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).

Drug Facts

Generic Name: Alogliptin

Brand Name(s): Nesina

Drug Availability: Prescription

Therapeutic Classification: Hypoglycemic

Available Generically: No

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Alogliptin benzoate

Dosage Form(s): Tablet

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.


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.

How Long Does Nesina Take to Work?

Nesina begins to work within two to three hours after you take a dose. It may take two to four weeks to see an improvement in your blood sugar readings.

Within three months, your healthcare provider may check your hemoglobin A1C (HbA1c) to monitor how well this medication is working for you. A1C is a blood test that measures your average blood sugar over a three-month period.

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 or 800-FDA-1088.

Common Side Effects

Common side effects associated with the use of Nesina include:

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.

Report Side Effects

Nesina may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Nesina Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For type 2 diabetes:
      • Adults—25 milligrams (mg) once a day.
      • Children—Use and dose must be determined by your doctor.


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.

What Happens If I Overdose on Nesina?

If you think you or someone else may have overdosed on Nesina, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking alogliptin, call 911 immediately.


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It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

This medicine may cause serious allergic reactions, including anaphylaxis, angioedema, or certain skin conditions (eg, Stevens-Johnson syndrome), which can be life-threatening and require immediate medical attention. Call your doctor right away if you have blistering, peeling, or loosening of the skin, chest tightness, chills, cough, diarrhea, difficulty swallowing, dizziness, fast heartbeat, hives, itching, skin rash, joint or muscle pain, large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness while you are using this medicine.

Pancreatitis (swelling and inflammation of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have a sudden and severe stomach pain, chills, constipation, nausea, vomiting, loss of appetite, fever, or lightheadedness.

Check with your doctor right away if you have chest pain or tightness, decreased urine output, dilated neck veins, extreme fatigue, irregular breathing, irregular heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain. These may be signs of heart failure.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). . People feel different symptoms of low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Some symptoms of low blood sugar include: behavior changes that are similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, a fast heartbeat, headaches that continue, nausea, shakiness, slurred speech, or unusual tiredness or weakness. Talk to your doctor about how to treat low blood sugar..

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar.

It is very important to carefully follow any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about the changes in the dosing of their diabetes medicine that might occur with lifestyle changes, such as changes in exercise or diet. Furthermore, counseling on contraception and pregnancy may be needed, because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
  • In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and that lists all of your medicines.

This medicine may cause severe and disabling joint pain. Call your doctor right away if you have severe joint pain while using this medicine.

This medicine may cause bullous pemphigoid. Tell your doctor right away if you have large, hard skin blisters while you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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:

Alogliptin is also available in the following combination drugs:

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

Frequently Asked Questions

  • What is the best time of day to take alogliptin?

    There is no best time of day to take Nesina, but it’s better to take it around the same time each day.

  • Is joint pain a side effect of Nesina, and does this side effect go away?

    Severe and disabling joint pain has been reported in people who took Nesina.

    Tell your healthcare provider if you have new or unusual joint pain while taking Nesina. They will most likely have you stop taking the medication. Based on previous cases, joint pain should go away in less than a month after stopping alogliptin.

  • Is it safe to take alogliptin with metformin?

    Yes. Healthcare providers commonly prescribe more than one diabetes medication, such as Nesina and Glucophage (metformin).

    These medications work in different ways to lower blood sugar. If your healthcare provider prescribes both Nesina and metformin to you, they can be safely taken at the same time. Be sure to follow your prescriber’s directions for each medication.

  • Are there any foods to avoid while taking alogliptin?

    No foods are known to interact with alogliptin. However, alogliptin is intended to be taken along with regular exercise and a healthy diet. If you are not sure what foods to choose, consider trying a low-carbohydrate diet or consult a licensed dietician.

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.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Patricia Weiser, PharmD
Patricia Weiser, PharmD, is a licensed pharmacist and freelance medical writer. She has more than 14 years of professional experience.