Nesina

(Alogliptin Benzoate)

The active ingredient in Nesina is alogliptin benzoate. Normally, your body regulates blood glucose by releasing specific incretin hormones like GLP-1 and GIP in response to meals. These hormones tell your body to generate more insulin and less sugar. However, a protein called dipeptidyl peptidase-4 (DPP-4) degrades these hormones. Alogliptin is a DPP-4 inhibitor, which implies it inhibits DPP-4 activity. In doing so, alogliptin permits insulin to stay in your body longer and instructs your body to produce less sugar. These acts reduce your blood sugar levels and give you greater glycemic control.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Nesina. However, the following is a synopsis of the general guidelines for the use of Nesina:

• You can take Nesina with or without food.
• Your blood sugar will need to be tested frequently, and you may require further blood tests at your doctor's office.
• If you experience low blood sugar (hypoglycemia) and feel extremely hungry, dizzy, angry, confused, worried, or shaky, eat or drink something with a high sugar content.
• If you suffer from severe hypoglycemia, your doctor may prescribe a glucagon injection kit. Make sure your family or close friends know how to administer this injection in an emergency.
• Stress, illness, surgery, exercise, alcohol consumption, and skipping meals all have an impact on blood sugar levels. Consult your doctor before changing your dose or drug schedule.
• Alogliptin is available as a single ingredient agent (Nesina, Takeda) as well as in combination therapy with pioglitazone (Oseni, Takeda) and metformin (Kazano, Takeda).

The most common side effects of Nesina seen in clinical trials as compared to placebo include:

• Upper respiratory tract infection.
• Nasopharyngitis (stuffy or runny nose and sore throat)
• Headaches.
• Constipation.
• Nausea.

Some individuals may experience serious side effects while using Nesina. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Pancreatic inflammation. Symptoms include fever, nausea, vomiting, and upper stomach pain.
• Severe allergic reactions. Symptoms include a skin rash or hives, swelling of the throat, face, lips, and tongue, and shortness of breath.
• Increased risk of hypoglycemia (low blood sugar levels), especially if taken with insulin or an insulin secretagogue.
• Increased risk of heart failure. Symptoms include shortness of breath while lying down, weight gain, and swelling in your feet or legs.
• Liver problems. Symptoms include nausea, upper stomach pain, tired feeling, loss of appetite, dark urine, clay-colored stools, and yellowing of the skin or eyes (jaundice).
• Severe joint pain within days and up to years after starting a medication like Nesina.

These are not all of the possible side effects of Nesina. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the U.S. Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Nesina, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

• Diabetic ketoacidosis.
• Liver disease, liver problems, or liver injury.
• Kidney disease or on dialysis.
• Heart failure.
• Inflammation of the pancreas (pancreatitis).
• Gallstones.
• Alcoholism.

Hypersensitivity reactions to alogliptin, as well as anaphylaxis, angioedema, or severe cutaneous adverse reactions like Stevens-Johnson syndrome.

Nesina will begin to reduce blood sugar levels within a few hours after the first dose. However, it can take up to a couple of months to see the full effect of this medication.

When Nesina is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Thiazolidinediones like pioglitazone.
• Sulfonylureas, such as glimepiride, glipizide, and glyburide.
• Insulin.

The typical dose of alogliptin is a 25 mg tablet taken by mouth, once daily. This dose may differ if you have kidney problems.

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Store at room temperature and keep out of reach of children.

Takeda Pharmaceuticals is the company that manufactures Nesina.

There are several lower-cost generic versions available.

You'll likely have to take it for a long time, if not forever. Do not discontinue taking alogliptin without consulting your doctor.

If you are or become pregnant, follow your doctor's instructions for using Nesina. Controlling diabetes is critical during pregnancy because excessive blood sugar levels can create difficulties in both the mother and the baby.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.