National Safe Medication Use Month | “Sarge Sisters” of the “Sag” Family—Saxagliptin and Sarpogrelate

"Sag" sounds like a beautiful name, which easily reminds people of a young woman. There is a pair of "good sisters" in the "Sag" family of drug names - sagrelate and saxagliptin.

Although they both have the same surname "Sha Ge", and even "Lei" and "Lie" may only be different in transliteration, their pharmacological effects and indications are actually completely different. Today, Yaowa will help you to distinguish them.

Sister: Sarpogrelate

Sarpogrelate was first launched in Japan in 1993 and in my country in 2001. It is an antiplatelet drug and a synthetic 5-hydroxytryptamine receptor selective antagonist that can inhibit platelet aggregation enhanced by 5-hydroxytryptamine. It is suitable for improving ischemic symptoms such as ulcers, pain, and cold sensation caused by chronic arterial occlusive disease.

Dosage and Administration: Adults take 100 mg each time, 3 times a day, orally after meals. The dose should be increased or decreased appropriately according to age and symptoms.

Precautions when using sarpogrelate:

1. Elderly patients should start with a low dose (150 mg/day) and use the drug with caution after observing the patient's condition.

2. It is contraindicated for patients with bleeding disorders (hemophilia, capillary fragility, gastrointestinal ulcer, urethral bleeding, hemoptysis, vitreous hemorrhage, etc.), pregnant women or women who may become pregnant.

3. Patients who are menstruating, have bleeding tendency and bleeding factors, are taking anticoagulants or drugs that inhibit platelet aggregation, and have severe renal dysfunction should carefully consider its use after fully weighing the pros and cons.

Sister: Saxagliptin

Saxagliptin was approved for marketing in the United States in 2009 and launched in my country in 2011. The drug is a hypoglycemic drug and a highly effective and selective dipeptidyl peptidase-4 (DPP-4) inhibitor used to treat type 2 diabetes. It is not used for patients with type 1 diabetes or diabetic ketoacidosis. It can be used as a monotherapy to improve blood sugar control on the basis of diet and exercise. When metformin hydrochloride alone does not control blood sugar well, it can be used in combination with saxagliptin to improve blood sugar control on the basis of diet and exercise.

Dosage and Administration: Oral administration. The recommended dose is 5 mg, once a day. The time of taking the medicine is not affected by meals and the medicine must not be cut or broken before taking.

Precautions when using saxagliptin:

1. Renal insufficiency: Patients with estimated glomerular filtration rate (eGFR) ≤ 45 ml/min/1.73 m2, including some patients with moderate or severe renal insufficiency, or patients with end-stage renal disease who require hemodialysis, should adjust the dose to 2.5 mg once a day. The drug should be used with caution in patients with severe renal insufficiency.

2. Hypersensitivity reactions: Severe hypersensitivity reactions have been reported after saxagliptin was put on the market, including anaphylactic reactions, angioedema, and exfoliative skin lesions. These reactions occurred within the first 3 months after treatment, and some reports occurred after the first dose. If severe hypersensitivity reactions are suspected, discontinue use.

3. Severe and disabling joint pain: There have been reports of severe and disabling joint pain after DPP-4 inhibitors were marketed. The time from the start of treatment to the onset of symptoms ranged from 1 day to several years, and the symptoms were relieved after discontinuation of the drug.

Sarpogrelate and saxagliptin are a pair of "good sisters". In certain conditions, such as for diabetic patients with diabetic foot ulcers or lower limb artery occlusion, they may be used together. However, their application purposes are different. Sarpogrelate is used to prevent thrombosis in blood vessels, while saxagliptin is used to lower blood sugar. Be sure to check the name of the drug carefully when taking it daily, and it is best to store it separately to avoid medication errors that delay the condition and cause adverse consequences.