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. Common side effects are upper respiratory tract infections, urinary tract infections, gastrointestinal disorders, rash and headaches (EMA, 2016). Low risk of hypoglycemia in monotherapy (EMA, 2015, Scheen 2011). Doses up to 16 times higher than normal for 2 weeks did not produce side effects (EMA, 2015). Since the last update we have not found published data on its excretion in breast milk. Its pharmacokinetic data (EMA 2015, Scheen 2011): low molecular weight, low percentage of binding to plasma proteins and very long half-life) make it likely it will pass into breast milk in concentrations that could be significant. 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: