song alogliptin and metformin (Oral route) al-oh-GLIP-tin BEN-zoe-ate, met-FOR-min hye-droe-KLOR-ide Oral route(Tablet) Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. Symptoms included malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Laboratory abnormalities included elevated blood lactate levels, anion gap acidosis, an increased lactate/pyruvate ratio, and metformin plasma levels generally greater than 5 mcg/mL. Risk factors include renal impairment, concomitant use of certain drugs (eg, carbonic anhydrase inhibitors), age 65 years or greater, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment. If lactic acidosis is suspected, immediately discontinue alogliptin/metformin and institute general supportive measures in a hospital setting; prompt hemodialysis is recommended . Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Pricing & Coupons Commonly used brand name(s) In the U.S. Kazano Available Dosage Forms: Tablet Therapeutic Class: Antidiabetic Pharmacologic Class: Alogliptin Chemical Class: Metformin Slideshow Aging Issues: 12 of the Most Common Health Concerns Affecting Seniors Uses For alogliptin and metformin Alogliptin and metformin combination may be used alone or together with other medicines and with a proper diet and exercise to treat high blood sugar levels caused by type 2 diabetes. Alogliptin helps to control blood sugar levels by increasing substances in the body that make the pancreas release more insulin. It also signals the liver to stop producing sugar (glucose) when there is too much sugar in the blood. Metformin reduces the absorption of sugar from the stomach, reduces the release of stored sugar from the liver, and helps your body use sugar better. alogliptin and metformin does not help patients who have insulin-dependent or type 1 diabetes. alogliptin and metformin is available only with your doctor's prescription. Before Using alogliptin and metformin In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For alogliptin and metformin, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to alogliptin and metformin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of alogliptin and metformin combination in the pediatric population. Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of alogliptin and metformin combination in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution for patients receiving alogliptin and metformin. Breast Feeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking alogliptin and metformin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using alogliptin and metformin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Acetrizoic Acid Diatrizoate Ethiodized Oil Iobenzamic Acid Iobitridol Iocarmic Acid Iocetamic Acid Iodamide Iodipamide Iodixanol Iodohippuric Acid Iodopyracet Iodoxamic Acid Ioglicic Acid Ioglycamic Acid Iohexol Iomeprol Iopamidol Iopanoic Acid Iopentol Iophendylate Iopromide Iopronic Acid Ioseric Acid Iosimide Iotasul Iothalamate Iotrolan Iotroxic Acid Ioxaglate Ioxitalamic Acid Ipodate Metrizamide Metrizoic Acid Tyropanoate Sodium Using alogliptin and metformin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Aspirin Balofloxacin Besifloxacin Bupropion Ciprofloxacin Dasabuvir Dofetilide Dolutegravir Enoxacin Fleroxacin Flumequine Gatifloxacin Gemifloxacin Ioversol Lanreotide Levofloxacin Lomefloxacin Moxifloxacin Nadifloxacin Norfloxacin Octreotide Ofloxacin Ombitasvir Paritaprevir Pasireotide Pazufloxacin Pefloxacin Pioglitazone Prulifloxacin Ritonavir Rufloxacin Sparfloxacin Thioctic Acid Tosufloxacin Vandetanib Using alogliptin and metformin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Acebutolol Atenolol Betaxolol Bisoprolol Bitter Melon Carteolol Carvedilol Celiprolol Esmolol Fenugreek Furazolidone Glucomannan Guar Gum Iproniazid Isocarboxazid Labetalol Levobunolol Linezolid Methylene Blue Metipranolol Metoprolol Moclobemide Nadolol Nebivolol Nialamide Oxprenolol Patiromer Penbutolol Phenelzine Pindolol Practolol Procarbazine Propranolol Psyllium Ranolazine Rasagiline Rifampin Safinamide Selegiline Sotalol Timolol Tranylcypromine Verapamil Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Other Medical Problems The presence of other medical problems may affect the use of alogliptin and metformin. Make sure you tell your doctor if you have any other medical problems, especially: Adrenal gland problem (underactive) or Congestive heart failure, acute or unstable or Dehydration, severe or Heart attack, acute or Heart failure, history of or Heart or blood vessel problems or Hypoxemia (decreased oxygen in the blood) or Kidney disease, history of or Liver disease or Poorly nourished condition or Sepsis (severe infection) or Shock (low blood pressure, blood circulation is poor) or Weakened physical condition Use with caution. May increase the risk of serious side effects. Alcohol, excessive use of or Diabetic ketoacidosis or metabolic acidosis (high ketones and acid in the blood) or Kidney disease, severe or Type 1 diabetes Should not be used in patients with these conditions. Anemia or Vitamin B12 deficiency Use with caution. May make these conditions worse. Angioedema (swelling of the face, lips, tongue, throat, arms, or legs), history with other dipeptidyl peptidase-4 (DPP-4) inhibitors Use with caution. May increase the risk of this condition occurring again. Gallbladder stones or Pancreas problems, history of Use with caution. May increase risk for getting pancreatitis (swelling and inflammation of the pancreas). Radiologic procedures (eg, X-rays, CT scans, and MRIs) that require dyes to be injected in your vein alogliptin and metformin should be stopped before you have one of these procedures. Proper Use of alogliptin and metformin Carefully follow the special meal plan your doctor gave you . This is the most important part of controlling your diabetes, and is necessary if the medicine is to work properly. Exercise regularly and test for sugar in your blood or urine as directed. alogliptin and metformin should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Swallow the tablet whole. Do not crush, break, or chew it. Take alogliptin and metformin with food. Dosing The dose of alogliptin and metformin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of alogliptin and metformin. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (tablets): For type 2 diabetes: Adults At first, 1 tablet (either alogliptin 12.5 milligrams [mg] plus metformin 500 mg or alogliptin 12.5 mg plus metformin 1000 mg) 2 times a day with food. Your doctor may adjust your dose as needed. However, the dose is usually not more than alogliptin 25 mg plus metformin 2000 mg per day. Children Use and dose must be determined by your doctor. Missed Dose If you miss a dose of alogliptin and metformin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Precautions While Using alogliptin and metformin It is very important that your doctor check your progress at regular visits to make sure that alogliptin and metformin is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects. Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear , and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure. Symptoms of lactic acidosis include abdominal or stomach discomfort, decreased appetite, diarrhea, fast, shallow breathing, a general feeling of discomfort, muscle pain or cramping, and unusual sleepiness, tiredness, or weakness. If symptoms of lactic acidosis occur, you should get immediate emergency medical help . Pancreatitis (swelling and inflammation of the pancreas) may occur while you are using alogliptin and metformin. Check with your doctor right away if you have a sudden and severe stomach pain, chills, constipation, nausea, vomiting, loss of appetite, fever, or lightheadedness. If you are rapidly gaining weight, having shortness of breath, chest pain, extreme tiredness or weakness, irregular breathing, irregular heartbeat, or excessive swelling of the hands, wrist, ankles, or feet, check with your doctor immediately. These may be symptoms of a heart problem. alogliptin and metformin may cause serious allergic reactions, including anaphylaxis, angioedema, or certain skin conditions (eg, Stevens-Johnson syndrome). These reactions can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, blistering, peeling, or loosening of the skin, fever or chills, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using alogliptin and metformin. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem. alogliptin and metformin may cause hypoglycemia (low blood sugar). This is more common when alogliptin and metformin is taken together with certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms of low blood sugar . It is important that you learn which symptoms you usually have so you can treat it quickly. Talk to your doctor about the best way to treat low blood sugar. Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away . It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar. There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes with a list of all your medicines. It is important to tell the doctor in charge that you are taking alogliptin and metformin if you are going to have any medical or surgical procedures. alogliptin and metformin may cause severe and disabling joint pain. Call your doctor right away if you have severe joint pain while using alogliptin and metformin. alogliptin and metformin may cause bullous pemphigoid. Tell your doctor right away if you have large, hard skin blisters while you are using alogliptin and metformin. alogliptin and metformin may cause some women who do not have regular monthly periods to ovulate. This can increase the chance of pregnancy. If you are a woman of childbearing potential, you should discuss birth control options with your doctor. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. alogliptin and metformin Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Blurred vision dizziness headache nervousness pounding in the ears slow or fast heartbeat Less common Anxiety bladder pain bloody or cloudy urine chest pain chills cold sweats coma confusion cool, pale skin decreased urine output depression difficult, burning, or painful urination dilated neck veins extreme fatigue frequent urge to urinate increased hunger irregular breathing irregular heartbeat lower back or side pain nausea nightmares seizures shakiness slurred speech swelling of the face, fingers, feet, or lower legs tightness in chest troubled breathing unusual tiredness or weakness weight gain Rare Blistering, peeling, or loosening of the skin bloating constipation cough darkened urine diarrhea difficulty with swallowing fever hives or itching indigestion joint or muscle pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs loss of appetite pains in the stomach, side, or abdomen, possibly radiating to the back puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue red skin lesions, often with a purple center red, irritated eyes sore throat sores, ulcers, or white spots in the mouth or on the lips vomiting yellow eyes or skin Incidence not known Dark-colored urine general feeling of tiredness or weakness large, hard skin blisters light-colored stools redness of the skin severe joint pain stomach pain, continuing welts Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Body aches or pain ear congestion loss of voice muscle aches sneezing stuffy or runny nose Less common Back pain Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Copyright 2017 Truven Health Analytics, Inc. All Rights Reserved. Next Side Effects Print this page Add to My Med List More about alogliptin/metformin Side Effects During Pregnancy Dosage Information Drug Interactions Support Group Pricing & Coupons En Español 1 Review Add your own review/rating Drug class: antidiabetic combinations Consumer resources Alogliptin and metformin Other brands: Kazano Professional resources Alogliptin and Metformin Tablets (FDA) Alogliptin and Metformin (Wolters Kluwer) Related treatment guides Diabetes, Type 2} Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Manufacturer Perrigo Company Drug Class Antidiabetic combinations Related Drugs Diabetes, Type 2 metformin , insulin aspart , glipizide , glimepiride , Januvia , pioglitazone , Victoza , Actos , Tradjenta , Glucophage , glyburide , Janumet , Invokana , Amaryl , Welchol , Onglyza , sitagliptin , Trulicity , Jardiance , Lantus , Farxiga , Levemir , Tresiba , Glucotrol , Bydureon , More... 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