alogliptin / metformin
Kazano (alogliptin / metformin) is a combination medication for adults with Type 2 diabetes. It contains two types of diabetes medications that work in different ways to lower blood sugar: a dipeptidyl-peptidase-4 (DPP-4) inhibitor called alogliptin and a biguanide called metformin. This medication is a tablet that's taken by mouth twice daily. Some side effects can include diarrhea and headache. Kazano (alogliptin / metformin) should be taken along with having a balanced diet and exercise plan.
What is Kazano (alogliptin / metformin)?
What is Kazano (alogliptin / metformin) used for?
- Type 2 diabetes in adults
How Kazano (alogliptin / metformin) works
Kazano (alogliptin / metformin) is a combination of two medications that work together to improve blood sugar levels.
- Alogliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, also known as a "gliptin." It blocks DPP-4, a protein that breaks down hormones responsible for telling your body to make more insulin and less sugar. When DPP-4 causes these hormone levels to drop, your blood sugar levels rise. By blocking the action of DPP-4, alogliptin helps your body make more insulin and less sugar. This helps lower your blood sugar levels.
- Metformin is a biguanide that lowers blood sugar levels in several ways. It lowers the amount of sugar that your liver makes. Metformin also lowers the amount of sugar that's absorbed through your gut from the food that you eat. In addition, it makes your body more sensitive to the effects of insulin, helping to move more sugar into your cells for energy. As a result of these three pathways, metformin helps lower the amount of sugar in your bloodstream.
Drug facts
Side effects of Kazano (alogliptin / metformin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Upper respiratory tract infection (8%)
- Common cold symptoms (e.g., cough, runny or stuffy nose; 7%)
- Diarrhea (6%)
- Higher blood pressure (6%)
- Headache (5%)
- Back pain (4%)
- Urinary tract infection (UTI; 4%)
Less Common Side Effects
- Nausea or vomiting
- Indigestion
- Having gas
- Stomach discomfort
- Low blood sugar levels
Kazano (alogliptin / metformin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Buildup of acid in the blood (lactic acidosis): confusion, weakness, fast heartbeat, rapid breathing, no appetite, nausea, vomiting
- Inflamed pancreas (pancreatitis): upper stomach pain, fever, nausea, vomiting
- Serious liver problems: tiredness, weakness, poor appetite, losing weight without trying, dark urine, eyes and skin turning more yellow, upper right-sided stomach pain
- Severe skin reaction or allergic reaction: rash, blisters, sores, trouble breathing, swelling
The following Kazano (alogliptin / metformin) 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
dizziness
headache
nervousness
pounding in the ears
slow or fast heartbeat
Less common
bladder pain
bloody or cloudy urine
chills
cold sweats
coma
confusion
cool, pale skin
decreased urine output
difficult, burning, or painful urination
dilated neck veins
extreme fatigue
frequent urge to urinate
increased hunger
irregular breathing
irregular heartbeat
lower back or side pain
nightmares
seizures
shakiness
slurred speech
swelling of the face, fingers, feet, or lower legs
tightness in chest
troubled breathing
unusual tiredness or weakness
Rare
Blistering, peeling, or loosening of the skin
darkened urine
difficulty with swallowing
indigestion
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loss of appetite
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
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:
Less common
Back pain
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.
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Pros and cons of Kazano (alogliptin / metformin)
Pros
- Combines two medications into one tablet for convenience
- Less likely to cause weight gain than some other diabetes medications
- Possible option for people with mild kidney problems
Cons
- Need to take with meals to prevent stomach upset
- Not approved for people with Type 1 diabetes
- Not safe for use in people with moderate-to-severe kidney disease
Pharmacist tips for Kazano (alogliptin / metformin)
- Take Kazano (alogliptin / metformin) twice a day with food. This medication contains metformin, which commonly causes stomach upset (diarrhea, nausea, vomiting, and belly pain). Food can help lower the risk of having these side effects.
- Swallow Kazano (alogliptin / metformin) tablets whole. Don't split them since it might affect the way the medication works. Ask your prescriber or pharmacist for other options if you're having trouble swallowing pills.
- It's best to avoid alcohol while you're taking Kazano (alogliptin / metformin). It can cause you to have low blood sugar levels (hypoglycemia). Drinking alcohol, especially in large amounts, also raises the medication's risk of causing a lot of lactic acid to build up in your blood (lactic acidosis), which can be dangerous.
- It's important to stay hydrated while you're taking Kazano (alogliptin / metformin), especially if you have side effects like vomiting or diarrhea or if you feel sick. This prevents dehydration, which also helps lower your risk for lactic acidosis from the medication.
- Make sure to get your routine blood tests done on time while you’re taking Kazano (alogliptin / metformin). These blood tests help your prescriber check for side effects, like liver problems or changes to your vitamin B12 levels. Your prescriber can also check your risk for lactic acidosis.
- Let your prescriber know ahead of time if you're scheduled for a surgery or procedure. They'll talk to you about whether you need to stop taking Kazano (alogliptin / metformin) a few days before surgery and when to restart it afterwards. You might not be able to eat or drink during the time around your procedure, which can raise your risk of lactic acidosis if you're still taking the medication.
- Tell your prescriber about any planned imaging procedures. Also let the imaging team know that you're taking Kazano (alogliptin / metformin). Contrast dyes in some imaging procedures can affect kidney function, which can raise the risk for lactic acidosis while you're taking this medication. Follow your care team's instructions on whether you need to pause treatment and only restart the medication once your care team checks that it's safe for you to.
- You might be at risk of having low blood sugar if you're taking Kazano (alogliptin / metformin) with certain other diabetes medications. Make sure to check your blood sugar if you feel shaky, dizzy, confused, or anxious or if your heartbeat is faster than usual. It's important to know how to treat low blood sugar (less than 70 mg/dL) and when you need to call 911.
- Discuss with your care team about having nutritious, balanced meals and exercising regularly. They'll work with you to find a plan that best fits your needs. This helps manage your blood sugar levels along with your diabetes medications.
Common questions about Kazano
Although it's not a common side effect, it's possible for some people to have constipation while they're taking Kazano. Some things you can do to help with constipation include drinking plenty of water throughout the day, adding more fiber to your diet, and exercising. There are also some over-the-counter options like polyethylene glycol (Miralax) that can give you relief. Speak with a healthcare professional if constipation becomes too uncomfortable.
No, Kazano isn't known to cause leg pain. Many other things, including cramps, rigorous exercise, and a pinched nerve, can cause leg pain. Try massaging your leg if you feel pain. But speak with a healthcare professional if you have concerning leg pain, especially if it's also swollen or red or if the pain gets worse.
Kazano can cause stomach upset, which might include stomach pain. This is a side effect of metformin, which is one of the active ingredients in this combination medication. Be sure to take Kazano with food to lower the risk of having this side effect.
It's best to limit, or even better avoid, drinking alcohol while you're taking Kazano. In general, alcohol puts you at risk of having low blood sugar. In addition, drinking too much alcohol while you're taking this medication can raise the risk of having a high level of acid in your blood (lactic acidosis). This condition can be dangerous and life-threatening if it isn't treated. Speak with your prescriber about your alcohol habits and consumption.
There are a few combination medications similar to Kazano that are good alternative options. Examples include Janumet (sitagliptan / metformin), Jentadueto (linagliptan / metformin), and Kombiglyze XR (saxagliptin / metformin). Similar to Kazano, they contain two types of diabetes medications: a DPP-4 inhibitor (or "gliptin") and metformin. Talk with your prescriber about your options for treating diabetes.
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Risks and warnings for Kazano (alogliptin / metformin)
Kazano (alogliptin / metformin) 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.
Lactic acidosis
- Risk factors: Kidney problems | Liver problems | Heart failure | Heart attack | Age 65 or older | Not eating food or fasting before surgery | Heavy alcohol use | Having an imaging procedure done that uses contrast dye | Taking certain medications that affect the kidneys
Kazano contains metformin, a medication that can cause a rare but serious condition called lactic acidosis (too much lactic acid in the blood). If left untreated, this condition can lead to other complications that can be life-threatening. Let your prescriber know about your medical history and your current medications before you start taking Kazano (alogliptin / metformin). They can check your risk for lactic acidosis.
Get medical attention as soon as possible if you notice that you're breathing fast or short of breath. Also get medical help if you have irregular heartbeat, muscle pain, or belly pain or if you feel very tired, sleepy, weak, or dizzy. These can be signs that you have too much lactic acid in your blood.
