Nesina (Alogliptin) - Oral

What Is Nesina?

Nesina (alogliptin) is an orally administered prescription drug used to improve glycemic control (blood sugar levels) in adults with type 2 diabetes mellitus that is taken alongside a healthy diet and regular exercise. Nesina comes as an oral tablet and contains alogliptin, its active ingredient.

Specifically, Nesina is classified as a diabetes medication that works to reduce blood sugar levels. It belongs to a class of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors, also known as “gliptins.”

Like other DPP-4 inhibitors, alogliptin works in two main ways to manage your blood sugar levels:

• Nesina stimulates your pancreas to release more insulin. Insulin is a hormone that signals your body to move sugar out of your blood and into your cells. Higher insulin levels lead to lower blood sugar. 
• Nesina reduces the amount of glucagon in your body. Glucagon is a hormone that tells your liver to release stored sugar into your blood. Lower glucagon levels also lead to lower blood sugar.

While not available as a generic product, Nesina as a brand-name product is available in the form of orally administered tablets (taken by mouth).

What Is Nesina Used For?

The Food and Drug Administration (FDA) approved Nesina to improve blood sugar levels in adults 18 and older with type 2 diabetes mellitus to be taken alongside a healthy diet and regular exercise.

Type 2 diabetes is a condition where a person's blood sugar levels become too high because the body fails to produce or use insulin normally.

As a chronic (long-term) condition, type 2 diabetes results in excessive amounts of sugar circulating in the bloodstream. As a result, high blood sugar levels can lead to nervous, circulatory, and immune system disorders. This condition is caused and often worsened by family genetics, poor diet, and lack of exercise.

Notably, Nesina is not for use in people with type 1 diabetes (a condition where the pancreas makes little to no insulin). Because Nesina works by stimulating the pancreas to release more insulin, it would not be effective in people with type 1 diabetes.

How to Take Nesina

Follow your healthcare provider’s instructions on how to take Nesina. The typical dosage is one tablet taken once daily, with or without food. Swallow the tablet whole. Do not chew, crush, or freeze the tablets.

During your treatment with this medication, follow your healthcare provider’s advice on how and when to monitor your blood sugar. They will also recommend diet changes and exercise routines to help keep your blood sugar levels within a healthy range.

Storage

Store Nesina at room temperature in a sealed container. Be sure to keep out of reach of children and pets. Additionally, avoid storing in places susceptible to high levels of moisture, such as a bathroom.

What Are the Side Effects of Nesina?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects associated with the use of Nesina include:

• Cold-like symptoms, such as sore throat and runny or stuffy nose
• Headache
• Upper respiratory infection (URI; an infection that impacts the nose, sinuses, and throat)
  

Severe Side Effects

Rarely, severe side effects have been reported with Nesina use. Nonetheless, users should monitor for the following side effects and their symptoms:

• Pancreatitis (inflammation of the pancreas): Upper abdominal pain, nausea, vomiting.
• Severe joint pain: Pain in one or more joints that does not go away
• Bullous pemphigoid, a rare skin reaction: Fluid-filled blisters or sores on your skin that may be itchy or painful
• Heart failure, particularly in people with recent heart problems: Fatigue, fluid retention, rapid weight gain, and shortness of breath
• Hypoglycemia (low blood sugar) in people taking certain other diabetes medications: Dizziness, nervousness, irritability, nausea, hunger, confusion.
• Liver problems: Pain in your abdomen, nausea, vomiting, itchiness, or jaundice (yellowish skin or eyes)
• Allergic reaction, or anaphylaxis: Rash, swelling around the lips, tongue, or face, and trouble breathing

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. 

Long-Term Side Effects

If you develop heart or liver failure while taking Nesina, these problems may affect your health for an extended period of time. 

Note, however, that these problems weren’t seen in clinical trials of this medication.

Instead, heart failure and liver problems, among other potential side effects, were reported in people after the drug was approved by the FDA. As a result, it is not known for certain if Nesina was the cause of these reports.

Dosage: How Much Nesina Should I Take?

Modifications

Users should be aware of the following before beginning Nesina:

Allergic reactions: Do not take Nesina if you are allergic to any of its ingredients, primarily alogliptin. If so, your healthcare provider may recommend alternative treatment options to address your type 2 diabetes.

Pregnancy: Discuss with your healthcare provider if you are currently pregnant or plan on becoming pregnant while taking Nesina.

Currently, there is insufficient data on Nesina use in pregnant people, and therefore information is inconclusive to determine a drug-associated risk for major birth defects or miscarriage. However, there are risks to the parent and fetus associated with poorly controlled diabetes in pregnancy.

Breastfeeding: There is little information on the presence of Nesina in human milk, the effects on the breastfed infant, or the effects on milk production. 

Therefore, the benefits of breastfeeding should be considered along with the parent's need for Nesina and any potential negative effects on the breastfed infant from Nesina.

Adults 65 and over: No overall differences in safety or effectiveness were observed between people 65 years and over and younger people. However, the greater sensitivity of some older individuals cannot be ruled out.

Children: The safety and effectiveness of Nesina in people under 18 have not been established.

Kidney problems: Your healthcare provider may recommend a lower dose of Nesina if you have certain health conditions, such as kidney disease.

Oral consumption: If you have trouble swallowing pills, ask your healthcare provider about a different treatment option. You should not cut or crush alogliptin tablets. Swallow the tablet whole.

Missed Dose

If you miss a dose of Nesina, take it as soon as you can. But if it is almost time for your next dose, skip the missed dose. Do not take two doses at the same time.

Overdose: What Happens If I Take Too Much Nesina?

You should not take more Nesina than your healthcare provider prescribes. If you or someone else may have taken too much of this medication, contact a healthcare provider or the Poison Control Center.

Precautions

What Are Reasons I Shouldn’t Take Nesina?

Potential users should be aware that the following may disqualify them from safely consuming Nesina:

Exfoliative dermatitis, history of angioedema, serious rash: Nesina is discouraged in people with hypersensitivity to alogliptin, such as anaphylaxis, urticaria (hives), angioedema (swelling under the skin as a result of blood vessel leakage), exfoliative dermatitis (severe skin inflammation that results in shedding), or other serious allergic skin conditions.

Hypercortisolism, hyperglycemia, hyperthyroidism: Conditions that predispose people to develop hyperglycemia may impact Nisina's effectiveness.

Hyperglycemia-related conditions include drug interactions, hormonal changes, fever, and uncontrolled hypercortisolism (Cushing's syndrome; a condition that occurs from exposure to high cortisol levels for an extended period of time). or hyperthyroidism (a condition where the thyroid gland doesn't release enough thyroid hormone).

As a result, frequent blood glucose monitoring may be necessary for these individuals.

Heart disease: The use of Nesina should be administered with caution in people who have a history of or who have increased risk factors for heart failure.

What Other Medications Interact With Nesina?

The combined use of Nesina with the following types of diabetes medications can increase the risk of hypoglycemia:

Sulfonylureas (oral diabetes medications), such as Amaryl (glimepiride), Glucotrol XL (glipizide), and Diabeta (glyburide).

Insulins, such as Humulin R (insulin human regular), Novolog, and Lantus (insulin glargine).

If your healthcare provider prescribes Nesina along with one of these medications, they may adjust your dosages. They may also have you monitor your blood sugar levels closely and watch for symptoms of hypoglycemia. 

Be sure to tell your healthcare provider about all of your current medications, including over-the-counter (OTC) medicines, herbs, and supplements, before starting alogliptin.

What Medications Are Similar?

Nesina contains the ingredient alogliptin and is classified as a DPP-4 inhibitor.

Other drugs in this class include:

• Januvia (sitagliptin)
• Onglyza (saxagliptin)
• Tradjenta (linagliptin)

Alogliptin is also available in the following combination drugs:

• Kazano (alogliptin and metformin)
• Oseni (alogliptin and pioglitazone)

Consult your healthcare provider or pharmacist if you have questions about alternatives to alogliptin.

How Can I Stay Healthy While Taking Nesina?

If you have type 2 diabetes, it is important to keep your blood sugar within a healthy range. Over time, high blood sugar can lead to serious health problems, such as heart disease, vision loss, nerve damage, and kidney failure.

Taking diabetes medications, following a healthy diet, and being physically active can help prevent complications of diabetes. These lifestyle choices may even help to stop diabetes from getting worse.

Weight loss can also help to lower blood sugar. Even a small amount of weight loss can help you get better control over your blood sugar levels and lower your risk of health problems like heart disease.