Indications
Trelagliptin is used, together with diet and exercise, to improve blood sugar control in adults with type 2 diabetes. It is taken only once a week, which can help people who find daily tablets hard to remember. It may be used alone or with other diabetes medicines.
How It Works
Trelagliptin is a long acting DPP-4 inhibitor. DPP-4 is an enzyme that breaks down incretin hormones, which the gut releases after meals. By blocking this enzyme, trelagliptin keeps incretins active for longer, so the pancreas releases more insulin and less glucagon when blood sugar is high. This lowers blood sugar with a low risk of hypoglycaemia (low sugar) when used alone.
Dosage and Administration
The usual adult dose is 100 mg once a week, on the same day each week, with or without food. People with moderate kidney impairment usually take 50 mg once a week; it is generally not recommended in severe kidney disease. If a dose is missed, take it as soon as you remember and then continue on the usual weekly day, as advised by your doctor or the leaflet. Follow your doctor’s prescription.
Interactions
- Sulfonylureas such as Gliclazide or Glimepiride, and Insulin, increase the risk of low blood sugar; the dose of these may need lowering.
- Corticosteroids, Thiazide diuretics and some other medicines can raise blood sugar and reduce its effect.
- Beta blockers may mask signs of low blood sugar.
Contraindications
- Allergy to Trelagliptin or other DPP-4 inhibitors.
- Type 1 diabetes or diabetic ketoacidosis.
- Severe infection, before or after major surgery, or serious injury, when insulin is usually needed.
- Severe kidney disease or dialysis.
Side Effects
It is usually well tolerated. Possible effects include low blood sugar (mainly with other diabetes medicines), constipation, skin rash or itching, and upper respiratory infections.
Get urgent medical help if you have severe, persistent stomach pain spreading to the back with or without vomiting (possible pancreatitis), blistering of the skin (bullous pemphigoid), swelling of the face or difficulty breathing, or signs of severe low blood sugar such as confusion, fits or fainting.
Pregnancy and Lactation
Not recommended during pregnancy; insulin is usually preferred. Avoid during breastfeeding unless the doctor advises otherwise.
Precautions and Warnings
- Kidney function should be checked before and during treatment.
- Learn the signs of low blood sugar (shaking, sweating, hunger, fast heartbeat) and keep sugar handy, especially if you also take a sulfonylurea or insulin.
- Use with care if you have had pancreatitis or heart failure.
- Continue diet and exercise advice and regular blood sugar checks.
Overdose
Overdose may cause low blood sugar or other effects. Contact a doctor or go to hospital; take sugar if signs of low blood sugar appear.
Therapeutic Class
Oral antidiabetic, dipeptidyl peptidase 4 (DPP-4) inhibitor, once weekly.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.