Alogliptin and Pioglitazone

Alogliptin and Pioglitazone Brand Name– Oseni

What is Alogliptin and Pioglitazone

Alogliptin and pioglitazone is a combination product containing 2 oral antidiabetic agents.

Alogliptin is a dipeptidyl-peptidase-4 (DPP-4) inhibitor and pioglitazone is a thiazolidinedione (TZD) antidiabetic agent.

The combination is used to improve glycemic control in adults with type 2 diabetes mellitus (DM). Alogliptin; pioglitazone lowers hemoglobin A1C by an estimated 0.4% to 0.9% over monotherapy with either agent alone based on clinical trials.

Metformin is first-line in the treatment of type 2 DM. In patients with established cardiovascular (CV) disease, heart failure (HF), or chronic kidney disease (CKD), a sodium-glucose co-transporter 2 (SGLT2) inhibitor or GLP-1 receptor agonist (GLP-1 RA) with proven CV benefit and reduction of CKD progression is recommended for add-on therapy, independent of baseline A1C or individualized A1C target.

In patients without indicators of high-risk or established CVD, HF, or CKD, DPP-4 inhibitors are a therapeutic option which are generally well tolerated, have a neutral effect on weight, and have minimal risk of hypoglycemia when used as monotherapy.

TZDs, like pioglitazone, are associated with glycemic durability; however, the benefits must be balanced with the risk of adverse effects such as heart failure, edema, decreased bone mineral density, and weight gain.

Indications

  • type 2 diabetes mellitus

For the treatment of type 2 diabetes mellitus in combination with diet and exercise

Side Effects

  1. anaphylactoid reactions
  2. angioedema
  3. arthralgia
  4. back pain
  5. blurred vision
  6. bone fractures
  7. bullous rash
  8. dyspnea
  9. edema
  10. elevated hepatic enzymes
  11. fluid retention
  12. headache
  13. heart failure
  14. hepatic failure
  15. hypoglycemia
  16. infection
  17. influenza
  18. macular edema
  19. menstrual irregularity
  20. myalgia
  21. new primary malignancy
  22. osteopenia
  23. pancreatitis
  24. pemphigus
  25. peripheral edema
  26. pharyngitis
  27. rash
  28. renal failure (unspecified)
  29. rhabdomyolysis
  30. serum sickness
  31. sinusitis
  32. Stevens-Johnson syndrome
  33. urticaria
  34. visual impairment
  35. weight gain

Monitoring Parameters

  • blood glucose
  • glycosylated hemoglobin A1c (HbA1c)
  • LFTs
  • serum bilirubin
  • serum creatinine/BUN
  • weight

Contraindications

  • acute heart failure
  • anemia
  • arthralgia
  • bladder cancer
  • bone fractures
  • breast-feeding
  • burns
  • cardiac disease
  • children
  • contraception requirements
  • diabetic ketoacidosis
  • edema
  • exfoliative dermatitis
  • fever
  • geriatric
  • heart failure
  • hepatic disease
  • history of angioedema
  • hypoglycemia
  • infection
  • menstrual irregularity
  • new primary malignancy
  • osteoporosis
  • pancreatitis
  • peripheral edema
  • polycystic ovary syndrome
  • pregnancy
  • pulmonary edema
  • renal disease
  • renal failure
  • renal impairment
  • serious rash
  • surgery
  • trauma
  • type 1 diabetes mellitus

