Alogliptin and Metformin (Oral)

Alogliptin and metformin is a prescription medication for type 2 diabetes patients who have high blood sugar. This medication helps to reduce levels of sugar in the blood.

Overview

Alogliptin and metformin comes in tablet form and helps to reduce high blood sugar in the blood triggered by type 2 diabetes. This medication should be incorporated into a healthy diet and exercise routine. Alogliptin and metformin can be used with other medications or can be taken alone.

Blood sugar levels are regulated with alogliptin because of its tendency to increase properties within the body that help the pancreas produce more insulin. Alogliptin also communicates to the liver that it should cease production of sugar (glucose). Metformin aids the stomach in lowering the absorption level of sugar, lowers the release rate of sugar that is stored in the liver, and aids the body in better overall utilization of sugar.

It is important to note that this medication will not be able to help patients who are insulin-dependent or who have type 1 diabetes.

A patient must obtain a prescription for alogliptin and metformin by a physician prior to taking the medication. A doctor can be sure that the patient will have a reduced chance of experiencing side effects from potential food or medicine interactions. The physician must be aware of all current medications (prescription and non-prescription) being taken by the patient.

Condition(s) treated?

  • Type 2 Diabetes

Type of medicine?

  • High blood pressure medication

Side Effects

When contemplating whether or not an individual should take a medication, they should compare and contrast the negative side effects of the medication versus how much relief it will bring to the patient. The doctor and the patient must work together to figure out if this is the right decision for the patient.

Medications can cause unwanted side effects along with the necessary benefits. Seek medical care if these side effects occur.

More Common Side Effects (Consult doctor immediately)

  • Slower/faster heartbeat than normal
  • Pounding from within ears
  • Nervousness
  • Headache
  • Dizziness
  • Blurry vision

Less Common Side Effects (Consult doctor immediately)

  • Weight gain
  • Weakness (unusual)
  • Urine issues (burning, decreased, difficult, frequent, or painful)
  • Tiredness (unusual)
  • Swollen fingers, face, feet, or legs
  • Speech issues (slurring)
  • Skin variations (cool or pale)
  • Side of body pain
  • Shakiness
  • Seizures
  • Nightmares
  • Neck veins dilation
  • Nausea
  • Hunger increase
  • Heartbeat (irregular)
  • Fatigue (extreme)
  • Depression
  • Confusion
  • Coma
  • Cold sweats
  • Chills
  • Chest pain or tightness
  • Breathing issues (irregular/trouble)
  • Blood in urine (or cloudy urine)
  • Bladder pain or discomfort
  • Back pain
  • Anxiety

Rare Side Effects (Consult doctor immediately)

  • Yellowing of the skin or eyes
  • Vomiting
  • Urine issues (darkened)
  • Throat (sore)
  • Swelling (intensely around the face, throat, eyelids, tongue, hands, legs, feet, genital areas)
  • Swallowing difficulty
  • Sores, white spots, or ulcers on the lips or in the mouth
  • Skin problems (loosening, blistering, or peeling)
  • Pain (abdomen, stomach, side, back)
  • Muscle pain
  • Lesions (red, some with purple center)
  • Joint pain
  • Indigestion
  • Hives/itching
  • Fever
  • Eye irritation (red)
  • Diarrhea
  • Cough
  • Constipation
  • Bloating
  • Appetite loss

Incidence Not Known (Consult doctor immediately)

  • Welts
  • Urine variations (dark-colored)
  • Tired or weakness
  • Stool variations (light-colored)
  • Stomache pain (continuing)
  • Skin redness
  • Joint pain (severe)

Occasionally, side effects happen to patients but do not require medical care. As the human body adjusts and becomes more used to and familiar with the medicine and how the body reacts to the medicine, these side effects can progress on their own. It is important to consult a physician with all side effects experienced, if any. A physician should be knowledgeable about methods to reduce or prevent certain side effects, and can answer questions or discuss bothersome symptoms.

Allergies

Be sure the physician is informed if there are any atypical, uncommon or allergic reactions to the prescription. Stop using the medication immediately if an allergic reaction occurs and consult a doctor.

The health care professional needs to also be aware of any other allergies (for example to animals, foods, preservatives, or dyes). Be sure to carefully read the package instructions or direction label for any over-the-counter products and be knowledgeable about any ingredients that may cause negative interactions.

Consult a physician if any of these side effects are experienced:

More Common Side Effects

  • Body pain or aches
  • Ear congestion
  • Muscle aches
  • Runny or stuffy nose
  • Sneezing
  • Voice loss

Less Common Side Effects

  • Back pain

Some patients may experience additional side effects that are unlisted. It is highly important to always consult a healthcare professional if other side effects are noticed.

Consult a physician for medical direction, side effects may also be reported to the FDA (1-800-FDA-1088).

Dosage

Different patients may need unique dosage quantities and rates of dosage. Be sure to carefully follow the instructions on the prescription bottle label from the physician. For informational purposes, the following data will summarize the average dose of the medication. Do not alter any dosage of any medication without prior approval from a physician. The medication strength will affect the amount prescribed.

The overall amount of doses prescribed per day will influence the efficiency of the medication in addition to total time between doses and the medical issue.

Manufacturer Dosage Instructions

Adults should take one tablet twice per day. The dose may consist of 12.5 milligrams (mg) alogliptin plus 500 mg metformin, or 12.5 mg alogliptin plus 1000 mg metformin.

Missed Dose

This prescription should be taken right away once the patient has found out that a dose has been overlooked. Unless it is closer to the scheduled next dose, the previous dose can be skipped and the dosage schedule can be resumed. Patients should never double dose.

Directions and Unpackaging

Only take this prescription as directed by a doctor. Amounts that are more or less than the doctor ordered (or doses that are taken more or less frequently) may increase the chances of adverse side effects.

A medication guide or patient directions will generally always come with alogliptin and metformin when packaged by the manufacturer. The patient or caretaker should read all instructions and medication summary information carefully prior to taking this medication.

Interactions

Drug Interactions

In certain instances, medicines should not be taken simultaneously at all. Other times, two medications can be used simultaneously even if there is a chance of possible interaction. During situations where it is permissible to combine the medications, the physician may adjust the amount of one or may proceed with other precautions.

While taking this medication, patients must inform their physician if they are also already taking any of the following medications. These interactions would be significant and should be avoided; this list is not necessarily comprehensive. Combining any of the below medications is not recommended. A physician may not prescribe this medication or may change the other medications a patient is taking if they need to take alogliptin and metformin.

Other medications should not be taken concurrently with alogliptin and metformin unless preapproved by a physician. The doctor may choose not to prescribe a patient this medication if the patient is taking any of the following medications, or one of the following medications may be changed.

Not Recommended

It is not recommended to combine use with the following similar medications, including:

  • Tyropanoate Sodium
  • Metrizoic Acid
  • Metrizamide
  • Ipodate
  • Ioxitalamic Acid
  • Ioxaglate
  • Ioversol
  • Iotroxic Acid
  • Iotrolan
  • Iothalamate
  • Iotasul
  • Iosimide
  • Ioseric Acid
  • Iopronic Acid
  • Iopromide
  • Iophendylate
  • Iopentol
  • Iopanoic Acid
  • Iopamidol
  • Iomeprol
  • Iohexol
  • Ioglycamic Acid
  • Ioglicic Acid
  • Iodoxamic Acid
  • Iodopyracet
  • Iodohippuric Acid
  • Iodixanol
  • Iodipamide
  • Iodamide
  • Iocetamic Acid
  • Iocarmic Acid
  • Iobitridol
  • Iobenzamic Acid
  • Ethiodized Oil
  • Diatrizoate
  • Acetrizoic Acid

Typically Not Recommended

In some cases a physician may allow a patient to combine this medication with one on the list of medications below. It is typically not recommended to combine the following medications with alogliptin and metformin, but certain conditions may require it. The physician may adjust the dosage or frequency of doses when prescribing any of the following medications in addition to alogliptin and metformin.

  • Vandetanib
  • Tosufloxacin
  • Thioctic Acid
  • Sparfloxacin
  • Rufloxacin
  • Ritonavir
  • Prulifloxacin
  • Pefloxacin
  • Pazufloxacin
  • Pasireotide
  • Paritaprevir
  • Ombitasvir
  • Ofloxacin
  • Octreotide
  • Norfloxacin
  • Nadifloxacin
  • Moxifloxacin
  • Lomefloxacin
  • Levofloxacin
  • Lanreotide
  • Gemifloxacin
  • Gatifloxacin
  • Flumequine
  • Fleroxacin
  • Enoxacin
  • Dolutegravir
  • Dofetilide
  • Dasabuvir
  • Ciprofloxacin
  • Bupropion
  • Besifloxacin
  • Balofloxacin
  • Aspirin

Increased Side Effects with Combined Use

Taking alogliptin and metformin with the following medications could cause a higher risk for various side effects, but the doctor may decide the combination could still prove to be the most optimal route of treatment. Dosage amounts and frequencies may be adjusted if any of the following medications are also being taken by the patient.

  • Tranylcypromine
  • Timolol
  • Sotalol
  • Selegiline
  • Safinamide
  • Rifampin
  • Rasagiline
  • Ranolazine
  • Psyllium
  • Propranolol
  • Procarbazine
  • Practolol
  • Pindolol
  • Phenelzine
  • Penbutolol
  • Patiromer
  • Oxprenolol
  • Nialamide
  • Nebivolol
  • Nadolol
  • Moclobemide
  • Metoprolol
  • Metipranolol
  • Methylene Blue
  • Linezolid
  • Levobunolol
  • Labetalol
  • Isocarboxazid
  • Iproniazid
  • Guar Gum
  • Glucomannan
  • Furazolidone
  • Fenugreek
  • Esmolol
  • Celiprolol
  • Carvedilol
  • Carteolol
  • Bitter Melon
  • Bisoprolol
  • Betaxolol
  • Atenolol
  • Acebutolol

Additional Interactions

Avoid taking this medication around the time when eating or drinking due to potential interactions with food. Consumption of tobacco or alcohol with certain medications can cause interactions to increase. Take caution and monitor for interactions whenever taking this medication. The subsequent interactions are not all-inclusive, but have been outlined due to the potential importance.

Conflicting Medical Problems

Those with additional medical issues may not be able to safely take this medication. Ensure the physician is aware of the following medical issues, if applicable. Other medical problems that are not on this list should also be disclosed.

  • Weakened physical condition (take additional caution)
  • Vitamin B12 deficiency (could make conditions worse)
  • Shock conditions (poor blood circulation or low blood pressure)
  • Sepsis (severe infection)
  • Radiologic procedures requiring injections of dyes into veins (CT scans, MRIs, and X-rays)
  • Poorly nourishment
  • Pancreas issues (history of; can raise risk for contracting pancreatitis)
  • Metabolic acidosis (high ketones/acid in blood)
  • Liver disease
  • Kidney disease (a history of)
  • Hypoxemia (reduced oxygen within blood)
  • Heart/blood vessel issues
  • Heart failure (a history of)
  • Heart attack (acute)
  • Gallbladder stones
  • Diepeptidyl peptidase-4 (DPP-4) inhibitors (can make condition occur again)
  • Diabetic ketoacidosis (high ketones/acid in blood)
  • Diabetes (Type 1)
  • Dehydration (severe)
  • Congestive heart failure (unstable or acute)
  • Angioedema (swelling of lips, arms, face, tongue, legs, or throat; can make condition occur again)
  • Anemia
  • Alcohol consumption (excessive use)
  • Adrenal gland issues (underactive)

Cease use of this medication when/if any of the previous procedures need to take place.

Warnings and Interactions

This medication can cause problems if the patient has any preexisting medical issues. Patients who are expecting to be on this prescription long-term should ensure a physician monitors their progress regularly at checkups. Patients who will be taking this medication long-term should ensure they attend their regular checkups. This will allow unwanted outcomes to be minimized and to monitor whether or not the medicine is working right. It may be necessary to have blood or urine tests conducted to monitor levels and undesired side effects.

An excess of metformin can trigger in lactic acidosis in certain cases. The severe symptoms exhibited when lactic acidosis occurs are typically fast to appear, and tend to happen when additional health problems unrelated to the medication occur in a severe manner, such as a kidney failure or heart attack.

Lactic acidosis can be recognized through the following symptoms: it can cause decreased appetite, stomach/abdominal uneasiness, shallow breathing, general discomfort, muscle cramping/pain, diarrhea, shallow (yet fast) breathing, weakness, or unusual tiredness. Immediate emergency medical attention should be received if a patient is believed to demonstrate symptoms of lactic acidosis.

Pancreatitis (inflammation and swelling of the pancreas) can occur while taking this medication. Consult a physician if chills, nausea, loss of appetite, severe and sudden stomach pain, constipation, vomiting, lightheadedness, or fever occurs.

Patients who have heart or liver problems should not take alogliptin and metformin.

Allergic reactions can be caused by alogliptin and metformin, including skin conditions (Stevens-Johnson syndrome), angioedema, or anaphylaxis.

Hypoglycemia (low blood sugar) can be caused by alogliptin and metformin. Blood sugar symptoms must be addressed immediately, otherwise they can cause people to pass out. Symptoms of low blood sugar to be wary of are anxiety, behavioral changes similar to a drunken state, drowsiness, hunger, heart beating fast, prolonged headaches, nausea, nervousness, nightmares, sleep interruption, shaky behavior, speech that is slurred, or atypical weakness or tiredness.

Hyperglycemia (high blood sugar) can also be caused by alogliptin and metformin if not enough medication is taken. If a dose is accidentally skipped, if the patient overeats, or does not take enough; hyperglycemia could occur. Symptoms of high blood pressure to be wary of are blurred vision, dryness of the mouth, drowsiness, flushed/dry skin, breath odor similar to fruit, urination rate and volume, appetite loss, stomachache, sleepiness, nausea, tiredness, vomiting, unconsciousness, troubled breathing, extreme thirst. Check your blood sugar and alert the physician if your body demonstrates symptoms of high blood pressure.

Emergency help is sometimes required for issues caused by diabetes. Patients should be proactive and prepare beforehand for emergencies. Individuals with diabetes should always wear a medical identification (ID) neck chain or bracelet. An ID card should also be kept in a purse or wallet, it should say that the patient has diabetes and should list every medication taken.

If the patient taking alogliptin and metformin has any surgical or medical procedures scheduled, they must inform their doctor.

This medication can cause disabling and severe joint pain. Alert your physician immediately if severe joint pain is experienced at all while taking this prescription.

Other medications should not be taken simultaneously as alogliptin and metformin unless preapproved by the doctor. This includes vitamin or herbal supplements, nonprescription medications (available over-the-counter) and prescription drugs.

Specific Demographic Use

Pediatric

Children should not take alogliptin and metformin because it has not yet been established whether or not this prescription is effective and safe for children.

Geriatric

No major problems have been identified in regards to geriatric-specific interactions to alogliptin and metformin. However, patients who are elderly are typically more likely to have kidney issues related to age, which is a reason the physician should be alerted to all previous conditions and diagnoses.

Pregnancy

Alogliptin and metformin has not reported to show any adverse effects for pregnant women, however there has not been adequate research conducted in this area.

Breastfeeding

While breastfeeding, compare and contrast the risk of using alogliptin and metformin. There have not been any suitable studies or findings regarding whether or not this medication will be safe for the mother and baby while breastfeeding.

Storage

Be sure this medication is kept away from children. Do not keep medication past expiration date or once it is not necessary anymore. Consult your physician to find out how best to dispose of unused medicine.

Alogliptin and metformin should be stored in a container that is shut and kept at room temperature. Do not store the container in direct light, near heat, or freezing temperatures.

Summary

While alogliptin and metformin is a highly beneficial medication for those with type 2 diabetes, it can be potentially risky to take if patients do not discuss their entire medical history with their physician. There are also many medications that can have interactions with alogliptin and metformin. Alogliptin and metformin can alleviate high blood pressure by reducing the levels of sugar in the blood, which can greatly improve the quality of life for patients who decide with their doctor that alogliptin and metformin is right for them.

Resources
Last Reviewed:
December 10, 2017
Last Updated:
April 05, 2018
Content Source: