Frequency | |||
---|---|---|---|
Side effect | GLP-1RA | DPP-4I | Potential mechanism |
GI | |||
Nausea | +++ | ++ | Gastric emptying ↓, activation nausea centres |
Vomiting | ++ | + | Gastric emptying ↓, activation nausea centres |
Diarrhoea | +++ | + | Unknown |
Constipation | ++ | + | Intestinal motility ↓ |
Flatulence | ++ | + | Unknown |
Gastric reflux | ++ | +/++ | Unknown |
Pancreatitis | +/− | +/− | Unknown |
Cholelithiasis | +/− | ? | Weight loss, bile acid production ↓, gallbladder motility ↓ |
Other | |||
Hypoglycaemia* | +/++ | +/++ | Insulin secretion ↑, intestinal glucose uptake ↓ |
Nasopharyngitis | + | + | Unknown |
Anaphylaxis | +/− | +/− | Immunoreactive |
Prerenal failure | +/− | +/− | Dehydration by vomiting, diuresis ↑ |
Based on the summary product characteristics of all registered GLP-1RA and DPP-4I.
*Predominantly observed in combination with sulfonylurea agents, not with metformin.
+++, very common (>1/10); ++, common (>1/100); +, uncommon (>1/1000); +/−, rare to very rare (>1/10 000); −, not present; ?, unknown.
DPP-4I, dipeptidyl peptidase 4 inhibitor; GLP-1RA, glucagon-like peptide-1 receptor agonist.