Description
Generic
Indications
When diet, exercise, and a single antidiabetic agent do not result in adequate glycemic control, Vildagliptin is used as a supplement to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. It is also used in dual combination with Metformin, a Sulphonylurea, a Thiazolidinedione, or Insulin.
Pharmacology
Vildagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that is thought to work by slowing the inactivation of incretin hormones in type 2 diabetes patients. The intestine releases incretin hormones throughout the day, including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), and levels rise in response to a meal.
Dosage & Administration
Vildagliptin is prescribed at a daily dose of 50 mg or 100 mg for monotherapy.
When used in tandem with Metformin or a Thiazolidinedione, 50 mg twice daily (morning and evening); 50 mg once daily in the morning when used in tandem with a Sulphonylurea.
Interaction
There were no interactions with pioglitazone, metformin, glibenclamide, digoxin, warfarin, amlodipine, ramipril, valsartan, or simvastatin in pharmacokinetic studies. Certain active substances, such as thiazides, corticosteroids, thyroid products, and sympathomimetics, may reduce Vildagliptin’s glucose-lowering effect, as they do with other oral antidiabetic medicinal products.
Contraindications
- Vildagliptin is not recommended for people who are allergic to the active ingredient or any of the excipients.
- Patients with renal impairment ranging from moderate to severe
- Patients with Hepatic Impairment: those whose alanine aminotransferase (ALT) or aspartate
- aminotransferase (AST) levels were >3 times the upper limit of normal prior to treatment (ULN).
Side Effects
The majority of side effects were mild and transient, necessitating no treatment interruptions. There is a rare case of hepatic dysfunction. Clinical trials lasting up to and including 2 years found no additional safety signals or unexpected risks when this combination was used.
Pregnancy & Lactation
Vildagliptin is not recommended for use during pregnancy. During lactation, Vildagliptin should be avoided.
Precautions & Warnings
Due to a lack of clinical experience, patients aged 75 and older should be treated with caution. LFTs should be checked before starting Vildagliptin, at three-monthly intervals for the first year, and then on a regular basis after that. If transaminase levels are elevated, patients should have a second liver function test to confirm the result and be followed up on.
Therapeutic Class
Inhibitor of Dipeptidyl Peptidase-4 (DPP-4)
Storage Conditions
Keep the temperature below 30°C and away from light and moisture. Keep out of children’s reach.
