Alogliptin & Pioglitazone

treats Type 2 Diabetes. Do not break or cut tablets before swallowing.

Alogliptin & Pioglitazone Overview

Reviewed: February 1, 2013
Updated: 

Alogliptin/pioglitazone is a prescription medication used with diet and exercise to improve blood sugar (glucose) control in adults with type 2 diabetes. It is a combination of two prescription medications, alogliptin and pioglitazone. Alogliptin belongs to a group of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors. It works by stopping the DPP-4 enzyme from removing a hormone that is responsible for telling your body to release insulin after you eat. This allows insulin to be released, which lowers blood sugar. Pioglitazone belongs to a group of drugs called thiazolidinediones. It lowers blood sugar by helping your body use its natural insulin better.

Alogliptin/pioglitazone comes in tablet form and is usually taken once daily, with or without food. Do not break or cut alogliptin/pioglitazone tablets before swallowing.

Some of the common side effects of alogliptin/pioglitazone include stuffy or runny nose and sore throat, back pain, and cold-like symptoms.

 

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Alogliptin & Pioglitazone Cautionary Labels

precautionsprecautionsprecautions

Uses of Alogliptin & Pioglitazone

Alogliptin/pioglitazone is a prescription medication used with diet and exercise to improve blood sugar (glucose) control in adults with type 2 diabetes.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Alogliptin & Pioglitazone Brand Names

Alogliptin & Pioglitazone may be found in some form under the following brand names:

Alogliptin & Pioglitazone Drug Class

Alogliptin & Pioglitazone is part of the drug class:

Side Effects of Alogliptin & Pioglitazone

Alogliptin/pioglitazone can cause other serious side effects. See "Alogliptin & Pioglitazone Precautions."

The most common side effects of alogliptin/pioglitazone include:

  • cold-like symptoms (upper respiratory tract infection)
  • stuffy or runny nose and sore throat
  • diarrhea
  • increase in blood pressure
  • headache
  • back pain
  • urinary tract infection
 
Alogliptin/pioglitazone may cause low blood sugar (hypoglycemia)If you take alogliptin/pioglitazone with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin, your risk of getting low blood sugar is higher. The dose of your sulfonylurea medicine or insulin may need to be lowered while you take alogliptin/pioglitazone. If you have symptoms of low blood sugar, you should check your blood sugar and treat if low, and then call your doctor. Signs and symptoms of low blood sugar may include:
  • shaking or feeling jittery
  • sweating
  • fast heartbeat
  • change in vision
  • hunger
  • headache
  • change in mood
  • confusion
  • dizziness

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of alogliptin/pioglitazone. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

 

Alogliptin & Pioglitazone Interactions

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • atorvastatin (Lipitor)
  • gemfibrozil (Lopid)
  • hormonal contraceptives (birth control pills, patches, rings, implants, and injections)
  • insulin or other medications to treat diabetes
  • ketoconazole (Nizoral)
  • midazolam (Versed)
  • nifedipine (Procardia)
  • rifampin (Rifadin, Rifater, in Rifamate)

This is not a complete list of alogliptin/pioglitazone drug interactions. Ask your doctor or pharmacist for more information.

Alogliptin & Pioglitazone Precautions

Alogliptin/pioglitazone can cause serious side effects, including:

1. New or worse heart failure: Pioglitazone, one of the medicines in this medication, can cause your body to keep extra fluid (fluid retention), which leads to swelling (edema) and weight gain. Extra body fluid can make some heart problems worse or lead to heart failure. Heart failure
means your heart does not pump blood well enough.
  • Do not take alogliptin/pioglitazone if you have severe heart failure.
  • If you have heart failure with symptoms (such as shortness of breath or swelling), even if these symptoms are not severe, alogliptin/pioglitazone may not be right for you. 

​Call your doctor right away if you have any of the following:

  • swelling or fluid retention, especially in the ankles or legs
  • shortness of breath or trouble breathing, especially when you lie down
  • an unusually fast increase in weight
  • unusual tiredness

2. Inflammation of the pancreas (pancreatitis). Alogliptin, one of the medicines in alogliptin/pioglitazone, may cause pancreatitis which may be severe. Certain medical conditions make you more likely to get pancreatitis.

Before you start taking alogliptin/pioglitazone tell your doctor if you have ever had:
  • pancreatitis
  • stones in your gallbladder (gallstones)
  • a history of alcoholism
  • kidney problems
  • liver problems

Stop taking alogliptin/pioglitazone and call your doctor right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis.

3. Liver problems. Call your doctor right away if you have symptoms, such as:

  • nausea or vomiting
  • stomach pain
  • unusual or unexplained tiredness
  • loss of appetite
  • dark urine
  • yellowing of your skin or the whites of your eyes

4. Broken bones (fractures). Usually in the hand, upper arm, or foot in women. Talk to your doctor for advice on how to keep your bones healthy.

5. Bladder cancer. There may be an increased chance of having bladder cancer when you take alogliptin/pioglitazone. You should not take alogliptin/pioglitazone if you are receiving treatment for bladder cancer. Tell your doctor right away if you have any of the following symptoms of bladder cancer:

  • blood or a red color in your urine
  • an increased need to urinate
  • pain while you urinate
6. Low blood sugar (hypoglycemia). If you take alogliptin/pioglitazone with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin, your risk of getting low blood sugar is higher. The dose of your sulfonylurea medicine or insulin may need to be lowered while you take alogliptin/pioglitazone. If you have symptoms of low blood sugar, you should check your blood sugar and treat if low, and then call your doctor. Signs and symptoms of low blood sugar may include:

  • shaking or feeling jittery
  • sweating
  • fast heartbeat
  • change in vision
  • hunger
  • headache
  • change in mood
  • confusion
  • dizziness

7. Diabetic eye disease with swelling in the back of the eye (macular edema). Tell your doctor right away if you have any changes in your vision. Your doctor should check your eyes regularly.

