Read all about

dipeptidyl peptidase 4 inhibitors

What is Dipeptidyl Peptidase 4 Inhibitors?

Dipeptidyl peptidase-4 inhibitors are a newer class of oral diabetes drugs. They are also known as gliptins and they are usually prescribed for individuals with type 2 diabetes who did not respond well to drugs such as metformin and sulphonylurea.


Januvia side effects and drug information Januvia goes by the brand name of sitagliptin, which is an oral anti-diabetic prescription medication that lowers blood sugar levels. Clinically, it works by

More information

Dipeptidyl peptidase-4 inhibitors may help with weight loss and decrease blood glucose levels although they have been linked with higher rates of pancreatitis.

Glucagon elevates blood glucose levels, and DPP-4 inhibitors lower glucagon and blood glucose levels. The mechanism of DPP-4 inhibitors is increasing incretin levels, which inhibit the release of glucagon, which in turn will increase insulin secretion, decreases blood glucose levels, and decreases gastric emptying.  A meta-analysis found no favorable effect of DPP-4 inhibitors on all-cause mortality, myocardial infarction, cardiovascular mortality, or stroke in patients with type 2 diabetes.

The drugs in this class include the following medications:

  • Sitagliptin (Januvia)
  • Vildagliptin (Galvus)
  • Saxagliptin (Onglyza)
  • Linagliptin (Tradjenta)

DPP-4 inhibitors are commonly used as a second or third-line medication for people with type 2 diabetes aster prescribing them with metformin and sulphonylureas, and as an alternative to thiazolidinedione medication.

Gliptins are effective in lowering blood glucose levels and help in reducing appetite. and having stroke They may be beneficial for people who need to lose weight.

Side effects

Adverse side effects of dipeptidyl peptidase 4 inhibitors include:

If you have a reaction that caused difficulty breathing or a severe skin reaction, immediately call for medical help.

In people who already taking sulphonylureas, there is an increased risk of hypoglycemia or low blood sugar when taking medicine in the DPP-4 class. The US FDA issued the warning that type 2 diabetes medicines such as sitagliptin, Linagliptin, Saxagliptin, and alogliptin may cause joint pain that can become severe and disabling. FDA added a new Warning and Precaution about this risk to the labels of all medicines in this class dipeptidyl peptidase-4 inhibitors. However, the studies that assessed the risk of rheumatoid arthritis among users of DPP-4 inhibitors are inconclusive.

A study conducted in 2014 found that there is an increased risk of heart failure with alogliptin and Saxagliptin, prompting the FDA to add a warning to the relevant drug labels in 2016.

A meta-analysis done in 2018 showed that using DPP-4 inhibitors was associated with a 58% increased risk of developing acute pancreatitis compared with no treatment or placebo.

An observational study conducted in 2018 suggested that there is an elevated risk of developing inflammatory bowel disease, such as ulcerative colitis, reaching a peak after three to four years of using the drug and decreasing after more than four years of use.

Dipeptidyl peptidase4 inhibitors have been associated with an increased risk of pancreatitis. If you experience severe pain in your upper stomach that may be accompanied by vomiting or nausea, call for medical help immediately.