Vildagliptin

What it is and how it works

Vildagliptin selectively inhibits DPP-4, increasing endogenous levels of the incretin hormones GLP-1 and GIP. This enhances glucose-dependent insulin secretion and suppresses inappropriate glucagon release, lowering fasting and postprandial glucose with a low intrinsic risk of hypoglycaemia.

Indications

Type 2 diabetes mellitus in adults, as monotherapy when metformin is inappropriate, or in combination with metformin, a sulfonylurea, a thiazolidinedione or insulin when glycaemic control is inadequate.

Dosage and administration (summary)

Orally, 50 mg twice daily (morning and evening); 50 mg once daily when combined with a sulfonylurea and in moderate or severe renal impairment; maximum 100 mg daily.

Contraindications

Hypersensitivity to vildagliptin or excipients.

Warnings and precautions

Not recommended in hepatic impairment (including pre-treatment ALT or AST more than 3 times the upper limit of normal); liver function should be tested before treatment and periodically during the first year. Discontinue if acute pancreatitis or bullous pemphigoid is suspected. Not for type 1 diabetes or diabetic ketoacidosis; hypoglycaemia risk increases when combined with sulfonylureas or insulin, which may need dose reduction.

Pregnancy

Avoid in pregnancy; insulin is preferred.

Storage and supply

Store below 30 °C in the original package, protected from moisture.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.