It is indicated as an adjunct to diet & exercise to improve glycemic control in patients with type 2 diabetes mellitus. Or monotherapy in dual combination with Metformin, a sulphonylurea, a thiazolidinedione, or insulin when diet, exercise & a single antidiabetic agent do not result in adequate glycemic control.
Vildagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, which is believed to exert its actions in patients with type 2 diabetes by slowing the inactivation of incretin hormones. Incretin hormones, including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are released by the intestine throughout the day, and levels are increased in response to a meal. These hormones are rapidly inactivated by the enzyme, DPP-4. The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. When blood glucose concentrations are normal or elevated, GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells by intracellular signaling pathways involving cyclic AMP. GLP-1 also lowers glucagon secretion from pancreatic alpha cells, leading to reduced hepatic glucose production. By increasing and prolonging active incretin levels, Vildagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose-dependent manner.
The recommended dose is 50 mg or 100 mg daily for monotherapy. 50 mg twice daily (morning & evening) when used in dual combination with Metformin or a thiazolidinedione; 50mg once daily in the morning when used in dual combination with a sulphonylurea. Viglita may be taken with or without a meal. No dosage adjustment is required in the elderly, or in patients with mild renal impairment.
In pharmacokinetic studies, no interactions were seen with pioglitazone, metformin, glibenclamide, digoxin, warfarin, amlodipine, ramipril, valsartan or simvastatin. As with other oral antidiabetic medicinal products the glucose-lowering effect of Vildagliptin may be reduced by certain active substances, including thiazides, corticosteroids, thyroid products and sympathomimetics.
Vildagliptin is contraindicated in patients with: Hypersensitivity to the active substance or to any of the excipients, Patients with moderate to severe renal Impairment, Patients with Hepatic Impairment: patients with pre-treatment alanine aminotransferase (ALT) or aspartate aminotrasferase (AST) >3 times the upper limit of normal (ULN), patients with type 1 diabetes
The majority of adverse reactions were mild & transient, not requiring treatment discontinuations. Rare case of hepatic dysfunction is seen. Clinical trials of up to & more than 2 years$#$#$#$ duration did not show any additional safety signals or unfore seen risks when use this combination.
Vildagliptin should not be used in pregnancy. Vildagliptin should not be used during lactation.
Information regarding overdose with vildagliptin is limited
Store below 30°C temperature & keep away from light & moisture. Keep out of reach of children.
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