Adverse effects, including nasopharyngitis, headache, nausea, heart failure, hypersensitivity and skin reactions, have been observed in clinical studies.
In response to a report of precancerous changes in the pancreases of rats and organ donors treated with the DPP IV inhibitor sitagliptin, the United States FDA and the European Medicines Agency each undertook independent reviews of all clinical and preclinical data related to the possible association of DPP-IV inhibitors with pancreatic cancer. In a joint letter to the New England Journal of Medicines, the agencies stated that they had not yet reached a final conclusion regarding a possible causative relationship.
A 2014 meta analysis found no evidence for increased pancreatic cancer risk in people treated with DPP IV inhibitors, but owing to the modest amount of data available, was not able to completely exclude possible risk.
Herper, Matthew; Langreth, Robert (27 April 2006). "Diabetes Drugs to Watch". Forbes.com. Pharmaceuticals. Retrieved 26 April 2009. See pages of this article for Galvus aka LAF237 (Novartis) and Januvia aka MK-0431 (Merck)
Nielsen, L (2005). "Incretin mimetics and DPP-IV inhibitors for the treatment of type 2 diabetes". Drug Discovery Today10 (10): 703–10. doi:10.1016/S1359-6446(05)03460-4. PMID15896683. Includes table describing an overview of type 2 diabetes drug therapies; 76 references.
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^Monami M, Dicembrini I, Mannucci E (January 2014). "Dipeptidyl peptidase-4 inhibitors and pancreatitis risk: a meta-analysis of randomized clinical trials". Diabetes Obes Metab16 (1): 48–56. doi:10.1111/dom.12176. PMID23837679.