Alogliptin

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Alogliptin.jpg

[edit] MECHANISM OF ACTION

Incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are released into the bloodstream from the small intestine in response to meals.

These hormones cause insulin release from the pancreatic beta cells in a glucose-dependent manner but are inactivated by the Dipeptidyl peptidase-4 (DPP-4) enzyme within minutes.

GLP-1 also lowers glucagon secretion from pancreatic alpha cells, reducing hepatic glucose production.

In patients with type 2 diabetes, concentrations of GLP-1 are reduced but the insulin response to GLP-1 is preserved.

Alogliptin is a Dipeptidyl peptidase-4 inhibitor (DPP-4 inhibitor) that slows the inactivation of the incretin hormones, thereby increasing their bloodstream concentrations and reducing fasting and postprandial glucose concentrations in a glucose-dependent manner in patients with type 2 diabetes mellitus.

[edit] INDICATIONS

Alogliptin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Alogliptin should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.

[edit] DOSAGE

25 mg once daily, with or without food.

Patient with renal impairment should use a lower dosage

[edit] DOSAGE FORMS AND STRENGTHS

  • 25 mg tablets
  • 12,5 mg tablets
  • 6,25 mg tablets

[edit] CONTRAINDICATIONS

  • History of a serious hypersensitivity reactions to alogliptin or to any dipeptidyl peptidase 4 (DPP4) inhibitor. These reactions include anaphylaxis, angioedema, and severe cutaneous adverse reactions including Stevens-Johnson syndrome.

[edit] WARNINGS AND PRECAUTIONS

  • Acute pancreatitis: There have been postmarketing reports of acute pancreatitis. If pancreatitis is suspected, promptly discontinue
  • Hypersensitivity reactions: There have been postmarketing reports of serious hypersensitivity reactions in patients treated with alogliptin. These reactions include anaphylaxis, angioedema, and severe cutaneous adverse reactions including Stevens-Johnson syndrome. If a serious hypersensitivity reaction is suspected, discontinue the drug. Use also with caution in patients with a history of angioedema to another DPP-4 inhibitor
  • Hepatic Effects: Measure liver enzymes promptly in patients who report symptoms that may indicate liver injury, including fatigue, anorexia, right upper abdominal discomfort, dark urine or jaundice. (Because of postmarketing reports of fatal and non-fatal hepatic failure in patients taking alogliptin)

[edit] INTERACTIONS

  • A lower dose of Insulin secretagogue, (e.g., sulfonylurea) or insulin dosage when used in combination with Alogliptin may be required to minimize the risk of hypoglycemia

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category B (US). Alogliptin like other antidiabetic medications, should be used during pregnancy only if clearly needed
  • It is not known whether alogliptin is secreted in human milk. Caution should be exercised when it is administered to a nursing woman

[edit] SIDE EFFECTS

  • Common adverse reactions are: nasopharyngitis, headache, and upper respiratory tract infection.
  • Serious hypersensitivity reactions: These reactions include anaphylaxis, angioedema, and severe cutaneous adverse reactions including Stevens-Johnson syndrome.

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

Takeda Prescribing Information revised 06/2013

[edit] REFERENCES

Diabetes (Antidiabetic drugs)
Insulin Secretagogues (drugs that increase insulin release from pancreas) Sulfonylureas Chlorpropamide (Diabinese)   Glibenclamide or Glyburide (Diabeta, Micronase, Glynase, Daonil, Euglycon)   Gliclazide (Diamicron)   Glimepiride (Amaryl, Solosa)   Glipizide (Glucotrol, Minidiab, Glibenese)   Gliquidone (Glurenorm)
Meglitinides Repaglinide (Prandin, Novonorm)   Nateglinide (Starlix)
Dipeptidyl peptidase-4 inhibitors Linagliptin (Trajenta)   Saxagliptin (Onglyza)   Sitagliptin (Januvia)   Vildagliptin (Galvus)
Incretin mimetics (GLP-1 agonists and analogs) Exenatide (Byetta)   Liraglutide (Victoza)   Lixisenatide (Lyxumia)   Dulaglutide (Trulicity)
Insulin Sensitizers (drugs that decrease insulin resistance)
Biguanides Metformin (Glucophage)
Thiazolidinediones Pioglitazone (Actos)
Drugs that retard the digestion and absorption of carbohydrates in the small intestine
Alpha-glucosidase inhibitors Acarbose (Glucobay, Precose)
Drugs that reduce glucose absorption in the kidney and increase glucose excretion in the urine
Sodium glucose cotransporter 2 (SGLT2) inhibitors Canagliflozin (Invokana)   Dapagliflozin (Farxiga)   Empagliflozin (Jardiance, Glyxambi, Synjardi)
Insulin and insulin analogs
Intermediate acting insulins Insulin lispro protamine (Humalog BASAL)   Isophane human insulin : Human insulin protamine (NPH) (Humulin I, Protaphane)
Long-acting insulins‎ Insulin detemir (Levemir)   Insulin glargine (Lantus)
Fast-acting insulins‎ Regular insulin : Insulin (Human recombinant) (Actrapid, Humulin R)
Ultra-rapid-acting insulins‎‎ Insulin aspart (Novorapid)   Insulin glulisine (Apidra)   Insulin lispro (Humalog)   Insulin human (Inhalation Powder) (Afrezza)
Premixed insulin‎‎‎ (ultra-rapid-acting + intermediate acting Insulin aspart / Insulin aspart protamine (Novomix)   Insulin lispro / Insulin lispro protamine (Humalog Mix)
Inhaled Insulin Insulin human (Inhalation Powder) (Afrezza)
Combination therapy
Sulfonylurea + Metformin Glibenclamide / Metformin (Bieuglicon M, Diaglimet, Glibomet, Gliconorm, Glicorest, Suguan M)
Thiazolidinedione + Metformin Pioglitazone / Metformin (Competact, Glubrava)
Thiazolidinedione + Sulfonylurea Pioglitazone / Glimepiride (Tandemact)
Dipeptidyl peptidase-4 inhibitors + Metformin Linagliptin / Metformin (Jentadueto)   Sitagliptin / Metformin (Efficib, Janumet, Velmetia)   Vildagliptin / Metformin (Eucreas)