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Overview: Qtern helps lower blood sugar levels in people with type 2 diabetes. Qtern increases insulin levels (especially after you eat), reduces sugar made from your liver, and helps you get rid of sugar when you pee. Common side effects are infections of the nose and throat. Notify your health care provider if you have severe or frequent episodes of low blood sugar, breathing problems, nausea, vomiting, dizziness, dark, cloudy, or bloody pee or pee that smells bad, headache, fever, joint pain, or an itchy skin rash with large blisters.

Uses

What is Qtern used for?

Qtern (dapagliflozin/saxagliptin) is commonly used to help lower blood sugar levels in people with type 2 diabetes.

Qtern may also be used for other conditions as determined by your health care provider.

How does Qtern work (mechanism of action)?

Qtern works in a few ways to help keep your blood sugar levels from getting too high. It increases the levels of natural hormones in your body to help lower blood sugar by increasing insulin levels, especially after meals. They also decrease the amount of blood sugar that is made by the liver. Qtern also lowers blood sugar levels by helping your body get rid of sugar when you pee.

How is Qtern supplied (dosage forms)?

Brand and other names

  • Qtern

Dosage forms and strengths

  • 5 mg/5 mg oral tablets
  • 10 mg/5 mg oral tablets

How should I store Qtern?

Qtern should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Qtern?

The most common side effects of Qtern are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Infection in the nose or throat, sore throat
  • Kidney and bladder infections
  • Cholesterol problems
  • Yeast infection of the vagina or penis

There may be other side effects of Qtern that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Qtern?

While less common, the most serious side effects of Qtern are described below, along with what to do if they happen.

Severe Allergic Reactions. Qtern may cause allergic reactions, which can be serious. Stop taking Qtern and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Diabetic Ketoacidosis (DKA). Qtern may cause diabetic ketoacidosis (a serious complication of diabetes). DKA can be life threatening. Stop taking Qtern and get help right away if you have any of the following symptoms of diabetic ketoacidosis.

  • Nausea or vomiting
  • Stomach pain
  • Feeling very tired, woozy, or confused
  • Trouble breathing
  • Your breath smells fruity or sweet
  • Very high blood sugar levels (>300 mg/dL)

Dehydration. Qtern may cause dehydration. Dehydration may lead to low blood pressure, especially when you stand up (orthostatic hypotension) or kidney damage. Call your health care provider right away if you have any of the following symptoms of dehydration, low blood pressure, or kidney damage.

  • Dizziness or lightheadedness
  • Weakness or unusual tiredness
  • Confusion
  • Unsteadiness
  • Peeing less than normal
  • Swelling in your legs, ankles, and feet
  • Loss of appetite or nausea
  • A hard time catching your breath or chest pain or pressure
  • Seizures

Urosepsis and Pyelonephritis. Qtern may cause pyelonephritis (a kidney infection) or urosepsis (an untreated urinary tract infection that spreads to your kidney). These are serious infections and may need to be treated in the hospital. Get help right away if you have any of the following symptoms of these serious infections.

  • Dark, cloudy, or bloody pee or pee that smells bad
  • Fever and chills
  • Loss of appetite
  • Needing to pee a lot or feeling pain when you pee
  • Pain in your lower back, side, or groin
  • Upset stomach, nausea, and vomiting

Low Blood Sugar (Hypoglycemia). Qtern can cause low blood sugar, especially when combined with insulin or other medicines that increase your insulin levels. Low blood sugar can be serious and may lead to death. You may need a lower dose of your other diabetes medicine to reduce your risk of hypoglycemia. Call your health care provider right away if you have any of the following symptoms of hypoglycemia.

  • Headache
  • Crankiness or anxiety
  • Hunger
  • Dizziness or confusion
  • Blurry vision
  • Slurred speech
  • Sweating
  • Feeling jittery or shakiness
  • Fast heartbeat
  • Seizures

Necrotizing Fasciitis (Fournier’s Gangrene). Qtern can cause necrotizing fasciitis, which is an aggressive skin and tissue infection that causes some of the tissue involved to die. Necrotizing fasciitis is rare, but very serious, can lead to death, and may require surgery to treat it. Get help right away if you have any of the following symptoms of this serious infection.