8. Release of an egg from an ovary in a woman (ovulation) leading to pregnancy. Ovulation may happen when premenopausal women who do not have regular monthly periods take alogliptin/pioglitazone. This can increase your chance of getting pregnant.

9. Severe and persistent joint pain. If you experience severe and persistent joint pain, contact your doctor right away. Do not stop taking your medication. Your doctor will decide if your medication is the possible cause of severe  joint pain and will discontinue the drug if appropriate.
 
Do not take alogliptin/pioglitazone if you:
  • have severe heart failure
  • are allergic to alogliptin, pioglitazone or any ingredient in alogliptin/pioglitazone or have had a serious allergic (hypersensitivity) reaction to alogliptin or pioglitazone. 

​Symptoms of a serious allergic reaction to alogliptin/pioglitazone may include:

  • swelling of your face, lips, throat, and other areas on your skin
  • difficulty with swallowing or breathing
  • raised, red areas on your skin (hives)
  • skin rash, itching, flaking or peeling

If you have these symptoms, stop taking alogliptin/pioglitazone and contact your doctor or go to the nearest hospital emergency room right away.

 

Alogliptin & Pioglitazone Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of this medication, there are no specific foods that you must exclude from your diet when receiving alogliptin/pioglitazone.

 

 

Inform MD

Before receiving alogliptin/pioglitazone, tell your doctor if you:

  • have heart failure
  • have a type of diabetic eye disease that causes swelling of the back of the eye (macular edema)
  • have kidney or liver problems
  • have or have had inflammation of the pancreas (pancreatitis)
  • have or have had cancer of the bladder
  • have other medical conditions
  • are pregnant or plan to become pregnant. It is not known if alogliptin/pioglitazone can harm your unborn baby. Talk to your doctor about the best way to control your blood sugar while you are pregnant or if you plan to become pregnant.
  • are a premenopausal woman, who does not have periods regularly or at all. Alogliptin/pioglitazone may increase your chance of becoming pregnant. Talk to your doctor about birth control choices while taking alogliptin/pioglitazone. Tell your doctor right away if you become pregnant while taking alogliptin/pioglitazone.
  • are breastfeeding or plan to breastfeed. It is not known whether alogliptin/pioglitazone passes into your breast milk and if it can harm your baby. You should not take alogliptin/pioglitazone if you breastfeed your baby. Talk with your doctor about the best way to feed your baby if you are taking alogliptin/pioglitazone.

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Alogliptin & Pioglitazone and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Alogliptin & Pioglitazone and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known whether alogliptin/pioglitazone passes into your breast milk and if it can harm your baby. You should not take alogliptin/pioglitazone if you breastfeed your baby. Talk with your doctor about the best way to feed your baby if you are taking alogliptin/pioglitazone.

Alogliptin & Pioglitazone Usage

  • Take alogliptin/pioglitazone exactly as your doctor tells you to take it.
  • Take alogliptin/pioglitazone 1 time each day with or without food.
  • Do not break or cut alogliptin/pioglitazone tablets before swallowing.
  • Your doctor may need to change your dose of alogliptin/pioglitazone to control your blood glucose. Do not change your dose unless told to do so by your doctor.
  • If you miss a dose, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose, and take the next dose at your regular time. Do not take 2 doses of alogliptin/pioglitazone at the same time.
  • If you take too much alogliptin/pioglitazone, call your doctor or go to the nearest hospital emergency room right away.
  • If your body is under stress, such as from fever, infection, accident, or surgery, the dose of your diabetes medicines may need to be changed. Call your doctor right away.
  • Stay on your diet and exercise programs and check your blood sugar as your doctor tells you to.
  • Your doctor may do certain blood tests before you start alogliptin/pioglitazone and during treatment as needed. Your doctor may change your dose of alogliptin/pioglitazone based on the results of your blood tests due to how well your kidneys are working.
  • Your doctor will check your diabetes with regular blood tests, including your blood sugar levels and your hemoglobin A1C.
  • Your doctor should check your eyes regularly while you take alogliptin/pioglitazone.

Alogliptin & Pioglitazone Dosage

The alogliptin/pioglitazone dose your doctor recommends will depend on several factors including:

  • the medications you are currently taking
  • other medical conditions you have
  • how well alogliptin/pioglitazone works for you
  • how well you tolerate the medication (side effects)

The maximum recommended daily dose is 25 mg alogliptin and 45 mg pioglitazone.

Alogliptin & Pioglitazone Overdose

If you take too much alogliptin/pioglitazone, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

Other Requirements

  • Store alogliptin/pioglitazone at room temperature between 68°F to 77°F (20°C to 25°C).
  • Keep container tightly closed and protect from moisture and humidity.
  • Keep alogliptin/pioglitazone and all medicines out of the reach of children.

Alogliptin & Pioglitazone FDA Warning

WARNING: CONGESTIVE HEART FAILURE

  • Thiazolidinediones, including pioglitazone, which is a component of alogliptin/pioglitazone, cause or exacerbate congestive heart failure in some patients.
  • After initiation of alogliptin/pioglitazone, and after dose increases, monitor patients carefully for signs and symptoms of heart failure (e.g., excessive, rapid weight gain, dyspnea, and/or edema). If heart failure develops, it should be managed according to current standards of care and discontinuation or dose reduction of pioglitazone in alogliptin/pioglitazone must be considered.
  • Alogliptin/pioglitazone is not recommended in patients with symptomatic heart failure.
  • Initiation of alogliptin/pioglitazone in patients with established New York Heart Association (NYHA) Class III or IV heart failure is contraindicated.
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