[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [DPP-4 inhibitors (gliptins)](https://durgical.com/en/pharmacology/classes/dpp-4-inhibitors/) › Vildagliptin

[Pharmacology](https://durgical.com/en/pharmacology/) · [DPP-4 inhibitors (gliptins)](https://durgical.com/en/pharmacology/classes/dpp-4-inhibitors/)

# Vildagliptin

A DPP-4 inhibitor used in Europe and other regions, not in the US. It binds the enzyme covalently and is cleared mainly by the kidney.

Updated 2026-11-01

- Class: [DPP-4 inhibitors (gliptins)](https://durgical.com/en/pharmacology/classes/dpp-4-inhibitors/)
- Enzyme: Dipeptidyl peptidase-4 (DPP-4)
- ATC code: A10BH02

✂**Dipeptidyl peptidase-4 (DPP-4)**Vildagliptin

ⓘ The figure shows vildagliptin in the active site of human DPP-4.

**Target in 3D:** Dipeptidyl peptidase-4 (DPP-4). PDB structure 6B1E (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6B1E) · Drag to rotate · pinch to zoom

## Mechanism of action

Vildagliptin, like saxagliptin a cyanopyrrolidine, forms a reversible covalent bond with the catalytic serine of DPP-4. Active GLP-1 and GIP last longer after meals, raising glucose-dependent insulin release and lowering glucagon.

- Blocks the DPP-4 enzyme in plasma and on cells
- Active GLP-1 and GIP last longer after meals
- More insulin and less glucagon when glucose is high
- Glucose falls without weight change

## Pharmacokinetics

**Absorption**
Oral, well absorbed from the small intestine.

**Elimination**
Mainly through the urine, so lower doses are used when kidney function is reduced.

## Indications

- Type 2 diabetes, alone or combined with metformin and other drugs [Type 2 diabetes mellitus →](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

## Adverse effects

### Common

- Hypoglycemia when combined with insulin or a sulfonylurea

### Serious (rare, important)

- Acute pancreatitis
- Serious allergic reactions: anaphylaxis, angioedema, Stevens–Johnson syndrome
- Bullous pemphigoid
- Severe, disabling joint pain

## Contraindications

- Hypersensitivity to vildagliptin
- Not for type 1 diabetes or ketoacidosis

## Key interactions

**Insulin or sulfonylureas**
Higher risk of hypoglycemia.

**GLP-1 receptor agonists**
Not combined: same pathway.

## What is monitored

- Kidney function
- HbA1c

## Administration and safety

- Oral tablet.
- Not given together with a GLP-1 receptor agonist.

## Nursing care

- Before: kidney function, history of pancreatitis and heart failure.
- During: abdominal pain, skin blisters, joint pain, swelling or breathlessness.
- Capillary glucose when combined with insulin or a sulfonylurea.

## Pregnancy and breastfeeding

Data in pregnancy are limited; insulin is the usual choice.

## Memory aid

Vildagliptin and saxagliptin are the 'sticky' gliptins: both grab DPP-4's serine with a covalent bond.

## Test yourself

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

## Which two gliptins bind DPP-4 covalently?

Vildagliptin and saxagliptin.

## Why is the vildagliptin dose lowered when kidney function falls?

It is cleared mainly in the urine, so it accumulates when filtration falls.

## Is vildagliptin expected to cause hypoglycemia alone?

Rarely. Like other gliptins, its effect is glucose-dependent; the risk rises with insulin or sulfonylureas.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/vildagliptin/)

## Related drugs

- [Sitagliptin](https://durgical.com/en/pharmacology/sitagliptin/)
- [Linagliptin](https://durgical.com/en/pharmacology/linagliptin/)
- [Saxagliptin](https://durgical.com/en/pharmacology/saxagliptin/)

## Related conditions

- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

[← Back to the class: DPP-4 inhibitors (gliptins)](https://durgical.com/en/pharmacology/classes/dpp-4-inhibitors/)

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

Sources: [The structure of DPP4 in complex with Vildagliptin](https://www.rcsb.org/structure/6B1E) (RCSB Protein Data Bank, 2017); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 51 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A10BH02) (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.

---
Source: https://durgical.com/en/pharmacology/vildagliptin/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/vildagliptin/