Alogliptin

Antidiabetic Drug

Drug class: Dipeptidyl peptidase-4 (DPP-4) inhibitor

Alogliptin (NESINA)（中文：阿格列汀）

Common Strengths of Alogliptin

Alogliptin is available in the following strengths:

• 6.25 mg, 12.5 mg, 25 mg tablets

Drug Trade Name of Alogliptin

• Nesina, Vipidia, Oseni

It is also sold under various brand names when combined with other antidiabetic medications, such as:

• NESINA MET TABLET 12.5MG/1000MG: Alogliptin 12.5mg + Metformin 1000mg
• NESINA MET TABLET 12.5MG/500MG: Alogliptin 12.5mg + Metformin 10500mg
• OSENI TABLET 25MG/15MG: Alogliptin 25mg + Pioglitazone 15mg
• OSENI TABLET 25MG/30MG: Alogliptin 25mg + Pioglitazone 30mg

Drug Usage

Treatment of type 2 diabetes mellitus in adults, as an adjunct to diet and exercise.

Mechanism of Action

Inhibits DPP-4 enzyme, increasing levels of incretin hormones which stimulate insulin release and decrease glucagon secretion, thereby lowering blood glucose.

Route of Administration

Alogliptin is administered orally in tablet form.

Dosages

• 25 mg once daily
• Normal Renal Function or Mild Renal Impairment (eGFR ≥60 mL/min/1.73 m²): No dosage adjustment is required. The recommended dose is 25 mg once daily.
• Moderate renal impairment (eGFR 30 to <60 mL/min/1.73 m²): 12.5 mg once daily
• Severe renal impairment/ESRD (eGFR 15 to <30 mL/min/1.73 m²): 6.25 mg once daily
• No dose adjustment needed for hypertension or heart failure

Side Effects

Frequency	Adverse reactions
Common	Upper respiratory tract infection
	Nasopharyngitis
	Headache
Uncommon	Hypoglycemia
	Rash
	Pruritus
	Pancreatitis
	Angioedema
	Stevens-Johnson syndrome

Pharmacokinetics

• Absorption
  • Rapidly absorbed, 100% bioavailable. The peak inhibition of DPP-4 occurs within 2 to 3 hours after dosing.
• Metabolism
  • Limited metabolism
• Elimination
  • Primarily renal excretion, half-life approximately 21 hours

The inhibition of DPP-4, which is crucial for its glucose-lowering effects, peaks within 2 to 3 hours and remains significant for up to 24 hours.

Drug Precautions

Pregnancy

Not recommended, limited data available

Breast Feeding

Not recommended

Children and Elderly

• Children: Safety and efficacy not established in <18 years
• Elderly: No dose adjustment is required based on age

Renal Impairment

Dose adjustment required (see dosages above)

Monitoring Requirements

• Renal function
• Blood glucose
• HbA1c
• Signs of pancreatitis

The main symptoms of pancreatitis include:

• Severe abdominal pain, typically in the upper abdomen, that may:
  • Feel worse after eating
  • Be sudden and intense in acute cases
• Nausea and vomiting
• Fever
• Rapid pulse/heart rate

Drug Interaction

May increase risk of hypoglycemia when used with insulin or sulfonylureas.

FAQ

How should I take the tablet?

Take once daily with or without food.

What should I avoid while taking?

Alcohol (may increase the risk of hypoglycemia)

What happens if I miss a dose?

Take as soon as remembered unless close to the next dose, do not double dose.