Adult Dosing
Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
- 1 tab PO BID
- Max: 25 mg/2000 mg
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
- Acute pancreatitis has been reported with use of alogliptin. Discontinue therapy if pancreatitis is suspected
- Hypersensitivity reactions such as anaphylaxis, angioedema and severe cutaneous adverse reactions have occured in patients treated with alogliptin. If hypersensitivity occurs promptly discontinue therapy, assess for other potential causes, institute appropriate monitoring and treatment, and initiate alternative treatment for diabetes
- Fatal and nonfatal hepatic failure has been reported. If liver injury is detected, promptly interrupt therapy and assess patient for probable cause, then treat cause if possible, to resolution or stabilization
- Insulin and insulin secretagogues (eg, sulfonylureas) are known to cause hypoglycemia; therefore, a lower dose of insulin of insulin secretagogue may be needed to minimize hypoglycemia risk
- Patients with type 2 diabetes may have fatty liver disease which may cause liver test abnormalities. Use cautiously in patients with abnormal liver tests
- Lactic acidosis is a serious complication that can occur due to metformin accumulation. Risk increases with conditions such as sepsis, dehydration, excess alcohol intake, hepatic impairment, renal impairment, and acute congestive heart failure [US Black box warning]
- Lactic acidosis is characterised by symptoms such as malaise, myalgias, respiratory distress, increasing somnolence, and nonspecific abdominal distress, laboratory abnormalities such as low pH, increased anion gap and elevated blood lactate [US Black box warning]
- If acidosis is suspected, discontinue therapy and hospitalize the patient immediately [US Black box warning]
- Therapy is not recommended in hepatic impairment and is contraindicated in renal impairment. Ensure normal renal function before initiating therapy and at least annually thereafter
- Serious hypersensitivity reactions such as anaphylaxis, angioedema and severe cutaneous adverse reactions have been reported in patients treated with alogliptin, if symptoms occur promptly discontinue therapy, assess for other potential causes, institute appropriate monitoring and treatment, and initiate alternative treatment for diabetes
- Concomitant medications that may affect renal function or result in significant hemodynamic change or may interfere with the disposition of metformin, such as cationic drugs that are eliminated by renal tubular secretion, should be used with caution
- Radiologic studies involving iodinated contrast may alter renal function and have been associated with lactic acidosis in patients receiving metformin; temporarily discontinue metformin containing products for 48 hr before and after the procedure
- Metformin may lower Vitamin B12 levels. Monitor hematologic parameters annually
- Therapy should be temporarily suspended for any surgical procedure and should not be restarted until the patient’s oral intake has resumed and renal function has been evaluated as normal
- Hypoxic conditions such as shock, acute CHF, acute MI have been associated with lactic acidosis and may also cause prerenal azotemia
- Alcohol is known to potentiate the effect of metformin on lactate metabolism. Patients should be warned against excessive alcohol intake
Cautions: use cautiously in
Pregnancy Category:B
Breastfeeding: No studies have been conducted. As per manufacturer's data, because of potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother, caution advised
US Trade Name(s)
US Availability
Kazano (alogliptin/metformin)
- TABS: 12.5/500 mg
- TABS: 12.5/1000 mg
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability