Patient with abnormal LFT, history of pancreatitis, moderate to severe heart failure. Hepatic and moderate to severe renal impairment.
DPP-4 inhibitors may cause disabling joint arthralgia. Pregnancy and lactation.
Indication
Type 2 diabetes mellitus
Contra Indication
Type 1 diabetes mellitus or diabetic ketoacidosis.
Hypersensitivity to alogliptin, including anaphylaxis, angioedema, or severe cutaneous adverse reactions including Stevens-Johnson syndrome
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Mode of Action
Alogliptin inhibits dipeptidylpeptidase-4 (DPP-4), an enzyme that inactivates incretin hormones. Inhibition of DPP-4 result in an increase in the levels of hormones [e.g. GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotrophic polypeptide)] which regulate glucose homeostasis by increasing insulin synthesis and release from pancreatic ?-cells and decreasing glucagon secretion from the pancreatic ?-cells, leading to reduced hepatic glucose production.
Interaction
Increased risk of hypoglycaemia with sulfonylurea (e.g. metformin), thiazolidinedione (e.g. pioglitazone) and insulin.
Pregnancy Category Note
Pregnancy Category: B
Lactation: Unknown whether distributed in breast milk
Adult Dose
Oral
Type 2 diabetes mellitus
Adult:
25 mg once daily.
Hepatic impairment
Mild-to-moderate (Child-Pugh A and B): No dosage adjustment required
Severe (Child-Pugh C): Not studied
Child Dose
N/A
Renal Dose
Renal impairment
Mild (CrCl >60mL/min): No dosage adjustment required
Moderate (CrCl ?30 to <60 mL/min): Decrease dose to 12.5 mg PO qDay
Severe (CrCl ?15 to <30 mL/min) or ESRD (CrCl <15 mL/min) or requiring hemodialysis: 6.25 mg PO qDay
May administer without regard to the timing of dialysis
Peritoneal dialysis: Not studied
Administration
May be taken with or without food.
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