Pancreas problems
Although rare, some people who took alogliptin developed inflammation in their pancreas (pancreatitis). It's not known whether people who previously had pancreatitis are at higher risk of this problem happening again while they're taking Kazano (alogliptin / metformin).
Contact your prescriber as soon as possible if you start to notice symptoms of pancreatitis, such as upper right-sided stomach pain, nausea, vomiting, fever, or yellowing of the skin or whites of the eyes. You might need to stop taking Kazano (alogliptin / metformin).
Heart failure
- Risk factors: Heart failure | Heart problems | Kidney problems
Speak with your prescriber about whether Kazano (alogliptin / metformin) is right for you if you have or have had heart failure, kidney problems, or are at risk for heart failure. There might be a chance that taking alogliptin (one of the ingredients in Kazano) might raise the risk for heart failure, especially for people who've recently had a heart-related event that required hospitalization (e.g., heart attack). But more research is needed to confirm that medications like alogliptin raise this risk.
Call your care team right away if you have any symptoms of heart failure, like trouble breathing, tiredness, swelling in the body, or sudden weight gain. They might recommend that you go to the hospital and that you stop taking Kazano (alogliptin / metformin).
Serious allergic reactions
- Risk factor: History of allergy to DPP-4 inhibitors (also called "gliptins")
Although rare, it's possible that you can have a serious allergic reaction to Kazano (alogliptin / metformin). These allergic reactions can include rash, peeling or blistering skin, swelling, trouble breathing, or life-threatening anaphylaxis. Stop taking Kazano (alogliptin / metformin) and get medical care right away if you have an allergic reaction to the medication.
Be sure to let your care team know if you've had an allergic reaction like severe swelling to other DPP-4 inhibitors or "gliptins", such as Januvia (sitagliptin) or Tradjenta (linagliptin). Although unclear, it's possible that you might have a similar allergic reaction to Kazano (alogliptin / metformin).
Liver problems
Studies showed that some people who took alogliptin, one of the active ingredients of Kazano, had abnormal liver lab results. These changes in lab results could be a sign of liver damage. Some people in the studies also had possibly life-threatening liver failure. Keep in mind that it's unclear whether alogliptan causes these liver problems.
Talk with your prescriber if you’re concerned about the risk for liver damage with Kazano (alogliptin / metformin). Let your care team know right away if you experience extreme tiredness, loss of appetite, belly discomfort, dark urine, or yellowing of the white of your eyes or skin while you're taking this medication. You'll need to get blood tests done so your prescriber can check your liver. You'll probably need to stop taking this medication if you develop liver problems during treatment.
Low vitamin B12 levels
- Risk factors: Long-term use of Kazano (alogliptin / metformin) | Not getting enough calcium or vitamin B12 through your diet | Lower than average calcium or vitamin B12 absorption
Taking diabetes medications that contain metformin, including Kazano (alogliptin / metformin), for a long period of time can affect your vitamin B12 levels. In particular, it can lower how much vitamin B12 that your body absorbs. This can sometimes lead to vitamin B12 deficiency and put you at risk for anemia.
Your prescriber might check your vitamin B12 levels and blood cell counts through blood work every so often during treatment. If needed, your prescriber can recommend vitamin B12 supplements to prevent your levels from dropping too low. Let your prescriber know if you often have low energy, dizziness, shortness of breath, or tingling or numbness in your hands and feet. These can be signs of vitamin B12 deficiency or related anemia.
Low blood sugar (hypoglycemia) when taken with certain diabetes medications
- Risk factors: Changes in diet and exercise | Taking other medications for diabetes, especially insulin or glipizide | Drinking alcohol | Over age 65 | Liver or kidney problems
You're at risk of having low blood sugar if you take Kazano (alogliptin / metformin) together with other diabetes medications, such as insulin or a sulfonylurea like glipizide. Very low blood sugar can be life-threatening.
Symptoms of low blood sugar include feeling shaky, very hungry, confused, or weak; being nervous or anxious; having a fast heartbeat; or sweating. It's important to know how to recognize and treat low blood sugar. Talk to your care team if you're concerned about having low blood sugar levels while you're taking Kazano (alogliptin / metformin).
