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Adverse Effects and Black Box Warnings Adverse effects of DPP-4 Inhibitors include (Kasina, 2023): Upper respiratory tract infection Nasopharyngitis Headache Urinary tract infection Headache Serious allergic reaction Anaphylaxis Angioedema Steven-Johnson syndrome Drug Interactions Drug interactions for DPP-4 inhibitors include (19): Sulfonylureas Insulin Insulin secretagogues Angiotensin-converting enzyme inhibitors Risk for angioedema CYP3A4 inhibitors Increase saxagliptin exposure and efficacy CYP3A4 inducers Reduce linagliptin exposure and efficacy Glimepiride Arthralgia, back pain, and headache Metformin Cough (linagliptin) Arthralgia, back pain, and headache P-gp inhibitors Increases sitagliptin absorption P-gp inducers Reduces linagliptin efficacy Pioglitazone Headache and upper respiratory tract infection (sitagliptin) Sulfonylureas Hyperlipidemia and weight gain Nasopharyngitis and lipid abnormalities Cough (linagliptin) Thiazolidinedione Peripheral edema (saxagliptin) Ask yourself