Home Drug Guide Alogliptin benzoate and Metformin hydrochloride

Drug Guide

Generic Name

Alogliptin benzoate and Metformin hydrochloride

Brand Names Kazano

Classification

Therapeutic: antidiabetic, combination oral hypoglycemic

Pharmacological: Dipeptidyl peptidase-4 (DPP-4) inhibitor and Biguanide

FDA Approved Indications

  • Management of type 2 diabetes mellitus as an adjunct to diet and exercise

Mechanism of Action

Alogliptin inhibits DPP-4 enzyme, increasing incretin levels which stimulate insulin release and decrease glucagon levels; Metformin reduces hepatic glucose production, decrease intestinal absorption of glucose, and improves insulin sensitivity.

Dosage and Administration

Adult: Typically, 25 mg alogliptin and 1000 mg metformin once daily, adjusted based on glycemic response and tolerability.

Pediatric: Not approved for use in pediatric patients.

Geriatric: Use with caution; start at lower doses due to potential renal impairment and comorbidities.

Renal Impairment: Adjust dosage based on renal function; contraindicated if eGFR <30 mL/min/1.73 m².

Hepatic Impairment: Use with caution; contraindicated in severe hepatic impairment.

Pharmacokinetics

Absorption: Alogliptin absorbed with moderate bioavailability; Metformin absorbed slowly from the gastrointestinal tract.

Distribution: Alogliptin protein binding approximately 20%; Metformin minimal protein binding.

Metabolism: Alogliptin undergoes minimal metabolism; Metformin is not metabolized.

Excretion: Primarily renal excretion for both components.

Half Life: Alogliptin approximately 12 hours; Metformin about 5 hours.

Contraindications

  • Severe renal impairment (eGFR <30 mL/min/1.73 m²)
  • History of hypersensitivity to components

Precautions

  • Renal function monitoring; risk of lactic acidosis with metformin; pancreatitis with alogliptin

Adverse Reactions - Common

  • nasopharyngitis (common)
  • headache (common)
  • hypoglycemia (when used with insulin or sulfonylureas) (less common)

Adverse Reactions - Serious

  • acute pancreatitis (rare)
  • lactic acidosis (due to metformin accumulation) (rare)

Drug-Drug Interactions

  • Other antidiabetic drugs increasing hypoglycemia risk
  • Cationic drugs affecting renal clearance

Drug-Food Interactions

  • Alcohol may increase risk of lactic acidosis

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels, renal function, and signs of hypoglycemia and lactic acidosis.

Diagnoses:

  • Risk for hypoglycemia
  • Impaired renal function

Implementation: Administer with meals to reduce GI side effects; monitor labs regularly.

Evaluation: Assess glycemic control and renal parameters periodically.

Patient/Family Teaching

  • Take medication as directed, preferably with meals.
  • Recognize symptoms of hypoglycemia and lactic acidosis.
  • Maintain hydration and regular medical follow-up.

Special Considerations

Black Box Warnings:

  • Lactic acidosis, especially in renal impairment or conditions predisposing to hypoxia

Genetic Factors: Genetic variations affecting drug metabolism are not well-established.

Lab Test Interference: None reported.

Overdose Management

Signs/Symptoms: Lactic acidosis, hypoglycemia (if combined with other agents)

Treatment: Discontinue medication; provide supportive care; consider hemodialysis for severe metformin overdose.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable for the shelf life listed in the package insert.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.