Alogliptin
Alogliptin is a once-daily oral diabetes medicine (a DPP-4 inhibitor) used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 6 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Alogliptin (Nesina) is a type 2 diabetes medicine that blocks the DPP-4 enzyme so that gut hormones prompting insulin release last longer. It’s usually added to metformin, has been on the U.S. market since about 2012 and is available as a generic. Most people notice little beyond a stuffy nose or headache, and because it boosts insulin only when blood sugar is high, it rarely causes lows on its own. Stop it and call your doctor for severe, constant stomach pain spreading to your back (possible pancreatitis, an inflamed pancreas), and report breathlessness, leg swelling, facial swelling or yellowing skin, since heart failure, allergic reactions and liver problems are also listed warnings.
Clinical pearls
- Take it once a day, with or without food, so pick whatever time of day you will remember most reliably.
- Expect periodic kidney blood tests, because the alogliptin dose is lowered when kidney function declines.
- If you also use insulin or a sulfonylurea such as glipizide, ask whether that dose should come down to prevent lows.
- Report severe joint pain or new skin blisters, since this drug class has been linked to both.
Patient information guide A plain-language walkthrough of Alogliptin, written from its FDA label.
What Alogliptin is used for
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Alogliptin is used to help control blood sugar in adults with type 2 diabetes.
- Nesina tablets are used with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
- Alogliptin tablets are used the same way: with diet and exercise, in adults with type 2 diabetes.
- Neither is for type 1 diabetes, and alogliptin tablets are not for diabetic ketoacidosis.
How Alogliptin works
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Alogliptin blocks an enzyme called DPP-4. This enzyme normally breaks down gut hormones (GLP-1 and GIP) within minutes. These hormones tell the pancreas to release insulin when blood sugar is high. GLP-1 also lowers glucagon, a hormone that tells the liver to make sugar.
By keeping these hormones active longer, alogliptin lowers blood sugar before and after meals. The effect depends on your glucose level.
Alogliptin dosage
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Alogliptin is a tablet taken by mouth, generally once a day. You can take it with or without food. Nesina's label notes the dose is adjusted for moderate or severe kidney impairment.
- Follow your prescriber's directions and your pharmacy label.
- Ask your pharmacist what to do if you miss a dose.
Dosing details from the FDA-approved label
From the Alogliptin prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Patients with normal renal function or mild renal impairment
- 25 mg orally once daily
- Can be taken with or without food
Read the label’s full dosing text
2 DOSAGE AND ADMINISTRATION The recommended dosage in patients with normal renal function or mild renal impairment is 25 mg orally once daily. ( 2.1 ) Can be taken with or without food. ( 2.1 ) Adjust dosage if moderate or severe renal impairment or end-stage renal disease (ESRD). ( 2.2 ) Degree of Renal Impairment Creatinine Clearance (mL/min) Recommended Dosage Moderate ≥30 to <60 12.5 mg once daily Severe/ESRD <30 6.25 mg once daily 2.1 Recommended Dosage The recommended dosage of alogliptin tablets is 25 mg taken orally once daily. Do not spilt tablet. Alogliptin tablets may be taken with or without food. [see Clinical Pharmacology (12.3) ] Instruct patients if a dose is missed, not to double their next dose. 2.2 Patients with Renal Impairment Assess renal function prior to initiation of alogliptin tablets and periodically thereafter [see Use in Specific Populations (8.6) ] . No dose adjustment of alogliptin tablets is necessary for patients with mild renal impairment (creatinine clearance [CrCl] ≥60 mL/min). The dose of alogliptin tablets is 12.5 mg once daily for patients with moderate renal impairment (CrCl ≥30 to <60 mL/min). The dose of alogliptin tablets is 6.25 mg once daily for patients with severe renal impairment (CrCl ≥15 to <30 mL/min) or with end-stage renal disease (ESRD) (CrCl <15 mL/min or requiring hemodialysis). Alogliptin tablets may be administered without regard to the timing of dialysis. Alogliptin tablets have not been studied in patients undergoing peritoneal dialysis [see Use in Specific Populations (8.6) , Clinical Pharmacology (12.3) ].
Read the full Dosage and Administration section on DailyMed →
Alogliptin side effects
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Most people tolerate alogliptin well. The most common side effects in studies were:
Common side effects
- Stuffy or runny nose and sore throat (nasopharyngitis)
- Headache
- Upper respiratory tract infection (a cold-like illness)
- Low blood sugar, mainly when combined with insulin or sulfonylureas
When to get medical help
- Severe, constant stomach pain that may spread to your back, with or without vomiting (possible pancreatitis). Stop the medicine and call your doctor.
