Reviewed on 5/13/2022

What Is Alogliptin and How Does It Work?

Alogliptin is a prescription medicine used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

  • Alogliptin is available under the following different brand names: Nesina

What Are Dosages of Alogliptin?

Adult dosage


  • 6.25mg
  • 12.5mg
  • 25mg

Diabetes Mellitus Type 2

Adult dosage

  • 25 mg orally once daily

Dosage Considerations – Should be Given as Follows: 

  • See “Dosages”

What Are Side Effects Associated with Using Alogliptin?

Common side effects of Alogliptin include:

Serious side effects of Alogliptin include:

  • severe pain in the upper stomach spreading to the back,
  • nausea and vomiting,
  • loss of appetite,
  • fast heart rate,
  • itching,
  • dark urine,
  • clay-colored stools,
  • jaundice (yellowing of the skin or eyes), and
  • a severe skin reaction.

Rare side effects of Alogliptin include:

  • none 
This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

What Other Drugs Interact with Alogliptin?

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

  • Alogliptin has severe interactions with no other drugs.
  • Alogliptin has serious interactions with no other drugs.
  • Alogliptin has moderate interactions with at least 26 other drugs.
  • Alogliptin has minor interactions with no other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

What Are Warnings and Precautions for Alogliptin?


Effects of drug abuse

  • None

Short-Term Effects

  • See “What Are Side Effects Associated with Using Alogliptin?”

Long-Term Effects

  • See “What Are Side Effects Associated with Using Alogliptin?”


  • Pancreatitis reported; if pancreatitis is suspected, discontinue therapy and initiate appropriate management
  • Caution with sensitivity to another DPP-4 inhibitor; discontinue if serious hypersensitivity reaction is suspected (see Contraindications)
  • Postmarketing cases of bullous pemphigoid requiring hospitalization reported with DPP-4 inhibitor use; patients typically recovered with topical or systemic immunosuppressive treatment and discontinuation of DPP-4 inhibitor; tell patients to report the development of blisters or erosions while receiving therapy; if bullous pemphigoid suspected, therapy should be discontinued and referral to a dermatologist considered for diagnosis and appropriate treatment
  • Fatal and nonfatal hepatic failure was reported; type 2 DM is also known to cause fatty liver disease and liver enzyme elevation; monitor carefully and interrupt alogliptin treatment if LFTs are elevated, do not restart alogliptin without another explanation for the liver test abnormalities; do not restart therapy if liver injury is confirmed and no alternative etiology can be found
  • Insulin and insulin secretagogues (eg, sulfonylureas) are known to cause hypoglycemia; therefore, a lower dose of insulin secretagogue may be needed to minimize hypoglycemia risk
  • There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with alogliptin or any other antidiabetic drug
  • DPP-4 inhibitors may cause disabling joint arthralgia; resolves within a month upon discontinuing the drug
  • Congestive heart failure (CHF) risk
    • The EXAMINE (Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care) trial enrolled 5,380 patients with type 2 diabetes and recent acute coronary syndrome
    • Hospitalization for CHF was observed in 106 (3.9%) patients treated with alogliptin and 89 (3.3%) patients treated with placebo; although the difference was not statistically significant (hazard ratio, 1.19), heart failure was not an endpoint of the study
    • Health care professionals should consider discontinuing medications containing alogliptin in patients who develop heart failure and monitor their diabetes control
    • If heart failure develops, evaluate and manage it according to current standards of care and consider discontinuation
    • Lancet. 2015 May 23;385(9982):2067-76

Pregnancy and Lactation

  • May be acceptable during pregnancy.
  • Lactation
    • Unknown whether distributed in breast milk 

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