Alogliptin / Metformin Dosage
Applies to the following strength(s): 12.5 mg-500 mg ; 12.5 mg-1000 mg
The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Diabetes Type 2
Individualize the initial dose based on patients current regimen
Initial dose: alogliptin 12.5 mg-metformin 500 mg OR alogliptin 12.5 mg-metformin 1000 mg orally twice a day
Maintenance dose: Adjust dose based on efficacy and tolerability
Maximum dose: alogliptin 25 mg-metformin 2000 mg per day
-When used in combination with insulin or insulin secretagogues such as sulfonylureas, a lower dose of insulin or the insulin secretagogue may be required to minimize the risk of hypoglycemia.
-Metformin dose should be gradually titrated and taken with food to reduce the gastrointestinal side effects.
Use: As an adjunct to diet and exercise, to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both alogliptin and metformin is appropriate.
Renal Dose Adjustments
-Mild renal dysfunction: No adjustment recommended
-Moderate to severe renal impairment: Use is contraindicated in males with serum creatinine levels of 1.5 mg/dL or greater; in females with serum creatinine levels of 1.4 mg/dL or greater; or abnormal creatinine clearance
-Use is contraindicated in conditions that may result in renal impairment such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia; regular renal function monitoring is recommended to reduce the risk of developing lactic acidosis
-Treatment should not be initiated in patients 80 years or older unless measurement of CrCl demonstrates that renal function is not reduced.
Liver Dose Adjustments
Hepatic impairment: Use not recommended
-If liver injury is detected, promptly interrupt therapy and assess for probable cause.
-If liver injury is confirmed and no alternative etiology is found, do not restart this drug.
Elderly: No dose adjustment is necessary based on age; however, ensure adequate renal function before initiating therapy.
Due to risk of hypoglycemia if used in combination with insulin, or insulin secretagogue such as a sulfonylurea, a lower dose of insulin, or insulin secretagogue should be considered to decrease the risk of hypoglycemia.
Alogliptin-metformin should be temporarily discontinued at the time of or prior to radiologic studies utilizing intravascular administration of iodinated contrast materials, withheld for 48 hours post procedure, and restarted once renal function has been confirmed as normal.
BOXED WARNING(S): Lactic acidosis is a rare, but serious, complication that can occur due to metformin accumulation.
-The risk increases with conditions such as sepsis, dehydration, excess alcohol intake, hepatic impairment, renal impairment, and acute congestive heart failure.
-The onset of lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgia, respiratory distress, increasing somnolence, and nonspecific abdominal distress.
-Laboratory abnormalities include low pH, increased anion gap, and elevated blood lactate.
-If acidosis is suspected, discontinue alogliptin-metformin and hospitalize the patient immediately.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Data not available
-Take orally twice a day with meals
-Swallow whole, do not split before swallowing
-If a dose is missed, do not double the next dose
-Temporarily stop treatment prior to radiologic studies utilizing iodinated contrast materials and for surgical procedures when restricted food or fluid intake is expected; may resume once adequate renal function is confirmed.
-This drug is not recommended for patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis as it would not be effective in these settings.
-Monitor glycemic control
-Renal: Assess renal function baseline and annually; more frequent monitoring is recommended in patients with serum creatinine levels at the upper limit of normal, elderly patients, and for patients at risk for developing renal impairment
-Hematologic: Measure hematologic parameters annually
-Hepatic: Obtain liver function tests prior to initiating treatment; monitor for signs and symptoms of liver dysfunction
-Monitor for signs and symptoms of pancreatitis
-Instruct patient to report signs and symptoms of pancreatitis; if persistent, severe abdominal pain occurs, seek medical advice promptly.
-Instruct patients to discontinue therapy and seek medical advice for symptoms of allergic reaction including skin rash, hives, and swelling of the face, lips, tongue, and throat.
-Instruct patients to report signs and symptoms of hepatic dysfunction
-Hypoglycemia may occur, more commonly when used in combination with insulin or a sulfonylurea.
-Patients should understand the importance of adhering to dietary instructions and regular physical activity; during periods of stress such as fever, trauma, infection, or surgery, management of diabetes may change and patients should be advised to seek medical advice.
-Inform patients about the risk of lactic acidosis, conditions that might predispose them to its occurrence, and symptoms to watch for and report.
-Advise patient that this drug will need to be temporarily stopped if undergoing radiologic studies with intravascular iodinated contrast materials or surgical procedures that will limit food or fluid intake.
-Advise patients on the risks of excessive alcohol intake.
-Instruct patients to contact their health care provider if they develop severe and persistent joint pain.
More about alogliptin/metformin
- Other brands: Kazano