ONGLYZA (Page 9 of 9)

14.3 Renal Impairment

A total of 170 patients participated in a 12-week, randomized, double-blind, placebo-controlled trial conducted to evaluate the efficacy and safety of ONGLYZA 2.5 mg once daily compared with placebo in patients with type 2 diabetes and moderate (n=90) or severe (n=41) renal impairment or ESRD (n=39). In this trial, 98% of the patients were using background antidiabetic medications (75% were using insulin and 31% were using oral antidiabetic medications, mostly sulfonylureas).

After 12 weeks of treatment, ONGLYZA 2.5 mg provided significant improvement in A1C compared to placebo (Table 12). In the subgroup of patients with ESRD, ONGLYZA and placebo resulted in comparable reductions in A1C from baseline to Week 12. This finding is inconclusive because the trial was not adequately powered to show efficacy within specific subgroups of renal impairment.

After 12 weeks of treatment, the mean change in FPG was −12 mg/dL with ONGLYZA 2.5 mg and −13 mg/dL with placebo. Compared to placebo, the mean change in FPG with ONGLYZA was −12 mg/dL in the subgroup of patients with moderate renal impairment, −4 mg/dL in the subgroup of patients with severe renal impairment, and +44 mg/dL in the subgroup of patients with ESRD. These findings are inconclusive because the trial was not adequately powered to show efficacy within specific subgroups of renal impairment.

Table 12: A1C at Week 12 in a Placebo-Controlled Trial of ONGLYZA in Patients with Renal Impairment*
Efficacy Parameter ONGLYZA 2.5 mgN=85 PlaceboN=85
* Intent-to-treat population using last observation on study.
Least squares mean adjusted for baseline value.
p-value <0.01 compared to placebo
Hemoglobin A1C (%) N=81 N=83
Baseline (mean) 8.4 8.1
Change from baseline (adjusted mean) −0.9 −0.4
Difference from placebo (adjusted mean) −0.4
95% Confidence Interval (−0.7, −0.1)

16 HOW SUPPLIED/STORAGE AND HANDLING

How Supplied

ONGLYZA® (saxagliptin) tablets have markings on both sides and are available in the strengths and packages listed in Table 12.

Table 12: ONGLYZA Tablet Presentations
Tablet Strength Film-Coated TabletColor/Shape Tablet Markings Package Size NDC Code
5 mg pinkbiconvex, round “5” on one side and “4215” on the reverse, in blue ink Bottles of 30 54868-6309-0

Storage and Handling

Store at 20°-25°C (68°-77°F); excursions permitted to 15°-30°C (59°-86°F) [see USP Controlled Room Temperature].

17 PATIENT COUNSELING INFORMATION

See FDA-approved Medication Guide.

17.1 Instructions

Patients should be informed of the potential risks and benefits of ONGLYZA and of alternative modes of therapy. Patients should also be informed about the importance of adherence to dietary instructions, regular physical activity, periodic blood glucose monitoring and A1C testing, recognition and management of hypoglycemia and hyperglycemia, and assessment of diabetes complications. During periods of stress such as fever, trauma, infection, or surgery, medication requirements may change and patients should be advised to seek medical advice promptly.

Patients should be informed that acute pancreatitis has been reported during postmarketing use of ONGLYZA. Before initiating ONGLYZA, patients should be questioned about other risk factors for pancreatitis, such as a history of pancreatitis, alcoholism, gallstones, or hypertriglyceridemia. Patients should also be informed that persistent severe abdominal pain, sometimes radiating to the back, which may or may not be accompanied by vomiting, is the hallmark symptom of acute pancreatitis. Patients should be instructed to promptly discontinue ONGLYZA and contact their healthcare provider if persistent severe abdominal pain occurs [see Warnings and Precautions (5.1) ].

Patients should be informed that serious allergic (hypersensitivity) reactions, such as angioedema, anaphylaxis, and exfoliative skin conditions, have been reported during postmarketing use of ONGLYZA. If symptoms of these allergic reactions (such as rash, skin flaking or peeling, urticaria, swelling of the skin, or swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing) occur, patients must stop taking ONGLYZA and seek medical advice promptly.

Patients should be informed that if they miss a dose of ONGLYZA they should take the next dose as prescribed, unless otherwise instructed by their healthcare provider. Patients should be instructed not to take an extra dose the next day.

Healthcare providers should instruct their patients to read the Medication Guide before starting ONGLYZA therapy and to reread it each time the prescription is renewed. Patients should be instructed to inform their healthcare provider if they develop any unusual symptom or if any existing symptom persists or worsens.

Patients should be informed that ONGLYZA tablets must not be split or cut.

17.2 Laboratory Tests

Patients should be informed that response to all diabetic therapies should be monitored by periodic measurements of blood glucose and A1C, with a goal of decreasing these levels toward the normal range. A1C is especially useful for evaluating long-term glycemic control. Patients should be informed of the potential need to adjust their dose based on changes in renal function tests over time.


