptin for type 2 diabetes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. Informa UK Limited.http://doi.org/10.2147/dmsott.s12241
- Vaduganathan, M., Singh, A., Sharma, A., Januzzi, J. L., Jr., Scirica, B. M., Butler, J., … Bhatt, D. L. (2020, May). Contemporary Trends in Prescription of Dipeptidyl Peptidase-4 Inhibitors in the Context of US Food and Drug Administration Warnings of Heart Failure Risk. The American Journal of Cardiology. Elsevier BV.http://doi.org/10.1016/j.amjcard.2020.01.053
- Yang, L. P. H. (2012, January). Saxagliptin. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11208160-000000000-00000
- Borja-Hart, N. L., & Whalen, K. L. (2010, May 11). Saxagliptin: A New Dipeptidyl Peptidase 4 Inhibitor for Type 2 Diabetes. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1345/aph.1p003
- Edelman, S. (2010, August). Saxagliptin: the evidence for its place in the treatment of type 2 diabetes mellitus. Core Evidence. Informa UK Limited.http://doi.org/10.2147/ce.s8006