alogliptin / pioglitazone
Oseni (alogliptin / pioglitazone) is a combination medication used to treat type 2 diabetes. It's meant to be taken along with healthy diet and exercise to lower your blood sugar. This medication is taken by mouth, typically once daily. A rare, but serious side effect of Oseni (alogliptin / pioglitazone) is that it can cause swelling from fluids. This means that it can worsen heart failure in people with a history of this condition. You'll need regular blood tests while receiving this medication to make sure it's safe for your kidneys and to make sure your blood sugar is under control.
What is Oseni (alogliptin / pioglitazone)?
What is Oseni (alogliptin / pioglitazone) used for?
Type 2 diabetes in adults
How Oseni (alogliptin / pioglitazone) works
Oseni (alogliptin / pioglitazone) is a combination of two medications:
Pioglitazone is thiazolidinedione. It works on the fat and muscle cells to help them become more sensitive to insulin. Insulin is a hormone that controls your blood sugar. When your body is able to better use insulin, it can help move more blood sugar into cells to be used for energy. Pioglitazone also works on the liver cells to lower the amount of sugar your liver produces.
Alogliptin is dipeptidyl peptidase-4 (DPP-4) inhibitor. It works by blocking DPP-4, an enzyme (protein) that breaks down certain hormones in your body. These hormones tell your body to make more insulin and to produce less sugar. When these hormones are low, your body ends up with low levels of insulin and high levels of blood sugar. Alogliptin blocks DPP-4, which can help produce more insulin to lower blood sugar levels.
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What are the side effects of Oseni (alogliptin / pioglitazone)?
Common Side Effects
- Sore throat, stuffy nose, and other common cold symptoms (5%)
- Cough, runny nose, and other symptoms of an upper respiratory tract infection (4%)
- Back pain (4%)
Other Side Effects
- Headache
- Muscle pain
- Shakiness, fast heartbeat, and other symptoms of low blood sugar
- Weight gain
Serious Side Effects
- Worsening heart failure: shortness of breath, unusual swelling, tiredness, and sudden weight gain
- Serious liver problems: feeling tired or weak, poor appetite, losing weight without trying, dark urine, eyes and skin turning more yellow, upper right stomach pain
- Inflamed pancreas: upper stomach pain, fever, nausea, and vomiting
- Severe skin or allergic reactions: rash, blisters, sores, trouble breathing, swelling
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Change in vision such as blurry vision, seeing halos around lights, vision loss
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Red or dark brown urine, pain or trouble when passing urine, passing frequent amounts of urine
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Severe joint pain
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Cough
- Diarrhea
- Headache
- Muscle pain
- Runny or stuffy nose
- Sore throat
Pros and cons of Oseni (alogliptin / pioglitazone)
Pros
Combines two medications into one pill for convenience
Available as a lower-cost generic medication
Only taken once a day without regard to food
Possible option for people with mild to moderate kidney problems
Cons
Not a safe option for people with heart failure or liver problems
Can cause weight gain (from fluids and from fat) in some people
Can cause vision problems
Not approved for people with type 1 diabetes
Pharmacist tips for Oseni (alogliptin / pioglitazone)
Tell your provider if you experience any changes in weight, trouble breathing, unusual tiredness, or swelling in the feet, ankles, or legs while taking Oseni (alogliptin / pioglitazone). Though rare, it's possible for this medication can cause or worsen heart failure. Let your provider know if you have a history of heart problems before starting Oseni (alogliptin / pioglitazone).
Talk to a provider if you notice blurry vision or vision changes while taking Oseni (alogliptin / pioglitazone). This is because Oseni (alogliptin / pioglitazone) can worsen an eye condition called macular edema, which is more commonly seen in people with high blood sugar. Make sure to get your regular eye exams so your provider can make sure this medication is safe for you.
Oseni (alogliptin / pioglitazone) can interact with some medications. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before you start Oseni (alogliptin / pioglitazone). Talk with your provider or pharmacist if you have any questions about interactions with this medication.
It's common for your blood sugar levels to go up when your body is under stress. Therefore, let your provider know if you experience a fever, an infection, an accident, or are undergoing surgery. Your provider might need to adjust the dose of Oseni (alogliptin / pioglitazone) to help control your blood sugar.
It's important to eat healthy and exercise regularly to keep your blood sugar under control. Make sure to work with your provider on a diet and exercise plan while taking Oseni (alogliptin / pioglitazone).
Avoid alcohol while taking Oseni (alogliptin / pioglitazone) because taking the two together can cause dangerously low blood sugar.
Frequently asked questions about Oseni (alogliptin / pioglitazone)
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What are the risks and warnings for Oseni (alogliptin / pioglitazone)?
Oseni (alogliptin / pioglitazone) 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 and swelling
Risk factors: Heart failure | Heart problems | Kidney problems | Higher dose of pioglitazone | Using insulin at the same time
Oseni (alogliptin / pioglitazone) can lead to heart failure, or worsen heart failure in people who already have it. This is because pioglitazone in Oseni can cause your body to hold onto more water, which leads to swelling around your heart. In addition, alogliptin in Oseni (alogliptin / pioglitazone) has also been shown to worsen heart failure in people with a history of heart problems. Discuss with your provider before starting Oseni (alogliptin / pioglitazone). Let your provider know right away if you experience symptoms such as trouble breathing, tiredness, swelling in your body, or sudden weight gain. Your provider might ask you to stop this medication if you have symptoms of heart failure.
Pancreas problems
Though rare, people who took alogliptin in clinical trials have reported inflammation of the pancreas (pancreatitis). 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. You might need to stop taking Oseni (alogliptin / pioglitazone).
Serious allergic reactions
Risk factor: History of allergy to gliptins
Oseni (alogliptin / pioglitazone) can sometimes cause serious allergic reactions, such as rash, peeling or blistering skin, swelling, trouble breathing, and dizziness. The risk is higher if you've had a history of allergy to DPP-4 inhibitors, such as sitagliptin (Januvia) or Tradjenta (linagliptin). Before taking Oseni (alogliptin / pioglitazone), make sure to let your provider know about your medical history. If you experience an allergic reaction to Oseni (alogliptin / pioglitazone), stop the medication and get medical care right away.
Liver problems
Risk factors: Type 2 diabetes | Heart failure | Heart problems
It's not clear whether Oseni (alogliptin / pioglitazone) can cause liver problems, but some studies showed that people who took this medication had abnormal lab results for liver health. Keep in mind that people with type 2 diabetes or heart problems might also have different liver problems, including fatty liver. If you’re concerned about the potential for liver damage, talk with your provider so they can decide how you can take Oseni (alogliptin / pioglitazone) safely. You might need to get blood tests done before and while you take Oseni (alogliptin / pioglitazone) so your provider can check your liver health. Let your provider know right away if you experience extreme tiredness, weight loss, belly discomfort, dark urine, or yellowing of the eyes or skin.
Bone fractures
Risk factors: Weaker bones | Females
Some studies showed that people who took pioglitazone in Oseni (alogliptin / pioglitazone) might have a higher risk of bone fractures in their arms and feet. The risk also seems to be higher with females. Before starting Oseni (alogliptin / pioglitazone), your provider will check your bone health to make sure this medication is safe for you.
Vision problems
People who take medications similar to pioglitazone in Oseni (alogliptin / pioglitazone) have reported vision problems. Keep in mind that diabetes can also affect your vision, which is why it's important for you to get regular eye exams while taking this medication. If you experience cloudy, blurry, or dim vision while taking Oseni (alogliptin / pioglitazone), please talk with your provider right away.
Joint pain
People who take diabetic medications similar to alogliptin in Oseni (alogliptin / pioglitazone) have experienced severe joint pain. This can happen anytime from a day to many years after starting this medication. For most people, the pain goes away after they stop the medication. If you experience any discomfort in your joints, speak to your provider right away.
Severe skin reactions
Alogliptin in Oseni (alogliptin / pioglitazone) can sometimes cause blisters and other severe skin reactions. Typically the blisters or sores go away once you stop taking the medication. If you have itching skin, rash with blisters, or sores, talk to a provider right away and stop taking Oseni (alogliptin / pioglitazone).
Oseni (alogliptin / pioglitazone) dosage forms
Typical dosing for Oseni (alogliptin / pioglitazone)
The typical starting dose for Oseni is 25 mg/15 mg (alogliptin / pioglitazone) by mouth once daily. The maximum dose is 25 mg/45 mg (alogliptin / pioglitazone) once daily.
Your dose might differ if you've kidney problems.
How much does Oseni (alogliptin / pioglitazone) cost?
Oseni (alogliptin / pioglitazone) contraindications
History of serious allergy to alogliptin or pioglitazone
History of moderate to severe heart failure (class 3 or 4)
What are alternatives to Oseni (alogliptin / pioglitazone)?
Type 2 diabetes in adults
Type 2 diabetes in adults
Oseni (alogliptin / pioglitazone) images
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References
Best studies we foundAmerican Diabetes Association. (n.d.). Insulin basics.
Centers for Disease Control and Prevention. (2018). Diabetes during pregnancy.
Centers for Disease Control and Prevention. (2022). Get active!
Centers for Disease Control and Prevention. (2022). How to treat low blood sugar (hypoglycemia).
Centers for Disease Control and Prevention. (2022). Manage blood sugar.
Eggleton, J. S., et al. (2023). Thiazolidinediones. StatPearls.
Ludmann, P. (2021). Bullous pemphigoid: Signs and symptoms. American Academy of Dermatology Association.
MedlinePlus. (2017). Fatty liver disease.
National Eye Institute. (2023). Macular edema.
Porter, D. (2023). What is macular edema? American Academy of Ophthalmology.
Takeda Pharmaceuticals America, Inc. (2023). OSENI- alogliptin and pioglitazone tablet, film coated [package insert]. DailyMed.
U.S. Food and Drug Administration. (2022). FDA announced that a safety review has found type 2 diabetes medicines containing saxagliptin and alogliptin may increase the risk of heart failure.
U.S. Food and Drug Administration. (2016). Information on dipeptidyl peptidase-4 (DPP-4) inhibitors.
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