Alogliptin: medicine to treat type 2 diabetes

1. About alogliptin

Alogliptin is a medicine used to treat type 2 diabetes.

Type 2 diabetes is an illness where the body does not make enough insulin, or the insulin that it makes does not work properly.

This can cause high blood sugar levels (hyperglycaemia).

Alogliptin is prescribed for people who still have high blood sugar, even though they have a sensible diet and exercise regularly.

Alogliptin is only available on prescription.

It comes as tablets that you swallow. It also comes as tablets containing a mixture of alogliptin and metformin. Metformin is another drug used to treat diabetes.

2. Key facts

Alogliptin works by increasing the amount of insulin that your body makes. Insulin is the hormone that controls sugar levels in your blood.
You take alogliptin once a day.
The most common side effects of alogliptin are headaches, indigestion, diarrhoea and skin rashes.
This medicine does not usually make you put on weight.
Alogliptin is also called by the brand name Vipidia. When it's combined with metformin the brand name is Vipdomet.

3. Who can and can't take alogliptin

Alogliptin can be taken by adults (aged 18 years and older).

Alogliptin is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

have had an allergic reaction to alogliptin or any other medicines in the past
have kidney disease or liver disease
have heart failure
have (or have previously had) problems with your pancreas
are pregnant or breastfeeding, or trying to get pregnant

This medicine is not used to treat type 1 diabetes (when your body does not produce insulin).

4. How and when to take it

Take alogliptin once a day.

You can take it at any time - for example, in the morning or in the evening. Just try to take it at the same time every day.

Take your tablet with a glass of water. Swallow the tablet whole, without breaking it.

You can take algoliptin with or without food.

How much will I take?

Alogliptin comes as 25mg, 12.5mg or 6.25mg tablets.

The usual dose is 25mg a day.

If you have problems with your kidneys, your doctor might give you a lower dose of 12.5mg or 6.25mg a day.

What if I take too much?

Urgent advice: Talk to your doctor if you take too much alogliptin and:

have stomach pains
are feeling or being sick (nausea or vomiting)
feel dizzy
are worried

What if I forget to take it?

Take the missed dose as soon as you remember, unless it's nearly time for your next dose, in which case skip the missed dose.

Never take 2 doses on the same day.

If you forget doses often, it may help to set an alarm to remind you.

You could ask your pharmacist for advice on other ways to remember your medicines.

5. Side effects

Like all medicines, alogliptin can cause side effects in some people.

But many people have no side effects or only minor ones.

Common side effects

These common side effects happen in more than 1 in 100 people.

Talk to your doctor or pharmacist if these side effects bother you or do not go away:

cold-like symptoms
headaches
stomach ache or indigestion
diarrhoea
rash or itchy skin

Serious side effects

It happens rarely, but some people may have serious side effects after taking alogliptin.

Call your doctor straight away if you have:

severe stomach pains
yellowing of your skin or the whites of your eyes turn yellow

Low blood sugar

Alogliptin does not usually cause low blood sugar (known as hypoglycaemia or "hypos") when taken on its own.

But hypos can happen when you take alogliptin with other diabetes medicines, such as insulin or gliclazide.

Early warning signs of low blood sugar include:

feeling hungry
trembling or shaking
sweating
confusion
difficulty concentrating

It's also possible for your blood sugar to go too low while you're asleep.

If this happens, it can make you feel sweaty, tired and confused when you wake up.

Low blood sugar may happen if you:

take too much of some types of diabetes medicines
eat meals irregularly or skip meals
are fasting
do not eat a healthy diet and are not getting enough nutrients
change what you eat
increase your physical activity without eating more to compensate
drink alcohol, especially after skipping a meal
take some other medicines or herbal medicines at the same time
have a hormone disorder, such as hypothyroidism
have kidney or liver problems

To prevent hypos, it's important to have regular meals, including breakfast. Never miss or delay a meal.

If you're planning to exercise more than usual, make sure you eat carbohydrates like bread, pasta or cereals before, during or afterwards.

Always carry a fast-acting carbohydrate with you, like sugar cubes, fruit juice or some sweets, in case your blood sugar level gets low. Artificial sweeteners will not help.

You may also need to eat a starchy carbohydrate, like a sandwich or a biscuit, to maintain your blood sugar for longer.

If taking in sugar does not help or the hypo symptoms come back, contact your doctor or the nearest hospital.

Make sure your friends and family know about your diabetes and the symptoms of low blood sugar levels so they can recognise a hypo if it happens.

Serious allergic reaction

It's possible to have a serious allergic reaction (anaphylaxis) to alogliptin.

Immediate action required: Call 999 or go to A&E if:

you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
you're wheezing
you get tightness in the chest or throat
you have trouble breathing or talking
your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of alogliptin.

For a full list, see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme.

6. How to cope with side effects

What to do about:

cold-like symptoms - try taking paracetamol or ibuprofen regularly for a few days. If the symptoms return when you stop taking the painkillers, ask your doctor for advice.
headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if they last longer than a week or are severe.
stomach ache or indigestion - try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your tummy may also help. If you're in a lot of pain, speak to your pharmacist or doctor.
diarrhoea - drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
rash or itchy skin - it may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you. If your rash gets worse or lasts for more than a week, make an appointment to see your doctor.

