alogliptin
Alogliptin (Nesina) is a medication that treats Type 2 diabetes. It's added to diet and exercise to help lower your blood sugar levels. But it isn't a first-choice treatment for this condition. Alogliptin (Nesina) is typically taken by mouth once a day. Some people may experience certain side effects, such as headaches or symptoms of the common cold (e.g., sore throat or runny nose), after starting this medication.
What is Alogliptin (Nesina)?
What is Alogliptin (Nesina) used for?
Type 2 diabetes
How Alogliptin (Nesina) works
Typically, your body controls blood sugar by releasing certain hormones. These hormones tell your body to make more insulin and to produce less sugar. But a protein called dipeptidyl peptidase-4 (DPP-4) breaks down these hormones. As a result, you have higher levels of sugar in your blood.
Alogliptin (Nesina) is a DPP-4 inhibitor, which means that it blocks the action of DPP-4. In doing so, alogliptin (Nesina) allows insulin to stick around longer in your body and tells your body to make less sugar. These actions lower your blood sugar levels.
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What are the side effects of Alogliptin (Nesina)?
Common Side Effects
- Upper respiratory tract infection (5%)
- Common cold (5%)
- Headache (4%)
Other Side Effects
- Constipation
- Nausea
- Rash
- Diarrhea
Serious Side Effects
- Inflammation of the pancreas: fever, nausea, vomiting, upper stomach pain
- Severe allergic reaction: severe rash or hives; swelling of the throat, face, lips, or tongue
Source: FDA
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
blurred vision
chills
cold sweats
coma
confusion
cool, pale skin
dizziness
fast heartbeat
headache
increased hunger
nightmares
seizures
shakiness
slurred speech
unusual tiredness or weakness
Less common
decreased urine output
dilated neck veins
extreme fatigue
irregular breathing
irregular heartbeat
swelling of the face, fingers, feet, or lower legs
tightness in chest
troubled breathing
Rare
Blistering, peeling, or loosening of the skin
dark-colored urine
difficulty with swallowing
feeling of discomfort
general feeling of tiredness or weakness
headache
indigestion
inflammation of the joints
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
loss of appetite
muscle aches
pains in the stomach, side, or abdomen, possibly radiating to the back
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
sores, ulcers, or white spots in the mouth or on the lips
stomach pain, continuing
swollen lymph glands
tightness in the chest
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Alogliptin (Nesina)
Pros
Taken once daily by mouth
Can be taken with or without food
Is available as a lower-cost generic
Cons
Dose may change if you have kidney problems, while other similar medications, like Tradjenta (linagliptin), don't need dose changes
Not a first-choice treatment for Type 2 diabetes
Isn’t approved for Type 1 diabetes
Pharmacist tips for Alogliptin (Nesina)
You can take alogliptin (Nesina) with or without food. In some cases, this medication can cause stomach upset and nausea. If you experience stomach-related side effects from alogliptin (Nesina), taking the medication with food may prevent them from happening.
If you miss a dose of alogliptin (Nesina), take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue taking the medication with your next dose. Don’t take two doses together to prevent possible side effects from happening.
Ask your provider how often you should be checking your blood sugar while you're taking alogliptin (Nesina). It’s important to check your blood sugar regularly to know if it’s going too low or too high. Talk with your provider if you notice your blood sugar levels going out of your goal range on a regular basis. They might need to make changes to your blood sugar medication.
Taking alogliptin (Nesina) with certain other diabetes medications, like insulin or glipizide, can cause low blood sugar. Some of the symptoms of low blood sugar are shakiness, anxiety, sweatiness, dizziness, and confusion. Check your blood sugar level if you feel any of these symptoms. If it’s below 70 mg/dL, drink a half cup of regular soda or juice, eat a tablespoon of sugar or honey, or take 4 glucose tablets.Then, recheck your blood sugar in 15 minutes.
Make sure you get any blood tests that your provider orders for you before starting alogliptin (Nesina) and occasionally during treatment. These blood tests help your provider check your kidney health to make sure this medication is still safe for you. Your kidneys help remove alogliptin (Nesina) from your body. So if your kidneys aren’t working well, this medication can build up in your body, which can affect your risk for side effects. Talk to your provider about when you need to check on your kidneys after starting alogliptin (Nesina).
Frequently asked questions about Alogliptin (Nesina)
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What are the risks and warnings for Alogliptin (Nesina)?
Alogliptin (Nesina) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart failure
Risk factors: History of heart failure | History of kidney issues | Recent acute coronary syndrome (ACS)
If you recently had an acute coronary syndrome (ACS), such as heart attack, let your provider know. Studies show that you’re at higher risk for other heart-related problems, such as heart failure, within the first 6 months following an ACS. There’s a chance that taking alogliptin (Nesina) might further raise your risk for heart failure, though more research is needed in this area. Let your provider know right away if you have any symptoms of heart failure, such as trouble catching your breath during normal activities, tiredness, and swelling in the legs, ankles, or feet. Your provider may recommend that you go to the hospital and that you stop taking alogliptin (Nesina).
