Vigatin

Indications

Vildagliptin is used with diet and exercise to control blood sugar in adults with type 2 diabetes. It can be used alone, or together with Metformin, a sulfonylurea (such as Gliclazide or Glimepiride), Pioglitazone or insulin.

How It Works

Vildagliptin blocks an enzyme called DPP-4. This keeps the gut hormones (incretins) that are released after meals active for longer, so the pancreas makes more insulin and less glucagon when blood sugar is high. Because it works mainly when sugar is high, on its own it rarely causes low blood sugar.

Dosage and Administration

• Alone, or with Metformin, Pioglitazone or insulin: 50 mg twice a day, morning and evening.
• With a sulfonylurea: 50 mg once a day in the morning.
• The maximum is 100 mg a day.
• Moderate or severe kidney problems: usually 50 mg once a day, as advised.

Take with or without food. Liver blood tests are done before starting and regularly during the first year.

Interactions

• Sulfonylureas and insulin: higher risk of low blood sugar; their dose may need lowering.
• ACE inhibitors (such as Enalapril or Ramipril): slightly higher risk of swelling of the face and throat (angioedema).
• Steroids, some diuretics and thyroid medicines can raise blood sugar and reduce the effect.

Contraindications

• Allergy to vildagliptin or any ingredient of the product
• Type 1 diabetes or diabetic ketoacidosis
• Liver disease, or liver enzymes raised before treatment

Side Effects

Common: dizziness, headache, shaking, nausea and swelling of the hands or feet. Low blood sugar (sweating, shaking, hunger, confusion) can happen mainly when taken with a sulfonylurea or insulin. Joint pain can occur.

Get urgent medical help if there is severe, persistent stomach pain that may spread to the back (possible pancreatitis), yellow skin or eyes, dark urine, swelling of the face, lips or throat, difficulty breathing, blistering of the skin, or low blood sugar that does not improve after taking sugar.

Pregnancy and Lactation

Not recommended during pregnancy; insulin is usually preferred to control blood sugar. It is not known whether it passes into breast milk, so it is not recommended while breastfeeding.

Precautions and Warnings

• Liver tests are needed; stop and see a doctor if you develop yellow skin, dark urine or unexplained tiredness.
• Tell the doctor about previous pancreatitis, severe heart failure or kidney disease.
• Learn the signs of low blood sugar and keep sugar or glucose with you.
• Keep up diet, exercise and regular blood sugar checks.

Overdose

High doses may cause muscle pain, tingling, fever, swelling and changes in blood tests. Seek medical advice; treatment is supportive.

Therapeutic Class

Oral antidiabetic, DPP-4 inhibitor (gliptin).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.