Onglyza (saxagliptin) is a prescription drug used for type 2 diabetes. Onglyza can cause side effects that range from mild to serious. Examples include urinary tract infection (UTI) and headache. Onglyza is discontinued. But its generic is available, and it shares the same side effects.

Onglyza is used along with a balanced, nutritious diet and exercise plan to improve blood sugar levels in adults with type 2 diabetes.

Onglyza comes as a tablet you swallow. It contains the active ingredient saxagliptin. (An active ingredient is what makes a drug work.)

Serious side effects may occur with Onglyza, including heart failure. Keep reading to learn about common, mild, and serious side effects Onglyza can cause.

For a general overview of the drug, including details about its uses, see this article.

Onglyza is discontinued. The removal of Onglyza from the market was a business decision by the manufacturer and not due to concerns regarding the drug’s safety or effectiveness.

While Onglyza is no longer prescribed by healthcare professionals, a generic version called saxagliptin is available that works like the brand-name version. The information on Onglyza in this article also applies to saxagliptin.

For more information about saxagliptin, see the drug’s prescribing information.

Some people may experience mild to serious side effects during Onglyza treatment. Examples of the drug’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

These are only some of the possible side effects of Onglyza. Keep reading to learn more about the mild to serious side effects this drug can cause.

Mild side effects have been reported with Onglyza. These include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Onglyza unless your doctor recommends it.

Onglyza may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Serious side effects have been reported with Onglyza. These include:

* To learn more about this side effect, see the “Side effects explained” section below.

If you develop serious side effects while taking Onglyza, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Onglyza, visit MedWatch.

Get answers to some frequently asked questions about Onglyza’s side effects.

Can Onglyza cause weight loss or weight gain?

Studies didn’t show weight loss or weight gain with Onglyza when taken alone. But other diabetes medications can affect weight.

Onglyza may be taken with other diabetes drugs, such as Glumetza (metformin). In a study evaluating the effects of taking metformin and Onglyza, some people reported weight loss.

For treating type 2 diabetes, Onglyza is meant to be taken along with a balanced, nutritious diet and exercise plan. People may experience weight loss if they are taking Onglyza and following a diet and exercise program.

If you’re concerned about Onglyza’s effect on your weight, talk with your doctor.

Does Onglyza 5 mg cause more side effects than Onglyza 2.5 mg?

Yes, a 5-milligram (mg) dose of Onglyza can cause more side effects than a 2.5-mg dose. In studies, headache was the only common side effect reported in people taking Onglyza 2.5 mg. However, people taking Onglyza 5 mg reported urinary tract infections (UTI) and upper respiratory infections, such as the common cold.

Learn more about some of the side effects Onglyza may cause.

Urinary tract infection

Urinary tract infections (UTIs) are common with Onglyza because this drug may affect the immune system. Symptoms of a UTI can include:

Without treatment, a UTI can worsen and spread to the kidneys, where it could lead to infection.

What might help

Report any symptoms of a UTI to your doctor. You may need antibiotics to treat it, and a severe infection could require hospitalization. Your doctor will ask about your symptoms and perform a physical exam. They may order urine tests to learn which bacteria caused the infection. This can help them choose the most appropriate antibiotic.

Heart failure

Heart failure is a possible severe side effect of Onglyza. In the drug’s studies, more people were hospitalized for heart failure if they were taking Onglyza and had risk factors for heart disease. These include atherosclerotic cardiovascular (heart-related) disease and being age 65 years or older.

People with kidney problems also have an increased risk of developing heart failure when taking Onglyza. Symptoms of heart failure to report to your doctor include:

What might help

Before you take Onglyza, your doctor will evaluate your risk factors for heart disease. If they recommend this drug to you and you develop heart failure during treatment, they may switch you to a different medication.


Though rare, arthralgia (severe and disabling joint pain) can occur days to years after starting Onglyza.

What might help

If you develop severe joint pain with Onglyza, tell your doctor. They may have you stop taking it, which may relieve your joint pain. But restarting the drug or taking a similar medication, such as Januvia (sitagliptin), can cause joint pain to return.

If you have concerns about joint pain developing from taking Onglyza, talk with your doctor.

