Introduction
Vildagliptin is an oral antidiabetic medication used to manage type 2 diabetes mellitus. It belongs to the class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors. It helps to regulate blood sugar levels by enhancing the body's natural ability to lower blood glucose.
Uses
Vildagliptin is primarily used for:
- Managing blood glucose levels in adults with type 2 diabetes mellitus.
- It is often used in combination with other antidiabetic agents, including metformin, sulfonylureas, or thiazolidinediones, when diet and exercise alone are insufficient.
| Brand Name | Vildagliptin |
|---|---|
| Type | |
| Weight | |
| Generic | Vildagliptin |
| Manufacturer | |
| Available in | English বাংলা |
Mechanism of Action
Vildagliptin works by inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4). This enzyme breaks down incretin hormones, such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). By inhibiting DPP-4, Vildagliptin increases the levels of these incretin hormones, which enhances insulin secretion from the pancreas and decreases glucagon levels, leading to improved blood glucose control.
How Long Does It Take to Work?
The effects of Vildagliptin can be observed within a few weeks of starting treatment. Optimal blood glucose control is generally achieved within 1 to 2 months of consistent use. The time to see significant improvements in glycemic control can vary depending on individual patient factors and the presence of other antidiabetic medications.
Absorption
Vildagliptin is rapidly absorbed after oral administration. Peak plasma concentrations are reached approximately 1 to 2 hours post-ingestion. The bioavailability of Vildagliptin is around 85%, meaning that a significant proportion of the administered dose is available for therapeutic effect.
Route of Elimination
Vildagliptin is primarily eliminated through the kidneys. Approximately 70% of the dose is excreted unchanged in the urine. A small proportion is metabolized in the liver and subsequently excreted in the urine.
Dosage
The recommended dose of Vildagliptin is-- 50 mg or 100 mg daily for monotherapy.
- 50 mg twice daily (morning and evening) when used in dual combination with Metformin or a Thiazolidinedione;
- 50 mg once daily in the morning when used in dual combination with a Sulphonylurea.
Pediatric use: Vildagliptin is not recommended in patients 18 years of age.
The typical starting dose of Vildagliptin is 50 mg taken orally once or twice daily. Depending on the patient's response and tolerance, the dose may be adjusted. The maximum recommended dose is 100 mg per day, usually divided into two doses. Dosage adjustments are required for patients with renal impairment.
Administration
Vildagliptin should be taken orally, with or without food. It is usually prescribed as a part of a comprehensive diabetes management plan, including lifestyle modifications such as diet and exercise. Consistent daily administration is necessary for optimal glycemic control.
Side Effects
Common side effects of Vildagliptin include:
- Headache
- Dizziness
- Nausea
- Upper respiratory tract infections
Less common but serious side effects can include:
- Hypoglycemia, particularly when used in combination with other antidiabetic agents.
- Pancreatitis, which may present with severe abdominal pain.
Toxicity
Overdose of Vildagliptin is rare but may lead to severe hypoglycemia if used with other hypoglycemic agents. Symptoms of hypoglycemia include sweating, shaking, confusion, and dizziness. In cases of overdose, supportive care and monitoring of blood glucose levels are recommended.
Precautions
Precautions include:
- Monitoring blood glucose levels regularly to avoid hypoglycemia.
- Assessing renal function before initiating therapy and periodically thereafter, as dose adjustments may be required for patients with renal impairment.
- Monitoring for signs of pancreatitis, particularly if symptoms such as severe abdominal pain occur.
Interaction
Vildagliptin may interact with other medications, including:
- Insulin and sulfonylureas, which can increase the risk of hypoglycemia.
- Other medications that affect renal function, which may alter Vildagliptin clearance.
Disease Interaction
Vildagliptin should be used with caution in patients with:
- Renal impairment, requiring dose adjustments.
- Pancreatic disorders, as there is a risk of pancreatitis.
Drug Interaction
Potential drug interactions include:
- Drugs that affect renal function, such as diuretics or ACE inhibitors, which may require dose adjustments of Vildagliptin .
- Antidiabetic drugs that can potentiate the risk of hypoglycemia when used in combination with Vildagliptin .
Food Interactions
There are no specific food interactions with Vildagliptin . It can be taken with or without food. However, maintaining a balanced diet and consistent carbohydrate intake is important for managing blood glucose levels effectively.
Pregnancy Use
The safety of Vildagliptin during pregnancy has not been well established. It should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Alternative antidiabetic treatments may be preferred during pregnancy.
Lactation Use
It is not known whether Vildagliptin is excreted in breast milk. Caution should be exercised when using Vildagliptin in lactating women, and a decision should be made whether to discontinue the drug or discontinue breastfeeding based on the drug's importance to the mother.
Acute Overdose
In case of acute overdose, hypoglycemia is a major concern. Symptoms may include confusion, dizziness, and sweating. Immediate treatment with glucose or glucagon may be required, and medical attention should be sought to manage symptoms and ensure safety.
Contraindication
Vildagliptin is contraindicated in patients with:
- Severe renal impairment or end-stage renal disease.
- Hypersensitivity to Vildagliptin or any component of the formulation.
Use Direction
Take Vildagliptin exactly as prescribed by your healthcare provider. Do not alter the dose without consulting your healthcare provider. Regular monitoring of blood glucose levels and renal function is essential during treatment.
Storage Conditions
Store Vildagliptin at room temperature, between 15°C and 30°C (59°F and 86°F). Keep the medication in its original container, tightly closed, and out of reach of children. Avoid exposure to moisture and excessive heat.
Volume of Distribution
The volume of distribution of Vildagliptin is approximately 71 liters, indicating that it is widely distributed in the body tissues.
Half Life
The elimination half-life of Vildagliptin is approximately 2.5 hours. This relatively short half-life supports the need for regular dosing to maintain therapeutic levels.
Clearance
Vildagliptin is primarily cleared through the kidneys. The clearance rate is influenced by renal function, with adjustments needed for patients with impaired renal function to prevent accumulation and potential adverse effects.
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