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Alogliptin-Pioglitazone
Alogliptin-Pioglitazone is a combination medication used to manage type 2 diabetes mellitus. It combines two active ingredients: alogliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, and pioglitazone, a thiazolidinedione (TZD). This combination helps to improve blood sugar control in adults when diet and exercise alone are insufficient. Alogliptin increases insulin release and decreases glucose production in the liver, while pioglitazone improves insulin sensitivity in peripheral tissues.
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Frequently Asked Questions
Can Alogliptin-Pioglitazone be taken with other diabetes medications?
Yes, Alogliptin-Pioglitazone can be used with other diabetes medications, such as insulin or sulfonylureas. However, careful monitoring for hypoglycemia is necessary, and dose adjustments may be required.
How should Alogliptin-Pioglitazone be stored?
Store Alogliptin-Pioglitazone at room temperature, away from moisture and light. Ensure that it is kept out of reach of children and pets.
Is Alogliptin-Pioglitazone safe during pregnancy?
There is limited data on the use of Alogliptin-Pioglitazone during pregnancy. It should only be used if the potential benefits outweigh the risks. Consult your healthcare provider for advice.
What should I do if I miss a dose of Alogliptin-Pioglitazone?
If you miss a dose, take it as soon as you remember, unless it is close to the time for your next dose. Do not double up on doses to make up for a missed one.
Comprehensive Drug Guide
How Does Alogliptin-Pioglitazone Work?
Alogliptin-Pioglitazone works through two complementary mechanisms. Alogliptin inhibits the enzyme DPP-4, prolonging the action of incretin hormones that increase insulin release and reduce glucagon levels in response to meals. Pioglitazone enhances insulin sensitivity in muscle and adipose tissue, allowing the body to use insulin more effectively. Together, these actions help to improve glycemic control in patients with type 2 diabetes.
Common Dosages
Alogliptin-Pioglitazone is commonly available in the following dosage combinations:
- 12.5 mg/15 mg tablets (alogliptin/pioglitazone)
- 12.5 mg/30 mg tablets (alogliptin/pioglitazone)
- 12.5 mg/45 mg tablets (alogliptin/pioglitazone)
Typical Dosing
The typical dosing for Alogliptin-Pioglitazone is:
- Adults: Start with 12.5 mg/15 mg, 12.5 mg/30 mg, or 12.5 mg/45 mg once daily, taken with or without food. The dosage may be adjusted based on glycemic control and tolerability.
- Elderly: Dose adjustments may be required based on renal function and the patient's response.
Typical Dosing
FDA Approved Indications
Alogliptin-Pioglitazone is FDA-approved for the treatment of:
- Type 2 diabetes mellitus, as an adjunct to diet and exercise to improve glycemic control in adults when single-agent therapy is insufficient.
Off-Label Uses
There are no widely recognized off-label uses for this combination medication.
Advice From The Pharmacist
Patients taking Alogliptin-Pioglitazone should:
- Take the medication as prescribed, typically once daily with or without food.
- Monitor blood sugar levels regularly and report any significant changes to their healthcare provider.
- Be aware of the symptoms of heart failure (e.g., shortness of breath, rapid weight gain, swelling) and report them to a healthcare provider immediately.
- Discuss all medications, supplements, and herbal products with their healthcare provider to avoid potential drug interactions.
Side Effects of Alogliptin-Pioglitazone
Common Side Effects
Common side effects of Alogliptin-Pioglitazone include:
- Upper respiratory tract infection
- Headache
- Edema (swelling)
- Weight gain
Uncommon/Severe Side Effects
Serious side effects may include:
- Congestive heart failure (particularly with pioglitazone)
- Bladder cancer (risk associated with pioglitazone)
- Hepatotoxicity (liver injury)
- Pancreatitis
- Fractures, especially in women
Risks and Warnings of Alogliptin-Pioglitazone
Major risks and warnings associated with Alogliptin-Pioglitazone include:
- Heart Failure: Pioglitazone may cause or exacerbate congestive heart failure. Patients should be monitored for signs of heart failure, and the drug should be discontinued if heart failure develops.
- Bladder Cancer: Long-term use of pioglitazone has been associated with an increased risk of bladder cancer. The risk should be considered in patients with a history of bladder cancer.
- Hepatic Impairment: Both alogliptin and pioglitazone have been associated with liver injury. Liver function tests should be performed before starting therapy and monitored periodically.
- Fracture Risk: Pioglitazone may increase the risk of fractures, especially in women. Bone health should be monitored during treatment.
Interactions with Alogliptin-Pioglitazone
Common Drug Interactions
Alogliptin-Pioglitazone may interact with:
- Insulin and Sulfonylureas: Increased risk of hypoglycemia. Dose adjustments may be needed.
- CYP2C8 inhibitors (e.g., gemfibrozil): May increase pioglitazone levels, leading to a higher risk of side effects.
- Rifampin: May reduce the effectiveness of pioglitazone by decreasing its blood levels.
Patients should maintain open communication with their healthcare provider regarding all medications, supplements, and herbal products they are taking.
Alternatives to Alogliptin-Pioglitazone
Alternative medications to Alogliptin-Pioglitazone include:
- Sitagliptin-pioglitazone: A combination of a DPP-4 inhibitor and pioglitazone used for type 2 diabetes.
- Sitagliptin-metformin (Janumet): Another combination of a DPP-4 inhibitor and metformin for managing blood sugar levels.
- GLP-1 receptor agonists (e.g., liraglutide, exenatide): Another class of drugs that can be used with or instead of pioglitazone for glycemic control.
