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An update on the clinical pharmacology of the dipeptidyl peptidase 4 inhibitor alogliptin used for the treatment of type 2 diabetes mellitus
Author(s) -
Chen XiaoWu,
He ZhiXu,
Zhou ZhiWei,
Yang Tianxin,
Zhang Xueji,
Yang YinXue,
Duan Wei,
Zhou ShuFeng
Publication year - 2015
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/1440-1681.12469
Subject(s) - alogliptin , medicine , pioglitazone , pharmacology , dipeptidyl peptidase 4 inhibitor , saxagliptin , pharmacokinetics , pharmacodynamics , adverse effect , type 2 diabetes mellitus , metformin , incretin , dipeptidyl peptidase 4 , type 2 diabetes , diabetes mellitus , sitagliptin , insulin , endocrinology
Summary Alogliptin, a dipeptidyl peptidase‐4 ( DPP ‐4) inhibitor that is a class of relatively new oral hypoglycaemic drugs used in patients with type 2 diabetes (T2 DM ), can be used as monotherapy or in combination with other anti‐diabetic agents, including metformin, pioglitazone, sulfonylureas and insulin with a considerable therapeutic effect. Alogliptin exhibits favorable pharmacokinetic and pharmacodynamic profiles in humans. Alogliptin is mainly metabolized by cytochrome P450 ( CYP 2D6) and CYP 3A4. Dose reduction is recommended for patients with moderate or worse renal impairment. Side effects of alogliptin include nasopharyngitis, upper‐respiratory tract infections and headache. Hypoglycaemia is seen in about 1.5% of the T2 DM patients. Rare but severe adverse reactions such as acute pancreatitis, serious hypersensitivity including anaphylaxis, angioedema and severe cutaneous reactions such as Stevens‐Johnson syndrome have been reported from post‐marketing monitoring. Pharmacokinetic interactions have not been observed between alogliptin and other drugs including glyburide, metformin, pioglitazone, insulin and warfarin. The present review aimed to update the clinical information on pharmacodynamics, pharmacokinetics, adverse effects and drug interactions, and to discuss the future directions of alogliptin.