1. Introduction
Alogliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor used to improve glycaemic control in adults with type 2 diabetes mellitus. It works by increasing incretin hormone levels, which stimulate insulin secretion and reduce glucagon secretion in a glucose-dependent manner.
2. Indications
- Approved Indications:
- Adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus.
- Off-Label Uses:
- Combination therapy with other antihyperglycaemic agents.
3. Dosage
- Standard Dose:
- 25 mg once daily.
- Dosage Adjustments in Renal Impairment:
- Moderate renal impairment (eGFR 30–60 mL/min): 12.5 mg once daily.
- Severe renal impairment or end-stage renal disease (eGFR <30 mL/min): 6.25 mg once daily.
4. Administration
- Administer orally once daily with or without food.
- Swallow the tablet whole; do not crush or chew.
5. Forms Available
- Tablets: 6.25 mg, 12.5 mg, 25 mg.
6. Side Effects
6.1. Common Side Effects
- Nasopharyngitis.
- Headache.
- Upper respiratory tract infections.
6.2. Less Common Side Effects
- Diarrhoea.
- Nausea.
- Weight gain (when combined with other therapies).
6.3. Rare but Serious Side Effects
- Pancreatitis.
- Hypersensitivity reactions (e.g., angioedema, Stevens-Johnson syndrome).
- Hepatic enzyme elevation.
7. Warnings
- Risk of acute pancreatitis; discontinue if suspected.
- Monitor for severe joint pain.
- Avoid use in patients with a history of serious hypersensitivity reactions to DPP-4 inhibitors.
8. Precautions
- Use with caution in patients with a history of pancreatitis.
- Monitor liver enzymes periodically.
- Not recommended for type 1 diabetes or diabetic ketoacidosis.
9. Interactions
- Drug-Drug Interactions:
- Enhanced hypoglycaemic risk when combined with sulfonylureas or insulin.
- Drug-Food Interactions:
- None significant.
10. Monitoring Parameters
- Blood glucose (fasting and postprandial).
- HbA1c (every 3–6 months).
- Renal function (eGFR) periodically.
- Signs of pancreatitis or hypersensitivity.
11. Use in Children
- Safety and efficacy have not been established in paediatric populations.
12. Use in Pregnancy
- No adequate data in pregnant women.
- Use only if the potential benefit justifies the risk to the foetus.
- Animal studies have shown no teratogenic effects.
13. Use in Elderly
- No dose adjustment needed unless renal impairment is present.
- Monitor renal function closely due to age-related decline.
14. Use in Kidney Disease
- Dose adjustments required based on eGFR:
- Moderate impairment: 12.5 mg once daily.
- Severe impairment or ESRD: 6.25 mg once daily.
15. Use in Liver Disease
- Not recommended in severe hepatic impairment due to lack of studies.
- Use with caution in mild-to-moderate hepatic impairment.
16. Patient Counselling Points
- Advise on proper dosing and the importance of adherence to diet and exercise.
- Inform about the signs of pancreatitis (e.g., severe abdominal pain).
- Report any symptoms of hypersensitivity immediately.
- Discuss the need for regular blood glucose and HbA1c monitoring.
17. Table of Brand Names, Manufacturers, and Prices
Brand Name | Manufacturer | Price (USD) |
---|---|---|
Nesina | Takeda Pharmaceuticals | $200 (30 tablets, 25 mg) |
Generic Options | Various | $50–100 (30 tablets, 25 mg) |
18. FAQs (15 Questions)
- What is alogliptin used for?
Alogliptin is used to improve blood sugar control in adults with type 2 diabetes mellitus. - How does alogliptin work?
It inhibits the DPP-4 enzyme, increasing incretin levels to regulate blood sugar. - Can alogliptin be taken with food?
Yes, it can be taken with or without food. - What are the common side effects of alogliptin?
Nasopharyngitis, headache, and upper respiratory infections. - Are there any serious side effects?
Pancreatitis and severe hypersensitivity reactions are rare but serious. - Can pregnant women use alogliptin?
It is not recommended unless benefits outweigh risks due to limited data. - Is alogliptin safe for children?
Safety and efficacy in children have not been established. - How should alogliptin be stored?
Store at room temperature, away from moisture and heat. - What happens if I miss a dose?
Take it as soon as you remember, but skip it if it’s near the next dose. - Can I take alogliptin with other diabetes medicines?
Yes, but monitor for increased risk of hypoglycaemia. - Does alogliptin cause weight gain?
Not significantly on its own, but may cause weight gain when combined with other agents. - What are the signs of pancreatitis from alogliptin?
Severe abdominal pain, nausea, and vomiting. - Is alogliptin safe for elderly patients?
Yes, but monitor renal function regularly. - Does alogliptin affect liver function?
It can cause liver enzyme elevation; monitoring is advised. - Do I need regular tests while taking alogliptin?
Yes, blood glucose, HbA1c, and renal function should be monitored regularly.