Manufactured by:
Bristol-Myers Squibb Company
Princeton, NJ 08543 USA

Marketed by:
Bristol-Myers Squibb Company
Princeton, NJ 08543
and
AstraZeneca Pharmaceuticals LP
Wilmington, DE 19850

1297954 / 1256314A3
Rev December 2011

Additional barcode labeling by:
Physicians Total Care, Inc.
Tulsa, Oklahoma 74146

MEDICATION GUIDE
ONGLYZA (on-GLY-zah)
(saxagliptin)
tablets

Read this Medication Guide carefully before you start taking ONGLYZA and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment. If you have any questions about ONGLYZA, ask your healthcare provider.

What is the most important information I should know about ONGLYZA?

Serious side effects can happen to people taking ONGLYZA , including inflammation of the pancreas (pancreatitis) which may be severe and lead to death.

Certain medical problems make you more likely to get pancreatitis.

Before you start taking ONGLYZA:

Tell your healthcare provider if you have ever had

  • inflammation of your pancreas (pancreatitis)
  • stones in your gallbladder (gallstones)
  • a history of alcoholism
  • high blood triglyceride levels

It is not known if having these medical problems will make you more likely to get pancreatitis with ONGLYZA.

Stop taking ONGLYZA and contact your healthcare provider right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis.

What is ONGLYZA?

  • ONGLYZA is a prescription medicine used with diet and exercise to control high blood sugar (hyperglycemia) in adults with type 2 diabetes.
  • ONGLYZA lowers blood sugar by helping the body increase the level of insulin after meals.
  • ONGLYZA is unlikely by itself to cause your blood sugar to be lowered to a dangerous level (hypoglycemia) because it does not work well when your blood sugar is low. However, hypoglycemia may still occur with ONGLYZA. Your risk for getting hypoglycemia is higher if you take ONGLYZA with some other diabetes medicines, such as a sulfonylurea or insulin.
  • ONGLYZA is not for people with type 1 diabetes.
  • ONGLYZA is not for people with diabetic ketoacidosis (increased ketones in your blood or urine).
  • If you have had pancreatitis in the past, it is not known if you have a higher chance of getting pancreatitis while you take ONGLYZA.

It is not known if ONGLYZA is safe and effective in children younger than 18 years old.

Who should not take ONGLYZA?

Do not take ONGLYZA if you:

  • are allergic to any ingredients in ONGLYZA. See the end of this Medication Guide for a complete list of ingredients in ONGLYZA.
Symptoms of a serious allergic reaction to ONGLYZA may include:
  • swelling of your face, lips, throat, and other areas on your skin
  • difficulty with swallowing or breathing
  • raised, red areas on your skin (hives)
  • skin rash, itching, flaking, or peeling
If you have these symptoms, stop taking ONGLYZA and contact your healthcare provider right away.

What should I tell my healthcare provider before taking ONGLYZA?

Before you take ONGLYZA, tell your healthcare provider if you:

  • have kidney problems.
  • are pregnant or plan to become pregnant. It is not known if ONGLYZA will harm your unborn baby. If you are pregnant, talk with your healthcare provider about the best way to control your blood sugar while you are pregnant.
  • are breast-feeding or plan to breast-feed. ONGLYZA may be passed in your milk to your baby. Talk with your healthcare provider about the best way to feed your baby while you take ONGLYZA.

Tell your healthcare provider about all the medicines you take , including prescription and nonprescription medicines, vitamins, and herbal supplements.

Know the medicines you take. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

ONGLYZA may affect the way other medicines work, and other medicines may affect how ONGLYZA works. Contact your healthcare provider if you will be starting or stopping certain other types of medications, such as antibiotics, or medicines that treat fungus or HIV/AIDS, because your dose of ONGLYZA might need to be changed.

How should I take ONGLYZA?

  • Take ONGLYZA by mouth one time each day exactly as directed by your healthcare provider. Do not change your dose without talking to your healthcare provider.
  • ONGLYZA can be taken with or without food.
  • Do not split or cut ONGLYZA tablets.
  • During periods of stress on the body, such as:
    • fever
    • trauma
    • infection
    • surgery
Contact your healthcare provider right away as your medication needs may change.
  • Your healthcare provider should test your blood to measure how well your kidneys are working before and during your treatment with ONGLYZA. You may need a lower dose of ONGLYZA if your kidneys are not working well.
  • Follow your healthcare provider’s instructions for treating blood sugar that is too low (hypoglycemia). Talk to your healthcare provider if low blood sugar is a problem for you.
  • If you miss a dose of ONGLYZA, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Just take the next dose at your regular time. Do not take two doses at the same time unless your healthcare provider tells you to do so. Talk to your healthcare provider if you have questions about a missed dose.
  • If you take too much ONGLYZA, call your healthcare provider or Poison Control Center at 1-800-222-1222, or go to the nearest hospital emergency room right away.

What are the possible side effects of ONGLYZA?

ONGLYZA can cause serious side effects, including:

  • See “What is the most important information I should know about ONGLYZA?
  • Allergic (hypersensitivity) reactions , such as:
    • swelling of your face, lips, throat, and other areas on your skin
    • difficulty with swallowing or breathing
    • raised, red areas on your skin (hives)
    • skin rash, itching, flaking, or peeling
If you have these symptoms, stop taking ONGLYZA and contact your healthcare provider right away.

Common side effects of ONGLYZA include:

  • upper respiratory tract infection
  • urinary tract infection
  • headache

Low blood sugar (hypoglycemia) may become worse in people who also take another medication to treat diabetes, such as sulfonylureas or insulin. Tell your healthcare provider if you take other diabetes medicines. If you have symptoms of low blood sugar, you should check your blood sugar and treat if low, then call your healthcare provider. Symptoms of low blood sugar include:

  • shaking
  • sweating
  • rapid heartbeat
  • change in vision
  • hunger
  • headache
  • change in mood

Swelling or fluid retention in your hands, feet, or ankles (peripheral edema) may become worse in people who also take a thiazolidinedione to treat diabetes. If you do not know whether you are already on this type of medication, ask your healthcare provider.

These are not all of the possible side effects of ONGLYZA. Tell your healthcare provider if you have any side effects that bother you or that do not go away. For more information, ask your healthcare provider.

Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

How should I store ONGLYZA?

Store ONGLYZA between 68°F and 77°F (20°C and 25°C).

Keep ONGLYZA and all medicines out of the reach of children.

General information about the use of ONGLYZA

Medicines are sometimes prescribed for conditions that are not mentioned in Medication Guides. Do not use ONGLYZA for a condition for which it was not prescribed. Do not give ONGLYZA to other people, even if they have the same symptoms you have. It may harm them.

This Medication Guide summarizes the most important information about ONGLYZA. If you would like to know more information about ONGLYZA, talk with your healthcare provider. You can ask your healthcare provider for additional information about ONGLYZA that is written for healthcare professionals. For more information, go to www.ONGLYZA.com or call 1-800-ONGLYZA.

What are the ingredients of ONGLYZA?

Active ingredient: saxagliptin

Inactive ingredients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, and magnesium stearate. In addition, the film coating contains the following inactive ingredients: polyvinyl alcohol, polyethylene glycol, titanium dioxide, talc, and iron oxides.

What is type 2 diabetes?

Type 2 diabetes is a condition in which your body does not make enough insulin, and the insulin that your body produces does not work as well as it should. Your body can also make too much sugar. When this happens, sugar (glucose) builds up in the blood. This can lead to serious medical problems.

The main goal of treating diabetes is to lower your blood sugar so that it is as close to normal as possible.

High blood sugar can be lowered by diet and exercise, and by certain medicines when necessary.

This Medication Guide has been approved by the U.S. Food and Drug Administration.


ONGLYZA (saxagliptin) tablets
Manufactured by:
Bristol-Myers Squibb Company
Princeton, NJ 08543 USA

Marketed by:
Bristol-Myers Squibb Company
Princeton, NJ 08543
and
AstraZeneca Pharmaceuticals LP
Wilmington, DE 19850

1297954 / 1256314A3 / 1296566A0
Rev December 2011

———————————————
REPRESENTATIVE PACKAGING

See How Supplied section for a complete list of available packages of ONGLYZA.

30 Tablets
ONGLYZA®
(saxagliptin) tablets
5 mg
DISPENSE WITH MEDICATION GUIDE
Rx onlyOnglyza 5 mg Bottle Label

ONGLYZA saxagliptin tablet, film coated
Product Information
Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:54868-6309(NDC:0003-4215)
Route of Administration ORAL DEA Schedule
Active Ingredient/Active Moiety
Ingredient Name Basis of Strength Strength
saxagliptin hydrochloride (saxagliptin) saxagliptin 5 mg
Inactive Ingredients
Ingredient Name Strength
lactose monohydrate
cellulose, microcrystalline
croscarmellose sodium
magnesium stearate
Product Characteristics
Color PINK Score no score
Shape ROUND (biconvex) Size 8mm
Flavor Imprint Code 5;4215
Contains
Packaging
# Item Code Package Description Multilevel Packaging
1 NDC:54868-6309-0 30 TABLET, FILM COATED (TABLET) in 1 BOTTLE, PLASTIC None
Marketing Information
Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
NDA NDA022350 09/22/2011
Labeler — Physicians Total Care, Inc. (194123980)
Establishment
Name Address ID/FEI Operations
Physicians Total Care, Inc. 194123980 relabel

Revised: 01/2012 Physicians Total Care, Inc.

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