Acts as a competitive inhibitor of dipeptidyl peptidase-4 (DPP-4), which slows the inactivation of incretin hormones, thereby increasing their concentrations and reducing fasting and postprandial glucose concentrations.
Assess for signs/symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, tremor, tachycardia, anxiety).
Monitor for signs/symptoms of pancreatitis (nausea, vomiting, anorexia, persistent severe abdominal pain, sometimes radiating to the back). If pancreatitis occurs, discontinue alogliptin and monitor serum and urine amylase, amylase/CCr ratio, electrolytes, serum calcium, glucose, and lipase.
Assess for signs/symptoms of HF (↑ shortness of breath, rapid ↑ in weight, swelling of feet) periodically during therapy.
Assess for rash periodically during therapy. May cause SJS. If severe rash occurs or if rash is accompanied with fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, hepatitis, and/or eosinophilia, permanently discontinue alogliptin.
Lab Test Considerations:
Monitor A1c before and periodically during therapy.
Monitor liver function tests before starting and periodically during therapy. Interrupt therapy and determine cause if significant ↑ in enzymes or abnormal tests persist or worsen. Do not restart therapy without explanation for abnormalities.
Monitor renal function before and periodically during therapy.
Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Advise to take as directed. Take missed doses as soon as remembered, unless it is almost time for next dose; do not double dose.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
Explain to patient that alogliptin helps control hyperglycemia but does not cure diabetes. Therapy is usually long term. Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hyperglycemic or hypoglycemic episodes.
Advise patient not to share this medication with others, even if they have the same symptoms; it may harm them.
Review signs/symptoms of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to take drink 4 ounces of orange juice or 2–3 tsp of sugar, honey, or corn syrup dissolved in water, and notify health care provider.
Advise patient in proper testing of blood glucose and urine ketones. These tests should be monitored closely during periods of stress or illness and health care provider notified if significant changes occur.
Advise patient to stop taking alogliptin and notify health care provider promptly if symptoms of hypersensitivity reactions (rash; hives; swelling of face, lips, tongue, and throat; difficulty in breathing or swallowing), liver dysfunction (fatigue, nausea, vomiting, anorexia, right upper abdominal discomfort, dark urine, yellowing of skin or whites of eyes), HF, or pancreatitis occur.
Advise patient to notify health care provider if severe joint pain occurs.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding.