alogliptin
Brand names: Nesina
Alogliptin and Metformin HCl is a drug that helps lower blood sugar in adults with type 2 diabetes. It works along with diet and exercise.
Drug Pricing (NADAC)
Brand Price
$13.10/unit
Generic Price
$5.02/unit
Generic Savings
62%
Generic Available
Yes (0 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine is used to treat type 2 diabetes.
Common side effects
Upper respiratory tract infection, Common cold, Diarrhea
Key warnings
This medicine can cause a serious condition called lactic acidosis.
How It Works
Alogliptin helps your body release more insulin after you eat. Metformin helps your body use insulin better and lowers the amount of sugar your liver makes. Together, they help lower your blood sugar levels.
How to Take It
Take this medicine by mouth twice a day with food. Your doctor will decide the right dose for you. Do not split the tablets. Follow your doctor's instructions carefully and do not take more than the recommended dose.
Pregnancy & Breastfeeding
Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if this medicine will harm your unborn baby. Discuss the risks and benefits with your doctor. Also, tell your doctor if you are breastfeeding.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store this medicine at room temperature (between 59°F and 86°F) in a tightly closed container.
Side Effects (from patient reports)
Based on 1,007 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 3,393 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2011–2025.
Total Reports
3,393
Death-Related Reports
356
Hospitalization Reports
1,564
Top Indication
Type 2 Diabetes Mellitus
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DIARRHOEA | 134 |
| 2 | NAUSEA | 124 |
| 3 | VOMITING | 110 |
| 4 | ACUTE KIDNEY INJURY | 101 |
| 5 | PEMPHIGOID | 101 |
| 6 | MALAISE | 93 |
| 7 | RASH | 92 |
| 8 | BLOOD GLUCOSE INCREASED | 86 |
| 9 | DYSPNOEA | 84 |
| 10 | DECREASED APPETITE | 82 |
| 11 | PNEUMONIA | 82 |
| 12 | PYREXIA | 78 |
| 13 | DIZZINESS | 77 |
| 14 | PRURITUS | 76 |
| 15 | DRUG INEFFECTIVE | 74 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
This medicine can cause a serious condition called lactic acidosis. Symptoms include feeling very sick, muscle pain, trouble breathing, sleepiness, and stomach pain. Get medical help right away if you have these symptoms. Certain conditions increase your risk, including kidney problems, taking certain other medicines, being 65 or older, and drinking a lot of alcohol.
Known Drug Interactions
Examples: Topiramate, zonisamide, acetazolamide or dichlorphenamide Drugs that Reduce Metformin Clearance Clinical Impact: Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2]/multidrug and toxin extrusion [MATE] inhibitors) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] .
Mechanism: Topiramate can stop your kidneys from clearing metformin properly, which may cause the drug to build up to dangerous levels.
What to do: Your doctor may need to monitor you more closely for side effects or adjust your dosage.
Examples: Topiramate, zonisamide, acetazolamide or dichlorphenamide Drugs that Reduce Metformin Clearance Clinical Impact: Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2]/multidrug and toxin extrusion [MATE] inhibitors) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] .
Mechanism: Zonisamide interferes with how your kidneys remove metformin from your body, which can increase the risk of a serious condition called lactic acidosis.
What to do: Use these drugs together with caution and follow your doctor's advice on monitoring your health.
( 7 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), may increase the accumulation of metformin. ( 7 ) Alcohol can potentiate the effect of metformin on lactate metabolism. ( 7 ) Metformin HCl Carbonic Anhydrase Inhibitors Clinical Impact: Carbonic anhydrase inhibitors frequently cause a decrease in serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis.
Mechanism: These two drugs work in different ways to lower blood sugar. When taken together, they have an additive effect to help control blood sugar levels.
What to do: Monitor your blood sugar levels regularly and follow your doctor's advice on managing your condition.
( 7 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), may increase the accumulation of metformin. Examples: Ranolazine, vandetanib, dolutegravir, and cimetidine Alcohol Clinical Impact: Alcohol is known to potentiate the effect of metformin on lactate metabolism.
Mechanism: Dolutegravir can slow down how quickly the body removes metformin. This can cause metformin to build up in the blood, increasing the risk of side effects.
What to do: Your doctor may need to monitor you more closely or adjust your medication doses.
( 7 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), may increase the accumulation of metformin. Examples: Ranolazine, vandetanib, dolutegravir, and cimetidine Alcohol Clinical Impact: Alcohol is known to potentiate the effect of metformin on lactate metabolism.
Mechanism: Ranolazine can interfere with the body's ability to clear out metformin. This leads to higher levels of metformin in the body.
What to do: Your healthcare provider should monitor your response and may need to adjust your metformin dose.
Common Questions
What should I do if I experience severe stomach pain?
Can this medicine cause heart problems?
What are the signs of a serious allergic reaction?
Can this medicine affect my liver?
Will this medicine affect my vitamin B12 levels?
Can this medicine cause low blood sugar?
What if I develop severe joint pain?
What should I do if I notice blisters on my skin?
Can I drink alcohol while taking this medicine?
Do I need to adjust my other diabetes medications?
What are the common side effects of alogliptin?
Does alogliptin interact with other medications?
What drug class is alogliptin?
Is there a generic version of alogliptin?
Is alogliptin safe during pregnancy?
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
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FDA requirements, cost savings, and when the difference matters
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Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for alogliptin
The FDA label for alogliptin (sold under brand names such as Nesina) classifies it as a prescription-only medication in the DPP-4 Inhibitor class. This medicine is used to treat type 2 diabetes. Official labeling lists 7 commonly reported side effects, including Upper respiratory tract infection, Common cold, Diarrhea.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 1,007 voluntary reports. The database also lists 7 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $5.02 versus $13.10 for the brand — a 62% generic savings.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: April 11, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages