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Nesina
Nesina (generic name: alogliptin) is a prescription medication used to manage type 2 diabetes mellitus. It belongs to the class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors, which help regulate blood sugar levels by increasing the release of insulin and decreasing the production of glucose by the liver. Nesina is typically used alongside diet and exercise to improve blood sugar control in adults with type 2 diabetes. It is not indicated for the treatment of type 1 diabetes or diabetic ketoacidosis.
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Frequently Asked Questions
How long does it take for Nesina to start working?
Nesina begins working within a few hours of taking a dose, but it may take several weeks of consistent use to notice significant improvements in blood sugar levels.
Can Nesina cause weight gain?
Nesina is generally considered to be weight-neutral, meaning it does not typically cause significant weight gain or loss.
Can I take Nesina if I have kidney problems?
Yes, but if you have renal impairment, your doctor will likely adjust your dose based on the severity of your kidney condition.
Is Nesina used alone or with other medications?
Nesina can be used alone or in combination with other antidiabetic medications, such as metformin, insulin, or sulfonylureas, to better control blood sugar levels.
What should I do if I miss a dose of Nesina?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose. Do not take two doses at the same time.
Comprehensive Drug Guide
How Does Nesina Work?
Nesina works by inhibiting the DPP-4 enzyme, which normally breaks down the incretin hormones GLP-1 and GIP. These hormones help regulate blood sugar levels by increasing insulin release from the pancreas in response to meals and by decreasing the liver's production of glucose. By inhibiting DPP-4, Nesina prolongs the activity of incretin hormones, leading to improved blood sugar control.
Common Dosages
- 6.25 mg, 12.5 mg, and 25 mg tablets.
Typical Dosing
- The recommended dose of Nesina is 25 mg once daily, with or without food.
- For patients with moderate renal impairment, the dose may be reduced to 12.5 mg once daily.
- For patients with severe renal impairment or end-stage renal disease, the dose may be reduced to 6.25 mg once daily.
Typical Dosing
FDA Approved Indications
- Management of type 2 diabetes mellitus to improve glycemic control in adults, in combination with diet and exercise.
Who Shouldn't Take Nesina?
- Type 1 diabetes mellitus or diabetic ketoacidosis.
- Known hypersensitivity to alogliptin or any of the ingredients in the formulation.
Advice From The Pharmacist
- Take Nesina once daily, with or without food, at the same time each day.
- Continue following your diet and exercise plan as directed by your healthcare provider.
- Monitor your blood sugar levels regularly and keep track of any unusual changes. If your blood sugar becomes consistently too low (hypoglycemia), contact your doctor.
- If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose—do not double up on doses.
- Be aware of the signs of pancreatitis, a rare but serious side effect. Symptoms include severe abdominal pain, nausea, or vomiting. Contact your doctor immediately if these occur.
Side Effects of Nesina
Common Side Effects
- Upper respiratory infection (cold symptoms)
- Headache
- Nasopharyngitis (inflammation of the nose and throat)
- Elevated blood sugar levels if not used with proper diet and exercise
Uncommon/Severe Side Effects
- Pancreatitis (severe abdominal pain, nausea, or vomiting)
- Severe allergic reactions (rash, itching, swelling, or difficulty breathing)
- Heart failure in individuals with a history of cardiovascular disease or heart failure
- Liver problems, including liver enzyme elevations or liver failure
Risks and Warnings of Nesina
- Pancreatitis: Nesina may increase the risk of developing pancreatitis. Discontinue use if severe abdominal pain or nausea occurs, and contact your healthcare provider immediately.
- Heart Failure: Use caution in patients with a history of heart failure, as DPP-4 inhibitors, including Nesina, have been associated with an increased risk of heart failure.
- Renal Impairment: Dosage adjustments are required for patients with moderate to severe renal impairment. Regular monitoring of kidney function is recommended.
- Hypersensitivity Reactions: Severe allergic reactions, such as angioedema, may occur. If signs of a severe allergic reaction appear, discontinue the medication and seek medical attention.
Interactions with Nesina
Common Drug Interactions
- Insulin and sulfonylureas: When used with other antidiabetic medications, such as insulin or sulfonylureas, Nesina may increase the risk of hypoglycemia. Dosage adjustments of the other medications may be necessary.
- CYP3A4 inhibitors: Drugs like ketoconazole or erythromycin may interact with Nesina and require monitoring or dosage adjustments.
- Rifampin: This antibiotic may reduce the effectiveness of Nesina by increasing its metabolism.
Alternatives to Nesina
- Januvia (sitagliptin): Another DPP-4 inhibitor used to manage type 2 diabetes.
- Onglyza (saxagliptin): A similar medication used for blood sugar control in type 2 diabetes patients.
- Tradjenta (linagliptin): A DPP-4 inhibitor with a slightly different profile for managing type 2 diabetes.
- Metformin: A first-line medication often used in combination with other diabetes drugs to improve blood sugar control.
