alogliptin benzoate: clinical use

Prescribing considerations

• Confirm use is for adult type 2 diabetes as additional therapy rather than type 1 diabetes, diabetic ketoacidosis or replacement of necessary insulin.
• Assess renal function before initiation and during treatment because systemic exposure increases as renal function declines.
• Use caution in people with previous pancreatitis or advanced symptomatic heart failure.
• Severe hepatic impairment has not been studied and use is not recommended.
• Review concurrent glucose-lowering treatment and hypoglycaemia risk.

Contraindications and cautions

• Hypersensitivity to alogliptin, an excipient, or a history of serious hypersensitivity—including anaphylaxis, anaphylactic shock or angioedema—to any DPP-4 inhibitor.

Monitoring

• Renal function before treatment and periodically thereafter.
• Glycaemic response and symptoms or readings suggesting hypoglycaemia.
• Prompt liver-function testing if symptoms suggest hepatic injury.
• Symptoms of pancreatitis, hypersensitivity, severe skin reactions or bullous pemphigoid.

Clinical pharmacology

Alogliptin is a highly selective DPP-4 inhibitor. It enhances glucose-dependent incretin activity, increasing insulin secretion and suppressing glucagon when glucose is raised. Metabolism is limited, and most elimination is renal as unchanged alogliptin, giving it a low propensity for CYP-mediated interactions.

Formulation and product differences

• The selected product is a single-ingredient film-coated tablet containing alogliptin as alogliptin benzoate, with the content expressed as equivalent alogliptin.
• Products combining alogliptin with metformin have separate prescribing information and should not be treated as interchangeable with the single-ingredient tablet.

Tablet

Route: Oral

Strengths: 6.25 mg, 12.5 mg, 25 mg