Select therapeutic use:
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.
May need lower dose of concomitant sulfonylurea or insulin to reduce risk of hypoglycemia.
Dipeptidyl peptidase-4 (DPP-4) inhibitor.
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