Interactions

  • Abiraterone
  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetazolamide
  • Acrivastine; Pseudoephedrine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Amprenavir
  • Androgens
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Aripiprazole
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atorvastatin
  • Atorvastatin; Ezetimibe
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • atypical antipsychotic
  • Azelastine; Fluticasone
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Beclomethasone
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzphetamine
  • Beta-blockers
  • Betamethasone
  • Betaxolol
  • Bexarotene
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bortezomib
  • Brexpiprazole
  • Brimonidine; Timolol
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Budesonide
  • Budesonide; Formoterol
  • Bumetanide
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Cannabidiol
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Cariprazine
  • Carteolol
  • Carvedilol
  • Cetirizine; Pseudoephedrine
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  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloroquine
  • Chlorothiazide
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Choline Salicylate; Magnesium Salicylate
  • Chromium
  • Ciclesonide
  • Clarithromycin
  • Clonidine
  • Clopidogrel
  • Clozapine
  • Cobimetinib
  • Codeine; Phenylephrine; Promethazine
  • Conjugated Estrogens
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  • Corticosteroids
  • Corticotropin, ACTH
  • Cortisone
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  • Deflazacort
  • Desloratadine; Pseudoephedrine
  • Dexamethasone
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Diazoxide
  • Dienogest; Estradiol valerate
  • Diethylpropion
  • Diethylstilbestrol, DES
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Disopyramide
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  • Dopamine
  • Dorzolamide; Timolol
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Ephedrine
  • Epinephrine
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Erythromycin; Sulfisoxazole
  • Esmolol
  • Esterified Estrogens
  • Esterified Estrogens; Methyltestosterone
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estramustine
  • Estrogens
  • Estropipate
  • Ethacrynic Acid
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethotoin
  • Etonogestrel
  • Fenofibrate
  • Fenofibric Acid
  • Fexofenadine
  • Fexofenadine; Pseudoephedrine
  • Fibric acid derivatives
  • Fludrocortisone
  • Flunisolide
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluoxymesterone
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Fosamprenavir
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Furosemide
  • Garlic, Allium sativum
  • Gemfibrozil
  • Glecaprevir; Pibrentasvir
  • Green Tea
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Hydantoins
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydrocortisone
  • Hydroxychloroquine
  • Hydroxyprogesterone
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Pseudoephedrine
  • Iloperidone
  • Indapamide
  • Indinavir
  • Insulins
  • Irbesartan
  • Isocarboxazid
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isoproterenol
  • Itraconazole
  • Ketoconazole
  • Labetalol
  • Lanreotide
  • Ledipasvir; Sofosbuvir
  • Leflunomide
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  • Leuprolide; Norethindrone
  • Levobetaxolol
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  • Levonorgestrel
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Linezolid
  • Liothyronine
  • Lisdexamfetamine
  • Lisinopril
  • Lithium
  • Lomefloxacin
  • Lopinavir; Ritonavir
  • Loratadine; Pseudoephedrine
  • Lorcaserin
  • Losartan
  • Lovastatin; Niacin
  • Lumateperone
  • Lurasidone
  • Magnesium Salicylate
  • Mecasermin rinfabate
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  • Medroxyprogesterone
  • Mepivacaine; Levonordefrin
  • Mestranol; Norethindrone
  • Methamphetamine
  • Methazolamide
  • Methyclothiazide
  • Methylphenidate
  • Methylprednisolone
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  • Metolazone
  • Metoprolol
  • Metyrapone
  • Midazolam
  • Midodrine
  • Moexipril
  • Mometasone
  • Monoamine oxidase inhibitors
  • Nadolol
  • Nandrolone Decanoate
  • Naproxen; Pseudoephedrine
  • Nebivolol
  • Nebivolol; Valsartan
  • Nelfinavir
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nicotine
  • Nifedipine
  • Norepinephrine
  • Norethindrone
  • Norgestrel
  • Octreotide
  • Olanzapine
  • Olmesartan
  • Ombitasvir; Paritaprevir; Ritonavir
  • Orlistat
  • Oxandrolone
  • Oxymetholone
  • Paliperidone
  • Pasireotide
  • Pegvisomant
  • Pemoline
  • Penbutolol
  • Pentamidine
  • Pentoxifylline
  • Perindopril
  • Perindopril; Amlodipine
  • Phendimetrazine
  • Phenelzine
  • Phenobarbital
  • Phenothiazines
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pindolol
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Prednisolone
  • Prednisone
  • Pregabalin
  • Prilocaine; Epinephrine
  • Progesterone
  • Progestins
  • Propoxyphene
  • Propranolol
  • Protease inhibitors
  • Pseudoephedrine
  • Pyrimethamine; Sulfadoxine
  • Quetiapine
  • Quinapril
  • Quinolones
  • Racepinephrine
  • Ramipril
  • Ranitidine
  • Reserpine
  • Rifampin
  • Risperidone
  • Ritodrine
  • Ritonavir
  • Sacubitril; Valsartan
  • Salicylates
  • Salsalate
  • Saquinavir
  • Segesterone Acetate; Ethinyl Estradiol
  • Selegiline
  • Sofosbuvir
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Somatropin, rh-GH
  • Sotalol
  • Sparfloxacin
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Sympathomimetics
  • Tacrolimus
  • Tegaserod
  • Telmisartan
  • Teriflunomide
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  • Thyroid hormones
  • Timolol
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  • tobacco
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  • Torsemide
  • Trandolapril
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  • Tranylcypromine
  • Triamcinolone
  • Triamterene
  • Trimethoprim
  • Trovafloxacin, Alatrofloxacin
  • Valsartan
  • Zafirlukast
  • Ziprasidone
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