Kazano

Generic Name: alogliptin/metformin (AL-oh-GLIP-tin/met-FOR-min)
Brand Name: Kazano

Kazano may rarely cause a serious and sometimes fatal condition called lactic acidosis. Most of these cases have occurred in diabetic patients who also have certain kidney problems. The risk of lactic acidosis may be greater if you have liver problems, kidney problems, or heart failure. The risk may also be greater in patients who are elderly or drink alcohol. Lab tests, including kidney function, may be performed while you take Kazano.

Do not begin to take Kazano if you are 80 years old or older, unless lab tests show that you do not have decreased kidney function. Do not take it if you have a severe infection, have low blood oxygen levels, or are dehydrated. Tell your doctor you take Kazano before you have any surgery or lab procedures.

Contact your doctor right away if you notice symptoms such as muscle pain or tenderness; unusual drowsiness, dizziness, or light-headedness; slow or irregular heartbeat; fast or difficult breathing; sudden stomach or bowel problems with nausea and vomiting; or unusual weakness or tiredness. Contact your doctor right away if you start to feel unusually cold, especially in your arms or legs, or if you have a general feeling of being unwell.


Kazano is used for:

Treating type 2 diabetes in certain patients. It is used along with diet and exercise.

Kazano is a dipeptidyl peptidase-4 (DPP-4) inhibitor and biguanide combination. It works by increasing the amount of insulin released by your body and decreasing the amount of sugar made by your body. It also helps make your body more sensitive to the insulin that you naturally produce.

Do NOT use Kazano if:

  • you are allergic to any ingredient in Kazano
  • you have type 1 diabetes
  • you have a severe infection, low blood oxygen levels, kidney problems, or high blood or urine ketone or acid levels (eg, diabetic ketoacidosis), or you are severely dehydrated
  • you have had a stroke or a recent heart attack, or you are in shock
  • you are 80 years old or older, unless lab tests show that you do not have decreased kidney function
  • you will be having certain surgery or lab procedures

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Flashback: FDA Drug Approvals 2013

Before using Kazano:

Some medical conditions may interact with Kazano. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness) caused by another DPP-4 inhibitor (eg, sitagliptin)
  • if you have heart failure, especially heart failure that is treated by medicine
  • if you have a history of heart problems, liver problems, lung or breathing problems, thyroid problems, stomach or bowel problems (eg, blockage, paralysis), adrenal or pituitary problems, or lactic acidosis
  • if you have a history of inflammation of the pancreas (pancreatitis) or stones in your gallbladder (gallstones)
  • if you have vomiting, diarrhea, poor health or nutrition, low blood calcium or vitamin B12 levels, or anemia
  • if you have an infection, fever, recent injury, or moderate to severe burns
  • if you drink alcohol or have a history of alcohol abuse
  • if you will be having surgery or lab procedures
  • if you take a beta-blocker (eg, propranolol) or you are using insulin

Some MEDICINES MAY INTERACT with Kazano. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Carbonic anhydrase inhibitors (eg, zonisamide, acetazolamide, dichlorphenamide) or topiramate because the risk of lactic acidosis may be increased
  • Calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), insulin, isoniazid, meglitinides (eg, repaglinide), nicotinic acid, phenothiazine (eg, chlorpromazine), phenytoin, sulfonylureas (eg, glipizide), sympathomimetics (eg, albuterol, pseudoephedrine), or thyroid hormones (eg, levothyroxine) because the risk of high or low blood sugar may be increased
  • Amiloride, cimetidine, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin because they may increase the risk of Kazano's side effects
  • Medicines that may harm the kidney (eg, aminoglycoside antibiotics [eg, gentamicin], amphotericin B, cyclosporine, nonsteroidal anti-inflammatory drugs [NSAIDs] [eg, ibuprofen], tacrolimus) because they may increase the risk of Kazano's side effects. Ask your doctor if you are unsure if any of your medicines might harm the kidney

This may not be a complete list of all interactions that may occur. Ask your health care provider if Kazano may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Kazano:

Use Kazano as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Kazano comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Kazano refilled.
  • Take Kazano by mouth with food to lower the chance of upset stomach.
  • Swallow Kazano whole. Do not break or cut before swallowing.
  • Take Kazano on a regular schedule to get the most benefit from it. Taking Kazano at the same times each day will help you remember to take it.
  • Continue to take Kazano even if you feel well. Do not miss any doses.
  • If you miss a dose of Kazano, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Kazano.

Important safety information:

  • Follow the diet and exercise program given to you by your health care provider. Proper diet, regular exercise, and regular blood sugar testing are important for best results with Kazano.
  • Do not drink large amounts of alcohol while you use Kazano. Talk to your doctor or health care provider before you drink alcohol while you use Kazano.
  • Do NOT take more than the recommended dose without checking with your doctor.
  • Tell your doctor or dentist that you take Kazano before you receive any medical or dental care, emergency care, or surgery.
  • If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
  • Carry an ID card at all times that says you have diabetes. Check your blood sugar levels as directed by your doctor. If they are often higher or lower than they should be and you take Kazano exactly as prescribed, tell your doctor.
  • It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.
  • Kazano usually does not cause low blood sugar. However, low blood sugar may occur when it is used along with certain other medicines for diabetes (eg, insulin, sulfonylureas). Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or nondiet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
  • Metformin may commonly cause stomach upset, indigestion, nausea, vomiting, or diarrhea at the beginning of treatment. If you develop unusual or unexpected stomach problems, or if you develop stomach problems later during treatment, contact your doctor at right away. This may be a sign of lactic acidosis.
  • Severe and sometimes fatal liver problems have been reported in patients taking Kazano. Call your doctor right away if you have symptoms of liver problems (eg, dark urine; stomach pain; unexplained nausea, vomiting, or loss of appetite; yellowing of the skin or eyes). Discuss any questions or concerns with your doctor.
  • Severe and sometimes fatal inflammation of the pancreas (pancreatitis) has been reported in patients taking Kazano. Discuss any questions or concerns with your doctor. Contact your doctor immediately if you develop severe or persistent stomach or back pain with or without nausea or vomiting.
  • Lab tests, including kidney and liver function, fasting blood glucose, hemoglobin A1c, and complete blood cell counts, may be performed while you use Kazano. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Kazano with caution in the ELDERLY; they may be more sensitive to its effects. Low blood sugar levels may also be more difficult to recognize in elderly patients.
  • Kazano should be used with extreme caution in CHILDREN; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY AND BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Kazano while you are pregnant. It is not known if Kazano is found in breast milk. If you are or will be breast-feeding while you take Kazano, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Kazano:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; cold-like symptoms; diarrhea; gas; headache; indigestion; nausea; runny or stuffy nose; sore throat; stomach upset; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); chest pain or discomfort; difficult or painful urination; dizziness or light-headedness; fast or difficult breathing; feeling of being unusually cold; general feeling of being unwell; muscle pain, tenderness, or weakness; red, swollen, blistered, or peeling skin; severe or persistent headache; slow or irregular heartbeat; symptoms of pancreas inflammation (eg, severe stomach or back pain with or without nausea or vomiting); unusual drowsiness; unusual or persistent stomach pain or discomfort; unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Kazano:

Store Kazano at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Kazano out of the reach of children and away from pets.

General information:

  • If you have any questions about Kazano, please talk with your doctor, pharmacist, or other health care provider.
  • Kazano is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Kazano or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Kazano. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Kazano. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Kazano.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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