DPP-4 inhibitors are a type of medication you might need to take if you have type 2 diabetes. They are also known as gliptins.
- What are DPP-4 inhibitors?
- How do DPP-4 inhibitors work?
- Who can take DPP-4 inhibitors?
- Different types of DPP-4 inhibitors
- How to take DPP-4 inhibitors
- Your prescription
- DPP-4 inhibitor side effects
- More information and support
What are DPP-4 inhibitors?
DPP-4 inhibitors are a treatment to lower blood sugar levels in people with type 2 diabetes.
They can be taken on their own, or with other diabetes medications.
How do DPP-4 inhibitors work?
DPP-4 inhibitors work by blocking the action of the enzyme DPP-4, which destroys incretins – hormones - that the body makes.
Incretins are naturally produced by the stomach when we eat. They help the body produce more insulin when it’s needed and lowers blood sugar levels.
Who can take DPP-4 inhibitors?
Adults over 18 years with type 2 diabetes can take DPP-4 inhibitors.
New guidelines from the National Institute for Health and Care Excellence (NICE) recommend that people with type 2 diabetes receive metformin and an SGLT-2 inhibitor as a starting treatment when they’re newly diagnosed, unless there’s a reason you can’t take those medications.
A DPP-4 inhibitor might be added to your prescription if further treatment is needed for you to reach your individual HbA1c target. If you think you would benefit from taking a DPP-4 inhibitor, talk to your healthcare team so that you can make an informed decision together about your treatment.
Who can’t take DPP-4 inhibitors?
Some medications might not be suitable for some people, which might be because of medical conditions or other reasons. The list below shows some of the reasons a DPP-4 inhibitor might not be a suitable treatment for you:
If you have heart failure;
If you have kidney disease or liver disease there are some DPP-4 inhibitors that might not be suitable for you;
If you have pancreatitis or you’ve had it in the past;
- You should not take DPP-4 inhibitors if you are pregnant of breastfeeding. If you’re planning a pregnancy, speak with a healthcare professional if you are using this medication;
- You may need to temporarily stop taking this medication if you’re going to have an operation.
The patient information leaflet that comes with the medication will have an up-to-date list of warnings and precautions. When you start a new medication, always check with your healthcare team that it’s suitable for you to take you can discuss any other medical conditions you have and any other medications you are taking.
Different types of DPP-4 inhibitors
There are five types of DPP-4 inhibitors. They are:
| Generic name | Brand name |
|---|---|
| Sitagliptin | Januvia |
| Vildagliptin | Galvus |
| Saxagliptin | Onglyza |
| Alogliptin | Vipidia |
| Linagliptin | Trajenta |
These medications can also be prescribed as a drug which contains both a DPP-4 inhibitor and metformin. They are:
| Generic name | Brand name |
|---|---|
| Sitagliptin + metformin | Janumet |
| Vildagliptin + metformin | Eucreas |
| Saxagliptin + metformin | Komboglyze |
| Alogliptin + metformin | Vipdomet |
| Linagliptin + metformin | Jentadueto |
There are also medications that have both a DPP-4 inhibitor and an SGLT2 inhibitor in one tablet:
| Generic name | Brand name |
|---|---|
| Linagliptin + empagliflozin | Glyxambi |
| Saxagliptin + dapagliflozin | Qtern |
If you have been prescribed one of these medications and you would like more information, then be sure to ask your healthcare professional.
How to take DPP4-inhibitors
DPP-4 inhibitors are tablets that you swallow. They can be taken with or without food.
But if you take a tablet that contains a DPP-4 inhibitor and metformin, you must take it with food.
Always take your DPP-4 inhibitor exactly as your healthcare professional has told you. The Patient Information Leaflet inside the box will tell you how to take it but always check with a doctor or pharmacist if you are not sure.
Your prescription
Your healthcare team should explain your prescription to you but it's important to make sure you ask if you don't feel you know enough.
And make sure you talk to your GP or your diabetes team if you struggle to take your DPP-4 inhibitor. They might be able to help by giving you a different dose.
In England, if you need to take any medication to manage your diabetes, your prescriptions will be free. Ask your healthcare team about a prescription exemption certificate if you don't have one, to make sure you don't get charged for your medication. Prescriptions are already free for everybody in the rest of the UK, so you shouldn't pay for your DPP-4 inhibitor.
DPP-4 inhibitor side effects
Like all medicines, DPP-4 inhibitors can cause side effects. But when side effects are listed as common in the Patient Information Leaflet, it doesn’t mean that everyone who takes the medication will get them.
The information about side effects is based on the likelihood of people having them. For example, if a side effect is very common then it can affect more than one in ten people, and if a side effect is very rare then it affects fewer than one in 10,000 people.
Because medicines can affect people differently, your healthcare team will speak to you about what’s best for you and discuss any side effects.
Common side effects can include:
- sickness
- diarrhoea
- headache.
These side effects usually settle down once your body gets used to the medicine.
Risk of low blood sugar
DPP-4 inhibitors do not usually cause blood sugar levels to become too low, also known as hypoglycaemia or ‘hypos’, when taken on its own. But hypos can happen when you take them with other diabetes medications such as insulin or a sulphonylurea.
To reduce the risk of hypos, your healthcare team may advise reducing the dose of medications like sulphonylureas, or insulin when you start taking a DPP-4.
These are not all the side effects. You will find a full list of known side effects in the Patient Information Leaflet. This comes in the medication box.
It’s also important that you take individual advice from your healthcare team before starting DPP-4 inhibitor treatment and report any side effects to your healthcare professionals, if you have any.
You can also report these side effects to the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.
More information and support
Still have more questions? Or is there anything you're not sure about DPP-4 inhibitors after reading this page? Contact our helpline on 0345 123 2399.
You can visit the NHS website for more information on DPP-4 inhibitors.