- Swelling of the face, lips, tongue or throat, trouble breathing, or a severe rash or skin peeling. These may be serious allergic reactions.
- Shortness of breath, swelling in your legs or feet, or sudden weight gain (possible heart failure)
- Yellowing of the skin or eyes, dark urine, or unusual tiredness (possible liver problems)
- Severe joint pain that interferes with daily activity
- Blisters or skin erosions (possible bullous pemphigoid)
- Signs of low blood sugar if you also take insulin or a sulfonylurea
Low blood sugar was not increased in most trials, but it can happen when alogliptin is combined with insulin or sulfonylureas. Call your doctor right away for severe stomach pain, signs of an allergic reaction, swelling or shortness of breath, yellow skin or eyes, severe joint pain, or blisters.
Alogliptin warnings and precautions
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- Pancreatitis: inflammation of the pancreas has been reported. Stop the medicine and get help if you have severe stomach pain.
- Heart failure: your doctor should weigh the risks and benefits if you are at risk for it.
- Serious allergic reactions: these include anaphylaxis, angioedema, and severe skin reactions such as Stevens-Johnson syndrome.
- Liver problems: liver failure, sometimes fatal, has been reported. Causality could not be excluded.
- Joint pain and blistering skin: severe joint pain and bullous pemphigoid have been reported with DPP-4 inhibitors.
- Low blood sugar: a risk when combined with insulin or sulfonylureas.
Alogliptin interactions
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The main interaction involves other diabetes medicines that can lower blood sugar.
- Insulin: a lower insulin dose may be needed to avoid low blood sugar.
- Sulfonylureas and other insulin secretagogues: a lower dose may be needed for the same reason.
Interactions listed in the FDA-approved label
From the Alogliptin prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Insulin secretagogues (e.g., sulfonylurea) and insulin: Insulin and insulin secretagogues are known to cause hypoglycemia; coadministration with alogliptin tablets may require lower dosages of the insulin secretagogue and insulin to reduce the risk of hypoglycemia. Lower dosages of the insulin secretagogue and insulin may be required.
Read the label’s full interactions text
7 DRUG INTERACTIONS 7.1 Insulin Secretagogues and Insulin Insulin and insulin secretagogues are known to cause hypoglycemia. Coadministration of alogliptin tablets with an insulin secretagogue (e.g., sulfonylurea) or insulin may require lower dosages of the insulin secretagogue and insulin to reduce the risk of hypoglycemia [see Warnings and Precautions (5.5) ] .
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Alogliptin
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- Do not use it if you have had a serious allergic reaction to alogliptin or its ingredients.
- Tell your doctor if you have heart failure or risk factors for it.
- Tell your doctor about kidney problems, since dosing may change.
- Not for type 1 diabetes or diabetic ketoacidosis.
- Pregnancy: human data are limited, so talk with your doctor.
- Breastfeeding: it is unknown whether it passes into human milk.
- Not established for children.
- Older adults had similar safety and effectiveness, though greater sensitivity in some cannot be ruled out.
Alogliptin overdose
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In clinical trials, very high doses (many times the recommended amount) did not cause serious reactions. If someone takes too much, the label advises monitoring and supportive care. Dialysis is unlikely to help, since very little alogliptin is removed. Call Poison Control or seek medical help right away.
What Alogliptin does in the body
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Alogliptin blocks DPP-4 strongly. Peak inhibition occurred within a few hours of a dose and stayed high at 24 hours, which supports once-daily use. Levels of active GLP-1 rose several-fold compared with placebo, and after-meal glucagon and blood sugar dropped. In a study of heart rhythm, alogliptin did not lengthen the QT interval.
How your body processes Alogliptin
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Alogliptin is almost fully absorbed, and food does not change this. Blood levels peak about one to two hours after a dose. The half-life is about 21 hours, and there is little buildup with repeated dosing. Little of it is broken down by the body, and most leaves unchanged in the urine. That is why kidney function affects dosing.
How to store Alogliptin
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Store at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F) .
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Alogliptin
356 supplements and herbal products have documented interactions with Alogliptin in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 6
- Moderate · 299
- Minor · 51
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Nutrient depletion considerations
Alogliptin has been associated with lower levels of 1 nutrient in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.
Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.
Alogliptin: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Alogliptin — the kind of thing our pharmacy team would talk through with you at the counter.
What is alogliptin for?
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How do I take it?
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What side effects should I expect?
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When should I call my doctor right away?
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Can I take it with my other diabetes medicines?
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Is it safe in pregnancy?
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Is Alogliptin available over the counter?
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When was Alogliptin first available?
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Who makes Alogliptin?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Alogliptin on HelloPharmacist
Alogliptin forms and strengths (how it comes)
Alogliptin is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Need a version that does not list lactose, a gluten source, a dye or gelatin? Inactive ingredients differ by manufacturer: see Alogliptin inactive ingredients by manufacturer.
Tablet
How this form is used
- Nesina is used with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
- Alogliptin tablets are used with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
- Nesina is taken by mouth once daily, with or without food.
- Nesina dosing is adjusted for moderate or severe kidney impairment or end-stage kidney disease.
Alogliptin on the U.S. market: products, makers and brands
How Alogliptin appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
5 companies list 10 Alogliptin product records with the FDA, mostly as tablet; the earliest marketing or approval year on record is 2012. Brand names on the directory include Nesina; the rest are generics.
Also listed with the FDA, not a patient dose form: Powder (6) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
How widely Alogliptin is used (Medicaid data)
A general measure of how commonly Alogliptin is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Alogliptin is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Alogliptin prescribed? Of the 1,601 medications we measure, Alogliptin ranks #500 by Medicaid prescriptions — more than 69% of them.
Utilization by Alogliptin product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
alogliptin 25 MG Oral Tablet Most dispensed
Summed across the 2 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1368006
alogliptin 12.5 MG Oral Tablet
Summed across the 2 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1368034
alogliptin 6.25 MG Oral Tablet
Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1368018
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Alogliptin, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 5 of 27 listed Alogliptin NDCs with Medicaid activity.
Compare Alogliptin products
A representative set of FDA-listed product records for Alogliptin — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Tablet | ||||
| 25 mg | Oral | A-S Medication Solutions | NDA AUTHORIZED GENERIC | View NDC → |
| 12.5 mg | Oral | Aphena Pharma Solutions - Tennessee, LLC | NDA AUTHORIZED GENERIC | View NDC → |
| 25 mg | Oral | Aphena Pharma Solutions - Tennessee, LLC | NDA AUTHORIZED GENERIC | View NDC → |
| 25 mg | Oral | Bryant Ranch Prepack | NDA AUTHORIZED GENERIC | View NDC → |
| 6.25 mg | Oral | Padagis Israel Pharmaceuticals Ltd | NDA AUTHORIZED GENERIC | View NDC → |
| 12.5 mg | Oral | Padagis Israel Pharmaceuticals Ltd | NDA AUTHORIZED GENERIC | View NDC → |
| 25 mg | Oral | Padagis Israel Pharmaceuticals Ltd | NDA AUTHORIZED GENERIC | View NDC → |
| 6.25 mg | Oral | Takeda Pharmaceuticals America, Inc. | NDA | View NDC → |
| 12.5 mg | Oral | Takeda Pharmaceuticals America, Inc. | NDA | View NDC → |
| 25 mg | Oral | Takeda Pharmaceuticals America, Inc. | NDA | View NDC → |
Showing 10 of 10 products — FDA National Drug Code Directory. See every product, package size and price: browse all 10 Alogliptin NDCs →
Alogliptin side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Alogliptin — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Alogliptin in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Alogliptin FDA approval history
How Alogliptin went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Alogliptin recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Alogliptin recalls since July 2021.
✅No Alogliptin recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 1368001 1 dose form · 3 strengths
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Dose form (SCDF) Oral Tablet RxCUI 1368005In current FDA listings
Look up RxCUI 1368001 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
Alogliptin supply and shortage status
Whether Alogliptin is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
💵 What Alogliptin costs pharmacies (NADAC benchmark)
The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.
| Form | Strength | Pharmacy acquisition benchmark | |
|---|---|---|---|
| Tablet, Film Coated · Oral | 25 mg | $4.91 per tablet | NDC details & price history |
| Tablet, Film Coated · Oral | 6.25 mg | $5.28 per tablet | NDC details & price history |
| Tablet, Film Coated · Oral | 12.5 mg | $4.96 per tablet | NDC details & price history |
Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.
Alogliptin brand names
Alogliptin is sold under one brand name in the FDA directory — Nesina. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Alogliptin: manufacturers and labelers
5 companies list Alogliptin products with the FDA. By number of product records, the largest are Padagis Israel Pharmaceuticals Ltd, Takeda Pharmaceuticals America, Inc., Aphena Pharma Solutions - Tennessee, LLC. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Alogliptin drug class (RxNorm)
Alogliptin belongs to the Dipeptidyl Peptidase 4 Inhibitor class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Alogliptin page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Aphena Pharma Solutions - Tennessee, LLC is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →