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

What is Kazano?

Kazano contains a combination of alogliptin and metformin. Alogliptin and metformin are oral diabetes medicines that help control blood sugar levels.

Metformin works by decreasing glucose (sugar) production in the liver and decreasing absorption of glucose by the intestines. Alogliptin works by regulating the levels of insulin your body produces after eating.

Kazano is used to treat type 2 diabetes.

Kazano is not for treating type 1 diabetes.

Important information

You should not use Kazano if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Stop taking Kazano and get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, trouble breathing, stomach pain, nausea, and feeling very weak or tired.

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Alogliptin can cause pancreatitis. Stop using Kazano and call your doctor at once if you have severe pain in your upper stomach spreading to your back, nausea and vomiting, and loss of appetite.

Before taking this medicine

You should not use Kazano if you are allergic to alogliptin or metformin, or if you have:

  • kidney disease; or

  • if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Some people taking Kazano develop a serious condition called lactic acidosis. This may be more likely if you have liver or kidney disease, congestive heart failure, a severe infection, if you are dehydrated, or if you drink large amounts of alcohol. Talk with your doctor about your risk.

To make sure Kazano is safe for you, tell your doctor if you have:

  • heart disease;

  • liver disease;

  • a history of pancreatitis;

  • gallstones;

  • a history of alcoholism; or

  • if you are over 80 years old and have not recently had your kidney function checked.

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking Kazano. Be sure your caregivers know ahead of time that you are using this medicine.

Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs.

Kazano is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether alogliptin and metformin passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Kazano is not approved for use by anyone younger than 18 years old.

How should I take Kazano?

Take Kazano exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take Kazano with meals.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, pale skin, irritability, dizziness, feeling shaky, or trouble concentrating.

Keep a source of sugar with you in case you have low blood sugar. Sugar sources include fruit juice, hard candy, crackers, raisins, and non-diet soda. Be sure your family and close friends know how to help you in an emergency. If you have severe hypoglycemia and cannot eat or drink, use a glucagon injection. Your doctor can prescribe a glucagon emergency injection kit and tell you how to use it.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.

Check your blood sugar carefully during times of stress, travel, illness, surgery or medical emergency, vigorous exercise, or if you drink alcohol or skip meals. These things can affect your glucose levels and your dose needs may also change. Do not change your dose of Kazano or dosing schedule without your doctor's advice.

Kazano is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Your doctor may have you take extra vitamin B12 while you are taking Kazano. Take only the amount of vitamin B12 that your doctor has prescribed.

Store at room temperature away from moisture and heat.

Kazano dosing information

Usual Adult Dose of Kazano 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 Kazano is appropriate.

What happens if I miss a dose?

Take the missed dose as soon as you remember (be sure to take the medicine with food). Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. You may have signs of low blood sugar, such as extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

What should I avoid while taking Kazano?

Avoid drinking alcohol. It lowers blood sugar and may increase your risk of lactic acidosis.

Kazano side effects

Get emergency medical help if you have signs of an allergic reaction to Kazano: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking this medicine and call your doctor right away if you have symptoms of pancreatitis: severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, or fast heartbeats.

Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Stop taking Kazano and get emergency medical help if you have even mild symptoms such as:

  • muscle pain or weakness;

  • numb or cold feeling in your arms and legs;

  • trouble breathing;

  • feeling dizzy, light-headed, tired, or very weak;

  • stomach pain, nausea with vomiting; or

  • slow or uneven heart rate.

Call your doctor at once if you have:

  • severe or ongoing pain in your joints;

  • pain or burning when you urinate;

  • liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Kazano side effects may include:

  • diarrhea;

  • increased blood pressure (severe headache, blurred vision, pounding in your neck or ears);

  • back pain, headache; or

  • cold symptoms such as stuffy nose, sinus pain, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Kazano?

Other drugs may increase or decrease the effects of Kazano on lowering your blood sugar. Tell your doctor about all medications you use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about Kazano.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Kazano only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2015 Cerner Multum, Inc. Version: 2.01. Revision Date: 2015-09-09, 11:20:09 AM.