A dipeptidyl peptidase-4 (DPP-4) inhibitor.

Trade name Nesina.

Includes drugs oksitagliptin, saxagliptin, alogliptin , and Linagliptin.

Inhibits inactivation of incretins.

DDP4 inhibitors increase and prolong incretin activity and increase insulin biosynthesis secretion.

Indicated as an adjunct diet and excise to improve glycemic control in patients with type two diabetes.

Not indicated for type one diabetes or for diabetic ketoacidosis.

Evaluated as monotherapy and in combination with other antidiabetic oral agents and insulin.

Has been associated with acute pancreatitis, and hepatic failure.

As with the other DPP-4 inhibitors does not cause hypoglycemia.

Adverse reactions include nasopharyngitis, headache, and upper respiratory tract infection.

EXAMINE trial studied alogliptin plus metformin and sulfonylurea and showed significant improvement when the third drug was added.

In the above study, triple therapy had lower rates of mortality.

Dosage recommended 25 mg once a day.

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