Severe joint pain
Recent reports show that some people had severe joint pain within days and up to years after starting a DPP-4 inhibitor, like alogliptin (Nesina). These symptoms went away soon after they stopped taking this medication. Talk to your provider if you start having severe joint pain after starting this medication. Your provider will likely talk to you about your symptoms and when they started. They’ll discuss with you about whether you should keep taking alogliptin (Nesina) or not.
Inflammation of the pancreas
Although rare, some people developed inflammation of the pancreas (pancreatitis) while taking alogliptin (Nesina). We don’t know for sure if alogliptin (Nesina) caused the pancreatitis, and more research is needed to find out. Some common symptoms of an inflamed pancreas are upper stomach pain, fever, nausea, and vomiting. If you start to feel any of these symptoms, contact your provider right away because they might ask you to stop taking alogliptin (Nesina).
Liver problems
While very rare, some people taking alogliptin (Nesina) developed damage to their liver that was sometimes fatal. It's not clear whether alogliptin (Nesina) was the cause of the liver problems. To be safe, watch out for symptoms of liver problems, such as yellowing of the skin, fatigue, dark urine, and upper stomach pain on the right side of your body. If you notice any of these side effects, let your provider know so they can check your liver function through blood work. Based on the lab test results, your provider may tell you to stop alogliptin (Nesina) while they figure out the cause of liver damage.
Severe itching rash
In rare cases, some people developed an itchy, blistering rash (pemphigoid) after starting a DPP-4 inhibitor, like alogliptin (Nesina). This type of rash happens when your body’s immune system starts attacking your skin and causes inflammation. It typically goes away after treatment with topical or oral medications that help calm down your immune system. If you notice a rash start to form while you’re taking alogliptin (Nesina), contact your healthcare provider and they may have you stop this medication.
Alogliptin (Nesina) dosage forms
Typical dosing for Alogliptin (Nesina)
The typical dose is 25 mg taken by mouth once daily.
Your dose may differ if you have kidney problems.
Interactions between Alogliptin (Nesina) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Balofloxacin
- Besifloxacin
- Chloroquine
- Ciprofloxacin
- Enoxacin
- Fleroxacin
- Flumequine
- Gatifloxacin
- Gemifloxacin
- Hydroxychloroquine
- Lanreotide
- Levofloxacin
- Lomefloxacin
- Moxifloxacin
- Nadifloxacin
- Norfloxacin
- Octreotide
- Ofloxacin
- Pasireotide
- Pazufloxacin
- Pefloxacin
- Prulifloxacin
- Rufloxacin
- Sparfloxacin
- Thioctic Acid
- Tosufloxacin
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Atenolol
- Betaxolol
- Bisoprolol
- Carteolol
- Carvedilol
- Celiprolol
- Esmolol
- Labetalol
- Levobunolol
- Metipranolol
- Metoprolol
- Nadolol
- Nebivolol
- Oxprenolol
- Penbutolol
- Pindolol
- Practolol
- Propranolol
- Sotalol
- Timolol
How much does Alogliptin (Nesina) cost?
What are alternatives to Alogliptin (Nesina)?
Improve blood sugar levels in adults with Type 2 diabetes (as an add-on to a nutritious diet and exercise routine)
What is the latest news about Alogliptin (Nesina)?
Alogliptin (Nesina) images
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References
Best studies we foundAmerican Diabetes Association. (n.d.). Blood glucose and insulin at work.
Bosi, E., et al. (2011). Alogliptin as a third oral antidiabetic drug in patients with type 2 diabetes and inadequate glycaemic control on metformin and pioglitazone: a 52-week, randomized, double-blind, active-controlled, parallel-group study. Diabetes, Obesity and Metabolism.
Centers for Disease Control and Prevention. (2022). How to treat low blood sugar.
Kasina, S. V. S. K., et al. (2022). Dipeptidyl peptidase IV (DPP IV) inhibitors. StatPearls.
Ludmann, P. (2021). Bullous pemphigoid: Causes. American Academy of Dermatology Association.
Sharma, A., et al. (2018). Early and chronic dipeptidyl‐peptidase‐IV inhibition and cardiovascular events in patients with type 2 diabetes mellitus after an acute coronary syndrome: A landmark analysis of the EXAMINE trial.
Takeda Pharmaceuticals America. (2016). NESINA (alogliptin) tablets, for oral use [package insert].
You and Your Hormones. (2021). Insulin.
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