7. Pregnancy and breastfeeding

Alogliptin is generally not recommended in pregnancy or while breastfeeding.

Talk to your doctor, as there may be other medicines that you can take instead of alogliptin.

Non-urgent advice: Tell your doctor if you're:

pregnant
trying to get pregnant
breastfeeding

8. Cautions with other medicines

Some medicines and alogliptin can interfere with each other. Some can increase your risk of getting side effects.

Tell your doctor if you're taking any other medicines before you start alogliptin.

These include:

insulin
other anti-diabetic medicines

If you're taking insulin or any other treatment for diabetes, your doctor may want to lower the dose of these medicines when you start alogliptin. This is to reduce the risk of low blood sugar (hypoglycaemia).

Also make sure that your doctor and pharmacist know you're taking alogliptin before starting or stopping any other medicine.

Mixing alogliptin with herbal remedies and supplements

There's very little information about taking herbal medicines and supplements with alogliptin.

Important

For safety, tell your doctor and pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

9. Common questions

How does alogliptin work?

Alogliptin belongs to a group of medicines called dipeptidylpeptidase-4 inhibitors (DPP-4 inhibitors) or gliptins.

It's used to treat type 2 diabetes, which is caused by problems with a hormone in your body called insulin.

Gliptins help your body make more insulin. They also stop your body releasing too much sugar (glucose) into your blood.

Both of these things help keep your blood sugar levels stable.

How long does it take to work?

Alogliptin starts to work within a few hours.

You need to take it every day to make sure your blood sugar stays as stable as possible.

How long will I take alogliptin for? Can I come off it?

Alogliptin helps keep your blood sugar level as normal as possible to prevent health problems.

You'll probably have to take it for a long time, even for the rest of your life.

Over time it gets harder to control blood sugar levels, so your doctor might eventually recommend stopping alogliptin and trying a different treatment.

Do not stop taking alogliptin without speaking to your doctor.

Does it cause hypoglycaemia ('hypos')?

Alogliptin does not usually cause low blood sugar (known as hypoglycaemia or "hypos").

If you're taking other medicines for diabetes, your doctor may recommend reducing the dose of your other medicines when you start alogliptin.

This will reduce your risk of hypos.

Is it safe to take long term?

Alogliptin is safe to take for a long time.

There do not seem to be any lasting harmful effects from taking it for many months or even years.

Are there similar medicines to alogliptin?

Alogliptin is a dipeptidylpeptidase-4 inhibitor (DPP-4 inhibitor).

Similar medicines include saxagliptin, sitagliptin, linagliptin and vildagliptin.

There are other diabetes medicines that you swallow. These include metformin, gliclazide, glimepiride, pioglitazone, canagliflozin, dapagliflozin and empagliflozin.

Are there different types of diabetes medicines?

There are several medicines that can lower blood sugar levels:

metformin
sulphonylureas, like gliclazide
pioglitazone
DPP-4 inhibitors, like alogliptin
SGLT2 inhibitors, like dapagliflozin
GLP-1 agonists, like exenatide (given by injection)
insulin (given by injection)

Your doctor might recommend taking more than one type of diabetes medicine at the same time.

Can I get diabetes medicines for free?

If you have diabetes, you're entitled to free prescriptions for all of your medicines, not just your diabetes ones.

To claim your free prescriptions, you'll need to have a medical exemption certificate (FP92A).

You can get an application form at your GP surgery.

Can I take alogliptin before surgery?

Yes, you can take alogliptin before surgery.

Tell your surgeon that you're taking alogliptin and any other medicines.

Will it affect my contraception?

Alogliptin does not affect any type of contraception, including the combined pill and emergency contraception.

Will it affect my fertility?

There's no firm evidence to suggest that taking alogliptin will reduce fertility in either men or women.

But speak to a pharmacist or your doctor if you're trying to get pregnant.

They may want to review your treatment.

Can I drink alcohol with it?

Yes, you can drink alcohol while taking alogliptin.

But it's best to drink no more than 2 units per day. Drinking more than this can increase your risk of low blood sugar.

Try to keep to the recommended guidelines of no more than 14 units of alcohol a week.

A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.

Is there any food or drink I need to avoid?

It's a good idea to cut down on foods with added sugar.

Check the nutrition labels as many foods and drinks are high in sugar, such as:

sweets
cakes
biscuits
chocolate
some fizzy drinks
juice drinks

Will it make me lose weight?

Alogliptin does not usually make people lose weight or put on any weight.

Can I drive or ride a bike?

If your blood sugar levels are stable, taking alogliptin should not affect your ability to drive, cycle or use machinery and tools.

If your blood sugar levels become too low, this can reduce your concentration.

If this happens to you, do not drive, cycle or use machines or tools until you feel better.

Can lifestyle changes help?

There are some lifestyle changes you can make to help control the symptoms of diabetes.