Indications for NESINA:
Adjunct to diet and exercise in type 2 diabetes, as monotherapy or combination therapy.
Limitations of Use:
Not for treatment of type 1 diabetes or diabetic ketoacidosis.
25mg once daily. Renal impairment: moderate (CrCl ≥30–<60mL/min): 12.5mg once daily; severe (CrCl ≥15–<30mL/min) or ESRD (CrCl <15mL/min or need hemodialysis): 6.25mg once daily.
Assess renal function prior to therapy and periodically thereafter. Monitor for signs/symptoms of pancreatitis, serious hypersensitivity reactions, or severe joint pain; discontinue if suspected or occurs. Consider risks/benefits in patients with known risk factors for heart failure; monitor for signs/symptoms; evaluate and consider discontinuing if develops. History of angioedema to other DPP-4 inhibitors. Hepatic impairment. Obtain LFTs before starting therapy; interrupt and evaluate if liver enzymes elevated or abnormal tests persist; do not restart if liver injury is confirmed and no other etiology can be found. Pregnancy (Cat.B). Nursing mothers.
Dipeptidyl peptidase-4 (DPP-4) inhibitor.
May need lower dose of concomitant sulfonylurea or insulin to reduce risk of hypoglycemia.
Nasopharyngitis, headache, upper respiratory tract infection; pancreatitis, heart failure, hypersensitivity reactions (eg, anaphylaxis, angioedema, Stevens-Johnson syndrome), hepatic failure (may be fatal), severe and disabling arthralgia, bullous pemphigoid.
6.25mg—30, 90; 12.5mg, 25mg—30, 90, 500