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Nesina (alogliptin) is a DPP-4 inhibitor. It blocks the enzyme dipeptidyl peptidase-4, which allows incretin hormones like GLP-1 to remain active longer. This stimulates the pancreas to release more insulin after meals and signals the liver to produce less glucagon, resulting in lower blood sugar levels.

Nesina is not indicated for people with type 1 diabetes or diabetic ketoacidosis. It should be used with caution in people with severe kidney disease, and the dose must be adjusted for moderate or severe kidney impairment. People with a history of serious hypersensitivity reactions to alogliptin or a history of pancreatitis should discuss risks with their physician before starting.

The standard adult dose is 25 mg taken once daily, with or without food. For patients with moderate kidney impairment the dose is reduced to 12.5 mg once daily, and for severe kidney impairment or end-stage renal disease it is reduced to 6.25 mg once daily. Your physician will determine the appropriate dose based on your kidney function.

When used alone, Nesina has a low risk of causing hypoglycemia because it works in a glucose-dependent manner. However, if it is combined with insulin or a sulfonylurea, the risk of low blood sugar increases. Your physician will review your full medication list to assess your individual risk.

Common side effects include nasopharyngitis (runny or stuffy nose), headache, and upper respiratory tract infections. Serious but less common risks include pancreatitis, severe joint pain, heart failure (particularly in people with existing cardiac risk), and rare severe allergic reactions. Contact your physician if you experience persistent abdominal pain, unusual joint pain, or signs of an allergic reaction.

Yes. Nesina is often prescribed alongside metformin, thiazolidinediones, sulfonylureas, or insulin. Your physician will review potential interactions and adjust doses as needed. Combination tablets such as Kazano (alogliptin-metformin) and Oseni (alogliptin-pioglitazone) are available for patients who qualify for a two-in-one option.

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