Vildagliptin

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Generic Name of Vildagliptin - Learn More

Vildagliptin

Vildagliptin Precaution - What You Need to Know

Before starting Vildagliptin, it is essential that patients consult their healthcare provider. Several precautions should be considered:

- Renal Impairment: Vildagliptin is primarily excreted by the kidneys, so dose adjustments may be required for patients with renal impairment (especially those with a creatinine clearance below 50 mL/min). Close monitoring of kidney function is recommended during treatment.
- Pancreatitis: Vildagliptin may increase the risk of pancreatitis. Patients with a history of pancreatitis or those who experience symptoms such as persistent abdominal pain should discontinue the drug and seek medical attention.
- Hepatic Impairment: Vildagliptin is metabolized in the liver. For patients with moderate liver impairment, the dose of Vildagliptin should be reduced. It is not recommended for use in patients with severe hepatic impairment.
- Heart Failure: Although not a direct contraindication, caution should be used when prescribing Vildagliptin to patients with congestive heart failure (CHF), as careful monitoring of cardiovascular status is necessary.
- Hypoglycemia: Vildagliptin is not associated with hypoglycemia when used alone but may increase the risk when combined with other antidiabetic medications like sulfonylureas or insulin.
- Elderly Patients: The elderly may require dose adjustments, particularly in those with renal or hepatic issues. Close monitoring is essential.
- Pregnancy and Breastfeeding: Vildagliptin is categorized as Pregnancy Category C, meaning it should only be used during pregnancy if the potential benefits outweigh the risks. It is not recommended during breastfeeding due to the unknown effects on a nursing infant.

Vildagliptin Indication - Uses and Benefits

Vildagliptin is primarily prescribed for the management of type 2 diabetes mellitus. It is used as part of a comprehensive treatment plan, including diet and exercise, to improve glycemic control in adults. The main therapeutic indications include:

- Type 2 Diabetes Mellitus: Vildagliptin works by enhancing the body's ability to lower blood glucose levels through the inhibition of the enzyme DPP-4 (dipeptidyl peptidase-4). This leads to prolonged action of incretin hormones, increasing insulin release and decreasing glucagon levels after meals.
- Monotherapy or Combination Therapy: Vildagliptin can be used alone (monotherapy) or in combination with other antidiabetic medications, such as metformin, thiazolidinediones, sulfonylureas, or insulin, in patients who have inadequate glycemic control with diet and exercise alone.

Vildagliptin Contraindications - Important Warnings

Vildagliptin should not be used in the following situations:

- Hypersensitivity: Contraindicated in patients with a known allergy or hypersensitivity to Vildagliptin or any of its components.
- Severe Renal Impairment: Vildagliptin is contraindicated in patients with severe renal impairment (e.g., creatinine clearance below 30 mL/min) due to insufficient data regarding its safety in this population.
- Active Pancreatitis: Patients with a history of pancreatitis or active pancreatitis should avoid using Vildagliptin.
- Liver Disease: The drug is contraindicated in severe hepatic impairment, as it is metabolized in the liver, and its safety profile is unclear in such cases.

Vildagliptin Side Effects - What to Expect

Vildagliptin is generally well tolerated, but like all medications, it may cause side effects. These include:

- Common Side Effects:
- Headache: Some patients report headaches when starting Vildagliptin.
- Nausea and Diarrhea: Gastrointestinal issues such as nausea, vomiting, or diarrhea can occur in some individuals.
- Dizziness: Mild dizziness may be experienced, especially when standing up quickly.
- Upper Respiratory Tract Infection: Infections such as colds and sinusitis are common during Vildagliptin therapy.

- Serious Side Effects:
- Pancreatitis: Although rare, there is an increased risk of pancreatitis, which is a serious condition requiring immediate medical attention.
- Severe Hypoglycemia: When used with other antidiabetic drugs like insulin or sulfonylureas, Vildagliptin can increase the risk of severe hypoglycemia.
- Hepatic Dysfunction: Elevated liver enzymes have been observed in some patients, indicating potential liver damage.
- Angioedema: Rare but serious allergic reactions such as swelling of the face, lips, or throat may occur.
- Renal Impairment: Worsening kidney function, especially in patients with pre-existing kidney issues, can be observed.

Vildagliptin Mode of Action - How It Works

Vildagliptin is a DPP-4 inhibitor (dipeptidyl peptidase-4 inhibitor), which works by blocking the action of the DPP-4 enzyme that degrades incretin hormones. Incretins (such as GLP-1 and GIP) play a key role in regulating glucose metabolism by:

- Stimulating insulin secretion from the pancreas in response to meals.
- Inhibiting glucagon release, which prevents the liver from producing excessive glucose during fasting.

By inhibiting DPP-4, Vildagliptin increases the levels of active incretin hormones, enhancing insulin release and decreasing glucagon levels in a glucose-dependent manner, helping to control blood sugar levels in patients with type 2 diabetes.

Vildagliptin Drug Interactions - What to Avoid

Vildagliptin can interact with several medications, altering its effectiveness or leading to potentially harmful effects. Notable interactions include:

- Antidiabetic Medications: When combined with sulfonylureas or insulin, Vildagliptin may increase the risk of hypoglycemia. Dose adjustments for these drugs may be necessary to avoid low blood sugar levels.
- Other DPP-4 Inhibitors: Concurrent use with other DPP-4 inhibitors (e.g., saxagliptin) is not recommended due to the increased risk of side effects, including pancreatitis and kidney problems.
- Cytochrome P450 Enzyme Inhibitors: Vildagliptin is not significantly metabolized by the cytochrome P450 enzymes, but drugs that inhibit CYP3A4 (e.g., ketoconazole) may alter the drug's pharmacokinetics, although this interaction is considered minimal.
- Rifampin and Antiepileptic Drugs: Drugs like rifampin, an antibiotic, and antiepileptic drugs (e.g., carbamazepine) may decrease the effectiveness of Vildagliptin by increasing its metabolism. Monitoring blood glucose levels is advised.
- Other Antihypertensive and Diuretic Drugs: If used in combination with drugs like ACE inhibitors or diuretics, the risk of hypotension or kidney-related issues should be monitored.

Vildagliptin Adult Dose - Recommended Dosage

The usual starting dose for adults is 50 mg once daily, although the dose may be adjusted depending on the patient’s renal function:

- For renal impairment (creatinine clearance between 30-50 mL/min), the dose should be reduced to 50 mg once daily.
- For moderate renal impairment (creatinine clearance between 30-50 mL/min), the dose should be reduced to 50 mg once daily.
- For patients with severe renal impairment (creatinine clearance below 30 mL/min), Vildagliptin should not be used.

The maximum recommended dose is 100 mg/day, typically taken in two divided doses of 50 mg.

Vildagliptin Child Dose - Dosage for Children

Vildagliptin is not recommended for use in pediatric patients under 18 years of age due to a lack of safety and efficacy data.

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Always consult your healthcare provider before taking Vildagliptin to ensure it is appropriate for your condition and to receive the correct dosage tailored to your health status.

Vildagliptin Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment, Vildagliptin dosage adjustments are essential:

- Mild renal impairment (creatinine clearance of 50-80 mL/min): No dose adjustment is necessary.
- Moderate renal impairment (creatinine clearance of 30-50 mL/min): The recommended dose is 50 mg once daily.
- Severe renal impairment (creatinine clearance less than 30 mL/min): Vildagliptin is contraindicated in patients with severe renal impairment.