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pioglitazone and alogliptin

A10BD09

Forms & Strengths

Tablet: 15 mg alogliptin / 15 mg pioglitazone
Tablet: 25 mg alogliptin / 15 mg pioglitazone
Tablet: 25 mg alogliptin / 30 mg pioglitazone
Tablet: 25 mg alogliptin / 45 mg pioglitazone

Adult Dosing

One tablet orally once daily
Select dose based on current regimen, effectiveness, and tolerability
Maximum daily dose: 25 mg alogliptin / 45 mg pioglitazone

Pediatric Dosing

Safety and effectiveness in pediatric patients below the age of 18 years have not been established

Indications

Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Used when treatment with both alogliptin and pioglitazone is appropriate

Mechanism of Action

Alogliptin: Dipeptidyl peptidase-4 (DPP-4) inhibitor that slows inactivation of incretin hormones
Pioglitazone: Thiazolidinedione (TZD) and selective agonist for peroxisome proliferator-activated receptor-gamma (PPAR-gamma)
Combined action improves glycemic control by decreasing insulin resistance and increasing insulin secretion in a glucose-dependent manner

Contraindications

Initiation in patients with established New York Heart Association (NYHA) Class III or IV heart failure
History of serious hypersensitivity reaction to alogliptin or pioglitazone
Type 1 diabetes mellitus or diabetic ketoacidosis

Adverse Reactions

Upper respiratory tract infection
Nasopharyngitis
Headache
Edema and fluid retention
Weight gain
Hepatic failure
Acute pancreatitis
Hypoglycemia (when used with insulin or insulin secretagogues)

Drug Interactions

Strong CYP2C8 inhibitors (e.g., gemfibrozil) may significantly increase pioglitazone exposure
Strong CYP2C8 inducers (e.g., rifampin) may decrease pioglitazone efficacy
Insulin secretagogues or insulin may increase risk of hypoglycemia
DPP-4 inhibitors may interact with ACE inhibitors, potentially increasing risk of angioedema

Curated Content: Needs Vetting Before Put to Clinical Use