It promotes pancreatic insulin secretion by inhibiting the DPP-4 enzyme that degrades the GLP-1 and GIP intestinal hormones involved in the physiological regulation of glucose, which are activated by eating (EMA 2016, Baetta, 2011, Scheen 2011). Administered orally once a day. Very low risk of hypoglycemia in monotherapy. Very low frequency of clinically significant side effects. Dosage up to 120 times higher than normal did not produce side effects (EMA 2016). Since the last update we have not found published data on its excretion in breast milk. Its pharmacokinetic data (EMA 2016, Scheen 2011): high volume of distribution and high percentage of protein binding make it unlikely that significant amounts will pass into breast milk, but low molecular weight, low metabolism and its effective elimination half-life of 12 hours would facilitate its possible passing into breast milk. Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity. Diet, exercise, and breastfeeding improve blood sugar levels. Among the antidiabetics of this same group, saxagliptin and vildagliptin would be preferable due to their short half-life (less than 3 hours). See below the information of these related products: