Vildagliptin
Indications
Vildagliptin is used for:
Type 2 DM
Adult Dose
Oral
Type 2 diabetes mellitus
Adult: 50 mg bid. Not recommended to use >100 mg/day.
W/ metformin or a thiazolidinedione: 50 mg twice daily; w/ a sulfonylurea: 50 mg/day in the morning.
Child Dose
Renal Dose
Renal impairment: Moderate, severe and ESRD: 50 mg once daily.
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity to vildagliptin
Precautions
Patient w/ cardiac failure (NYHA functional class IV), type 1 DM; history of acute pancreatitis. Not intended for the treatment of diabetic ketoacidosis. Hepatic impairment, including patients w/ pre-treatment ALT or AST >3 times the upper limit of normal (ULN). Moderate or severe renal impairment, ESRD. Monitoring Parameters Monitor liver function.
Pregnancy-Lactation
Interactions
Decreased hypoglycaemic effect w/ thiazides, corticosteroids, thyroid products and sympathomimetics.
Adverse Effects
Side effects of Vildagliptin :
Nausea, peripheral oedema, headache, tremor, asthenia, dizziness, constipation, hypoglycaemia, arthralgia, hepatic dysfunction, nasopharyngitis, upper resp tract infection, pancreatitis, exfoliative and bullous skin reactions.
Mechanism of Action
Vildagliptin is a dipeptidylpeptidase-4 (DPP-4) inhibitor that improves glycaemic control by preventing DPP-4 from inactivating the incretin hormones glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide, thus prolonging incretin activity in response to ingestion of nutrients. This increases insulin sensitivity, decreases glucagon secretion and improves ?-cell function.