Vildagliptin is an oral anti-diabetic medication belonging to the dipeptidyl peptidase-4 (DPP-4) inhibitor class, also known as gliptins. It is indicated for the management of type 2 diabetes mellitus. It works by enhancing the body's own incretin system, increasing insulin secretion in a glucose-dependent manner and decreasing glucagon secretion, thereby lowering blood glucose levels without causing significant hypoglycemia or weight gain.
Adult: The recommended dose is 50 mg twice daily or 100 mg once daily. When used in combination with a Sulfonylurea, a lower dose of the sulfonylurea may be required to reduce the risk of hypoglycemia.
Note: Can be taken with or without food. Tablet should be swallowed whole with a glass of water. For the twice-daily regimen, doses should be taken in the morning and evening. For the once-daily 100mg regimen, it can be taken at any time of the day consistently.
Vildagliptin is a potent, selective, and reversible inhibitor of the enzyme dipeptidyl peptidase-4 (DPP-4). DPP-4 rapidly degrades the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). By inhibiting DPP-4, vildagliptin increases and prolongs the active levels of these endogenous incretin hormones.
Pregnancy: Category B3 (as per some regulatory bodies). There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. Insulin is the preferred drug for glycemic control during pregnancy.
Driving: Vildagliptin has no or negligible influence on the ability to drive and use machines. However, patients should be alerted to the risk of dizziness and hypoglycemia, especially when used in combination, which may impair these abilities.
| Sulfonylureas (e.g., Glimepiride, Gliclazide) | Increased risk of hypoglycemia. Sulfonylurea dose may need reduction. | Major |
| Insulin | Increased risk of hypoglycemia. Insulin dose may need adjustment. | Major |
| Thiazolidinediones (e.g., Pioglitazone) | Increased risk of peripheral edema. | Moderate |
| ACE Inhibitors (e.g., Ramipril) | Potential increased risk of angioedema, though evidence is limited. | Moderate |
| Strong Inducers of CYP450 Enzymes (e.g., Rifampicin, Phenytoin, Carbamazepine) | May decrease plasma concentration of vildagliptin, reducing efficacy. | Moderate |
Same composition (Vildagliptin (50mg)), different brands: