Alogliptin

ATC code

A10BH04

Therapeutic class

Dipeptidyl peptidase-4 (DPP-4) inhibitor · Oral hypoglycemic agent

Forms

oral tablet

Brand names

Vipidia (EU) · Nesina (US)

Overall confidence

high

Regulatory sources consulted

Approved indications

Indicated in adults aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control in combination with other glucose lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control.

Contraindications

Absolute

Hypersensitivity to the active substance or to any of the excipients, or a history of a severe hypersensitivity reaction, including anaphylaxis, anaphylactic shock and angioedema, to any dipeptidyl peptidase-4 (DPP-4) inhibitor.

Clinical warnings

Major warning · Acute pancreatitis: Cases of acute pancreatitis have been observed. Patients should be informed of the characteristic symptoms (persistent, severe abdominal pain). If pancreatitis is suspected, treatment should be discontinued. — EMA
Major warning · Bullous pemphigoid: Cases of bullous pemphigoid requiring hospitalization have been reported. If suspected, treatment should be discontinued. — EMA

Drug interactions

ModerateSulfonylureas (e.g., Glyburide)A10BB
Mechanism: Additive pharmacodynamic effect, increasing the risk of hypoglycemia.
Recommendation: Consider a lower dose of the sulfonylurea to reduce the risk of hypoglycemia when initiating treatment with alogliptin.
EMA SPC

Adverse events

Common (≥1%)

upper respiratory tract infection · nasopharyngitis · headache · abdominal pain · pruritus

Rare but serious

acute pancreatitis · hepatic failure · bullous pemphigoid · angioedema · anaphylaxis

Pregnancy and lactation

There are no data from the use of alogliptin in pregnant women. As a precautionary measure, it is preferable to avoid its use during pregnancy. It is unknown whether it is excreted in human milk; a risk to the breastfed infant cannot be excluded.