Joint pain
People who take diabetes medications similar to alogliptin, one of the ingredients in Kazano, have had severe and disabling joint pain. This joint pain can happen anytime from a day to many years after starting the medication. For most people, the pain goes away after they stop the medication. Speak to your prescriber right away if you feel any discomfort in your joints while you're taking Kazano (alogliptin / metformin).
Severe skin reaction
Some people who took alogliptin, a component of Kazano, have had an itchy, blistering rash called bullous pemphigoid. Typically, the blisters or sores related to this skin reaction go away once you stop taking the medication and get appropriate treatment.
Let your care team know if you notice itchy skin, rash with blisters, or sores while you're taking Kazano (alogliptin / metformin). You might need to stop taking the medication while your care team helps figure out what's going on.
Kazano (alogliptin / metformin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 12.5mg/500mg | 60 tablets | $92.20 | $1.54 |
| 12.5mg/1000mg | 60 tablets | $136.41 | $2.27 |
Typical dosage for Kazano (alogliptin / metformin)
The typical starting dose is 12.5 mg/500 mg (alogliptin / metformin) by mouth twice daily with food. Your prescriber will adjust your dose depending on your blood sugar levels.
The maximum dose is 12.5 mg/1,000 mg (alogliptin / metformin) twice daily.
Interactions between Kazano (alogliptin / metformin) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Acetrizoic Acid
- Diatrizoate
- Ethiodized Oil
- Iobenzamic Acid
- Iobitridol
- Iocarmic Acid
- Iocetamic Acid
- Iodamide
- Iodipamide
- Iodixanol
- Iodohippuric Acid
- Iodopyracet
- Iodoxamic Acid
- Ioglicic Acid
- Ioglycamic Acid
- Iohexol
- Iomeprol
- Iopamidol
- Iopanoic Acid
- Iopentol
- Iophendylate
- Iopromide
- Iopronic Acid
- Ioseric Acid
- Iosimide
- Iotasul
- Iothalamate
- Iotrolan
- Iotroxic Acid
- Ioxaglate
- Ioxitalamic Acid
- Ipodate
- Metrizamide
- Metrizoic Acid
- Tyropanoate Sodium
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.
- Aspirin
- Balofloxacin
- Besifloxacin
- Bupropion
- Capmatinib
- Chloroquine
- Ciprofloxacin
- Dasabuvir
- Dofetilide
- Dolutegravir
- Enoxacin
- Fleroxacin
- Flumequine
- Gatifloxacin
- Gemifloxacin
- Hydroxychloroquine
- Ioversol
- Lanreotide
- Levofloxacin
- Lomefloxacin
- Moxifloxacin
- Nadifloxacin
- Norfloxacin
- Octreotide
- Ofloxacin
- Ombitasvir
- Paritaprevir
- Pasireotide
- Pazufloxacin
- Pefloxacin
- Pioglitazone
- Prulifloxacin
- Ritonavir
- Rufloxacin
- Sitagliptin
- Sparfloxacin
- Tafenoquine
- Thioctic Acid
- Tosufloxacin
- Vandetanib
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
- Bitter Melon
- Carteolol
- Carvedilol
- Celiprolol
- Colesevelam
- Esmolol
- Fenugreek
- Furazolidone
- Glucomannan
- Guar Gum
- Iproniazid
- Isocarboxazid
- Labetalol
- Levobunolol
- Linezolid
- Methylene Blue
- Metipranolol
- Metoprolol
- Moclobemide
- Nadolol
- Nebivolol
- Nialamide
- Oxprenolol
- Patiromer
- Penbutolol
- Phenelzine
- Pindolol
- Practolol
- Procarbazine
- Propranolol
- Psyllium
- Ranolazine
- Rasagiline
- Rifampin
- Safinamide
- Selegiline
- Sotalol
- Timolol
- Tranylcypromine
- Verapamil
How much does Kazano (alogliptin / metformin) cost?
Kazano (alogliptin / metformin) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Kazano (alogliptin / metformin) will not be safe for you to take.
- Severe kidney problems
- Sudden or long-term condition of having high levels of acid in your body, such as diabetic ketoacidosis (DKA)
What are alternatives to Kazano (alogliptin / metformin)?
Kazano (alogliptin / metformin) images
