Alogliptin (as benzoate), Metformin HCl
Indications
Alogliptin (as benzoate), Metformin HCl is used for:
ALOGLIPTIN
Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
METFORMIN
For use as an adjunct to diet and exercise in adult patients (18 years and older) with niddm. May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome (pcos). Jentadueto is for the treatment of patients when both linagliptin and metformin is appropriate
Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
METFORMIN
For use as an adjunct to diet and exercise in adult patients (18 years and older) with niddm. May also be used for the management of metabolic and reproductive abnormalities associated with polycystic ovary syndrome (pcos). Jentadueto is for the treatment of patients when both linagliptin and metformin is appropriate
Adult Dose
Child Dose
Renal Dose
Administration
Contra Indications
Precautions
Pregnancy-Lactation
Interactions
Adverse Effects
Side effects of Alogliptin (as benzoate), Metformin HCl :
Mechanism of Action
ALOGLIPTIN
Alogliptin inhibits dipeptidyl peptidase 4 (dpp-4), which normally degrades the incretins glucose-dependent insulinotropic polypeptide (gip) and glucagon like peptide 1 ( glp-1). The inhibition of dpp-4 increases the amount of active plasma incretins which helps with glycemic control. Gip and glp-1 stimulate glucose dependent secretion of insulin in pancreatic beta cells. Glp-1 has the additional effects of suppressing glucose dependent glucagon secretion, inducing satiety, reducing food intake, and reducing gastric emptying
METFORMIN
Metformin's mechanisms of action differ from other classes of oral antihyperglycemic agents. Metformin decreases blood glucose levels by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. These effects are mediated by the initial activation by metformin of amp-activated protein kinase (ampk), a liver enzyme that plays an important role in insulin signaling, whole body energy balance, and the metabolism of glucose and fats. Activation of ampk is required for metformin's inhibitory effect on the production of glucose by liver cells. Increased peripheral utilization of glucose may be due to improved insulin binding to insulin receptors. Metformin administration also increases ampk activity in skeletal muscle. Ampk is known to cause glut4 deployment to the plasma membrane, resulting in insulin-independent glucose uptake. The rare side effect, lactic acidosis, is thought to be caused by decreased liver uptake of serum lactate, one of the substrates of gluconeogenesis. In those with healthy renal function, the slight excess is simply cleared. However, those with severe renal impairment may accumulate clinically significant serum lactic acid levels. Other conditions that may precipitate lactic acidosis include severe hepatic disease and acute/decompensated heart failure
Alogliptin inhibits dipeptidyl peptidase 4 (dpp-4), which normally degrades the incretins glucose-dependent insulinotropic polypeptide (gip) and glucagon like peptide 1 ( glp-1). The inhibition of dpp-4 increases the amount of active plasma incretins which helps with glycemic control. Gip and glp-1 stimulate glucose dependent secretion of insulin in pancreatic beta cells. Glp-1 has the additional effects of suppressing glucose dependent glucagon secretion, inducing satiety, reducing food intake, and reducing gastric emptying
METFORMIN
Metformin's mechanisms of action differ from other classes of oral antihyperglycemic agents. Metformin decreases blood glucose levels by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. These effects are mediated by the initial activation by metformin of amp-activated protein kinase (ampk), a liver enzyme that plays an important role in insulin signaling, whole body energy balance, and the metabolism of glucose and fats. Activation of ampk is required for metformin's inhibitory effect on the production of glucose by liver cells. Increased peripheral utilization of glucose may be due to improved insulin binding to insulin receptors. Metformin administration also increases ampk activity in skeletal muscle. Ampk is known to cause glut4 deployment to the plasma membrane, resulting in insulin-independent glucose uptake. The rare side effect, lactic acidosis, is thought to be caused by decreased liver uptake of serum lactate, one of the substrates of gluconeogenesis. In those with healthy renal function, the slight excess is simply cleared. However, those with severe renal impairment may accumulate clinically significant serum lactic acid levels. Other conditions that may precipitate lactic acidosis include severe hepatic disease and acute/decompensated heart failure