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Alogliptin / pioglitazone Side Effects

In Summary

Commonly reported side effects of alogliptin/pioglitazone include: upper respiratory tract infection. Other side effects include: bone fracture, headache, nasopharyngitis, and pharyngitis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to alogliptin / pioglitazone: oral tablet

In addition to its needed effects, some unwanted effects may be caused by alogliptin / pioglitazone. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking alogliptin / pioglitazone:

More common:
  • Anxiety
  • blurred vision
  • chest pain
  • chills
  • cold sweats
  • confusion
  • cool, pale skin
  • decreased urine output
  • depression
  • dilated neck veins
  • dizziness
  • extreme fatigue
  • fast heartbeat
  • headache
  • increased hunger
  • irregular breathing
  • irregular heartbeat
  • nausea
  • nightmares
  • seizures
  • shakiness
  • slurred speech
  • swelling of the face, fingers, feet, or lower legs
  • tightness in the chest
  • troubled breathing
  • unusual tiredness or weakness
  • weight gain
  • Blistering, peeling, or loosening of the skin
  • bloating
  • blood in the urine
  • constipation
  • cough
  • darkened urine
  • diarrhea
  • difficulty with swallowing
  • feeling of discomfort
  • fever
  • frequent, strong, or increased urge to urinate
  • hives, itching, or rash
  • indigestion
  • inflammation of the joints
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • muscle aches
  • pain in the back, lower abdomen, or stomach
  • painful urination
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • swollen lymph glands
  • vomiting
  • yellow eyes or skin
Incidence not known:
  • Change in vision
  • general feeling of tiredness or weakness
  • light-colored stools
  • severe joint pain
  • stomach pain, continuing

Minor Side Effects

Some of the side effects that can occur with alogliptin / pioglitazone may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common:
  • Back pain
  • body aches or pain
  • ear congestion
  • loss of voice
  • sneezing
  • stuffy or runny nose

For Healthcare Professionals

Applies to alogliptin / pioglitazone: oral tablet


The most common side effect reported include nasopharyngitis, back pain and upper respiratory tract infection.[Ref]


Common (1% to 10%): Hypertension (2.3%)

Common (1% to 10%): Congestive heart failure (CHF) (8.2%), at least one hospitalized CHF event (5.7%), hospitalization for worsening CHF (4.7%), non-fatal, hospitalized CHF (4.7%), death due to cardiovascular causes (2.3%), emergency room visit for CHF (1.2%), fatal CHF (1%)
Postmarketing reports: Congestive heart failure (with and without known heart disease and with and without concomitant insulin)[Ref]


Common (1% to 10%): Hypoglycemia (up to 4.5%)

Common (1% to 10%): Hypoglycemia (up to 5.4%)

Common (1% to 10%): Hypoglycemia (up to 4.7%)[Ref]


Uncommon (0.1% to 1%): Pancreatitis (0.2%)
Postmarketing reports: Acute pancreatitis[Ref]


Uncommon (0.1% to 1%): Elevated ALT (0.3%)
Frequency not reported: Decreased hemoglobin and hematocrit[Ref]


Postmarketing reports: Hepatic enzyme elevations, fulminant hepatic failure

Uncommon (0.1% to 1%): Elevated serum alanine aminotransferase (ALT) (0.3%)
Postmarketing reports: Fatal and non-fatal hepatic fail[Ref]


Uncommon (0.1% to 1%): Hypersensitivity reactions (0.6%)
Postmarketing reports: Anaphylaxis, angioedema, rash, urticaria, severe cutaneous adverse reactions (Stevens-Johnson syndrome)[Ref]


Frequency not reported: Weight gain, edema
Postmarketing reports: Rapid increased in weight[Ref]


Common (1% to 10%): Back pain (4.2%)

Common (1% to 10%): Back pain (2%)
Frequency not reported: Arthralgia

Common (1% to 10%): Myalgia (5.4%), back pain (3.4%)
Uncommon (0.1% to 1%): Elevation in serum creatine phosphokinase (CPK) (0.2%)[Ref]

Alogliptin: Between October 2006 and December 2013, thirty-three cases of severe arthralgia have been reported to the FDA Adverse Event Reporting System Database. Each case involved the use of 1 or more dipeptidyl peptidase-4 (DPP-4) inhibitor. In all cases, substantial reduction in prior activity level was reported, 10 patients were hospitalized due to disabling joint pain. In 22 cases, symptoms appeared within 1 month of starting therapy, in 23 cases symptoms resolved less than 1 month after discontinuation. A positive rechallenge was reported in 8 cases, with 6 cases involving use of a different DPP-4 inhibitor. Sitagliptin had the greatest number of cases reported (n=28) followed by saxagliptin (n=5), linagliptin (n=2), alogliptin (n=1), and vildagliptin (n=2).[Ref]

Nervous system

Common (1% to 10%): Headache (4.2%)

Common (1% to 10%): Headache (9.1%)[Ref]


Postmarketing reports: Macular edema[Ref]


Uncommon (0.1% to 1%): Bladder cancer (up to 0.44%)[Ref]


Very common (10% or more): Nasopharyngitis (4.9%), upper respiratory tract infection (4.1%)

Common (1% to 10%): Influenza (5.5%), nasopharyngitis (4.7%), upper respiratory tract infection (4.3%)

Common (1% to 10%): Upper respiratory tract infection (up to 13.2%), sinusitis (6.3%), nasopharyngitis (3.9%)[Ref]


1. "Product Information. Oseni (alogliptin-pioglitazone)." Takeda Pharmaceuticals America, Lincolnshire, IL.

2. US Food and Drug Administration "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain. Available from: URL:" ([2015, Aug 28]):

Not all side effects for alogliptin / pioglitazone may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.