  • Pain, redness, tenderness, or swelling of the perineum (of and around the anus and genitals)
  • Fever
  • General feeling of illness or discomfort

Inflammation of the Pancreas (Pancreatitis). Qtern may cause inflammation of the pancreas, which is called pancreatitis. Stop taking Qtern and call your health care provider right away if you have symptoms of pancreatitis including vomiting or severe pain in the upper part of your belly that travels to your back.

Heart Failure. Qtern may increase your risk of heart failure. Tell your health care provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Severe Joint Pain. Qtern may cause joint pain that can be severe. Call your health care provider if you have new or increased joint pain while taking this medicine.

Severe Skin Reactions. Qtern can cause a rare skin reaction called bullous pemphigoid. This reaction may start as an itchy skin rash and large blisters may form on the skin. You may need treatment in a hospital if this reaction happens. Call your health care provider right away if you get a rash or blisters on the skin while taking this medicine.

Broken Bones. Qtern may increase your risk of a fracture (broken bone). Discuss your medical history with your health care provider so your risk of fracture can be assessed. 

Warnings & Precautions

Who should not use Qtern?

Allergies to Ingredients. People who are allergic to any of the following should not take Qtern.

  • Dapagliflozin
  • Saxagliptin
  • Qtern
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Qtern.

Kidney Problems. Qtern should not be used if your kidneys are not working as well as they should be or if you are on dialysis. If there is a concern about the health of your kidneys, your health care provider may do tests to know if they are working well enough to take this medicine.

What should I know about Qtern before using it?

Do not take Qtern unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Qtern with other people, even if they have the same condition as you. It may harm them.

Keep Qtern out of the reach of children.

Certain conditions that cause increased stress on your body, like fever, trauma (such as a car accident), infection, or surgery can change the amount of diabetes medicines you need to take to control your diabetes. Talk to your health care provider if you have any of these conditions to decide if your medicine needs to be changed.

Talk to your health care provider about how to prevent, recognize, and manage low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and diabetes-related problems.

People who are 65 years or older can be at greater risk for some side effects from Qtern. Talk to your health care provider about your risks if you are in this age group.

Do not cut, break, or split Qtern. Tablets should be swallowed whole.

Qtern will cause your pee to test positive for sugar.

What should I tell my health care provider before using Qtern?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Qtern is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Other Medicines and Supplements. Qtern may interact with other medicines and supplements. Before taking Qtern, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Risk Factors for Diabetic Ketoacidosis. Tell your health care provider if you have any of the following risk factors for diabetic ketoacidosis. Your health care provider may monitor you more closely or choose a different medicine for you.

  • Type 1 diabetes or a history of diabetic ketoacidosis. Your health care provider may want you to monitor for ketones (acids made in your liver) if you are taking Qtern.
  • Decrease in your insulin dose
  • Serious infection
  • Low-salt diet. Your health care provider may suggest you stop using a low-salt diet.
  • Ketogenic diet (high fat/low carbohydrate)
  • Drink alcohol often or in large amounts
  • Pancreas problems, including a history of pancreatitis or surgery on your pancreas.
  • Dehydration
  • Eating or drinking less than normal
  • Vomiting or diarrhea

Pregnancy. Qtern may cause harm to a fetus. Tell your health care provider if you are or plan to become pregnant. If you get pregnant, talk to your health care provider about the best way to manage your blood sugar while you are pregnant.

Breastfeeding. It is not known if Qtern passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop Qtern.

How can I get more information about Qtern?

For more information about Qtern, you can visit the drugmaker's website at www.astrazeneca-us.com/medicines/astrazeneca-medications.html or call them at 800-236-9933.

Interactions

Does Qtern interact with foods or drinks?

There are no known interactions between Qtern and foods or drinks.

Being on a low-salt diet while taking Qtern may increase your risk of dehydration. See the Side Effects section for more details. 

Drinking too much alcohol while taking Qtern may increase your risk of diabetic ketoacidosis. See the Side Effects section for more details. It is unknown if drinking alcohol will affect Qtern in other ways, but alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of Qtern. It is best to limit the amount of alcohol you drink.

Does Qtern interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are taking any of the following before taking Qtern.

  • Lithium, which is a medicine for certain mental health conditions
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Another medicine for diabetes

Some other medicines may alter the blood levels of Qtern. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Qtern. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Qtern?

If you or someone else has used too much Qtern, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Qtern?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.