Bullous pemphigoid

While not reported in studies, bullous pemphigoid has been reported as a severe side effect since Onglyza came on the market. Bullous pemphigoid is a condition that causes the immune system to attack the skin. People with this condition develop blisters on their skin and may require hospitalization.

What might help

Report any skin blisters or wounds to your doctor while you’re taking Onglyza. They’ll tell you whether you need to stop taking the drug and may refer you to a dermatologist for treatment.

Bullous pemphigoid is treated with creams or ointments such as corticosteroids. These slow down the immune system. Clobex (clobetasol) is a strong topical corticosteroid (one that is applied to the skin) that doctors may prescribe for bullous pemphigoid.

To treat this side effect, some people may also need oral medication, such as Imuran (azathioprine) or methotrexate. While these can also reduce the effectiveness of the immune system, people taking these drugs usually recover from bullous pemphigoid.

Allergic reaction

Like most drugs, Onglyza can cause an allergic reaction in some people. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

If your doctor confirms you’ve had a mild allergic reaction to Onglyza, they’ll decide whether you should continue taking it.

If you have symptoms of a serious allergic reaction, such as swelling, trouble breathing, or severe skin inflammation, call 911 or your local emergency number immediately. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Onglyza, they may have you switch to a different treatment.

Keeping track of side effects

During your treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Taking notes and sharing them with your doctor will help them learn more about how a drug affects you. They can then use this information to adjust your treatment plan if needed.

Onglyza may have negative effects on people with certain medical conditions. This is known as a drug-condition interaction. Other factors may also affect whether this drug is a good treatment option. Note that Onglyza is discontinued, but your doctor may prescribe saxagliptin, Onglyza’s generic, instead. The warnings below for Onglyza also apply to saxagliptin.

Talk with your doctor about your health history before starting treatment. Factors to consider include those described below.

Pancreatitis. Pancreatitis (inflammation of the pancreas) is a severe side effect of Onglyza. It’s not known whether having a history of pancreatitis is a risk factor for developing it with this drug. If you’ve had pancreatitis, tell your doctor before starting treatment.

Heart failure. Onglyza can worsen heart failure. If you have this condition, your doctor will consider the benefits and risks of Onglyza for you. If you do take this drug, they’ll monitor you for signs and symptoms of worsening heart failure. Report any symptoms to your doctor. If your heart function worsens, they may have you stop taking Onglyza.

Allergic reaction. If you’ve had an allergic reaction to Onglyza or any of its ingredients, your doctor will likely not recommend it for you. Ask them about other medications that might be better options.

Kidney problems. If you have kidney problems, your doctor may recommend a lower dose of Onglyza for you. People with kidney problems who take this drug also have an increased risk of heart failure. Your doctor will order kidney function tests to monitor your kidney health throughout your treatment with Onglyza.

Alcohol and Onglyza

Some medications interfere with alcohol, but Onglyza isn’t one of them. That said, drinking alcohol can raise or lower your blood sugar level and make it difficult to manage your blood sugar. This can make your diabetes worse. Before starting treatment, talk with your doctor about how much alcohol, if any, is safe to consume with this drug.

Pregnancy and breastfeeding while taking Onglyza

Doctors are unsure whether Onglyza is safe to take during pregnancy. But unmanaged diabetes during pregnancy is known to be unsafe for both the pregnant person and the fetus.

High blood sugar can cause complications with delivery, including stillbirth. And unmanaged diabetes can cause problems with fetal development (commonly known as birth defects).

If you’re pregnant or considering pregnancy while taking Onglyza, talk with your doctor.

It’s also unknown whether Onglyza is safe to take while breastfeeding. If you’re breastfeeding or considering breastfeeding while taking this drug, talk with your doctor. They can help you decide whether the benefits of breastfeeding your child outweigh the possible risks from this medication.

Onglyza causes a few mild side effects, and severe side effects of Onglyza can happen to people with heart failure. If you have questions about the side effects Onglyza can cause, talk with your doctor. Examples of questions to help get you started include:

  • Does my age affect my risk of side effects with Onglyza?
  • Is it safe to take this drug if I skip a meal?
  • How do the side effects of Januvia and Onglyza compare?

To learn more about Onglyza, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.