Alogliptin

gliptins
DPP-4 inhibitors (gliptins)

An oral DPP-4 inhibitor (gliptin) for type 2 diabetes: it keeps the gut's incretin hormones active, so insulin rises only when glucose is high.

Updated Nov 1, 2026

Also called: alogliptin benzoate

Quick facts

Group: DPP-4 inhibitors (gliptins)
Target: Dipeptidyl peptidase-4 (DPP-4)
Used for: Type 2 diabetes
Key effects: Headache · Stuffy or runny nose
Monitor: HbA1c and blood glucose · Kidney function
ATC: A10BH04

No doses: the clinician sets them by the current guideline.

Mechanism of action

Dipeptidyl peptidase-4 (DPP-4)Alogliptin

The figure shows alogliptin (catalogued under its development code TAK-322) in the active site of human DPP-4.

Target in 3D: Dipeptidyl peptidase-4 (DPP-4). PDB structure 3G0B (RCSB PDB, public domain). View the structure at RCSB PDB

DPP-4 rapidly inactivates the incretin hormones GLP-1 and GIP released by the gut after meals. Alogliptin selectively inhibits DPP-4, so active incretin levels rise; insulin release increases and glucagon falls in a glucose-dependent way. Used alone it rarely causes hypoglycaemia and is weight-neutral.

Inhibits the enzyme DPP-4
Active GLP-1 and GIP last longer after meals
Glucose-dependent insulin rises; glucagon falls
Blood glucose falls with little hypoglycaemia

Indications

Type 2 diabetes, with diet and exercise, alone or with other glucose-lowering drugs Type 2 diabetes mellitus →

Adverse effects

Common

Headache
Stuffy or runny nose, sore throat
Hypoglycaemia when combined with insulin or a sulfonylurea

Contraindications

History of serious hypersensitivity to alogliptin (anaphylaxis, angioedema, severe skin reactions)

Key interactions

Insulin or sulfonylureas: Higher risk of hypoglycaemia; their dose may be lowered.

What is monitored

HbA1c and blood glucose
Kidney function, to adjust the dose
Liver tests before starting and if symptoms appear
Symptoms of pancreatitis or heart failure

Administration and safety

Oral tablet, once a day, with or without food.
Dose is adjusted to kidney function.
Fixed combinations with metformin or pioglitazone exist; check for duplicate gliptins.

Pregnancy and breastfeeding

Safety in pregnancy is not established; insulin is the usual treatment for diabetes in pregnancy.

Nursing care

Before: kidney function, liver tests, history of pancreatitis or heart failure.
During: severe abdominal pain spreading to the back, breathlessness or swelling, jaundice, blisters, severe joint pain.
Teach hypoglycaemia recognition when used with insulin or a sulfonylurea.
Teach that sick days (vomiting, diarrhoea) can change glucose control.

Pharmacokinetics

Absorption: Oral, almost completely absorbed, with or without food.
Metabolism: Little metabolism (minor CYP2D6 and CYP3A4); it neither inhibits nor induces the main CYPs.
Elimination: Mostly unchanged in urine, so the dose is reduced in kidney impairment.
Half-life: About 21 hours, allowing once-daily dosing (label).

Test yourself

Think of the answer, then tap the question to see it.

How do DPP-4 inhibitors lower glucose without much hypoglycaemia?

They raise active GLP-1 and GIP, whose effect on insulin depends on glucose being high.

Why is the alogliptin dose adjusted in kidney disease?

It is mostly excreted unchanged in urine.

Which serious adverse effect presents with severe abdominal pain radiating to the back?

Acute pancreatitis.

Which cardiovascular warning applies to alogliptin?

Heart failure; more hospitalizations for heart failure were seen in patients with recent acute coronary syndrome.

Add to my cards (4)

Connections

← Back to the class: DPP-4 inhibitors (gliptins)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Alogliptin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); DailyMed - ALOGLIPTIN tablet, film coated (DailyMed (U.S. National Library of Medicine), 2025); Crystal structure of dipeptidyl peptidase IV in complex with TAK-322 (RCSB Protein Data Bank, 2010); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake

Representative model, for educational purposes only.