Vildagliptin
Generic Name: Vildagliptin
Uses & Medical Indications
Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, as monotherapy or in dual/triple combination with metformin, sulfonylureas, or insulin.
Type 2 Diabetes Mellitus, Hyperglycemia
Work Mechanism & Pharmacology
Patient Overview of Work Mechanism
Vildagliptin protects the body's natural gut hormones (incretins) from being broken down by the DPP-4 enzyme. This prompts the pancreas to release more insulin when blood sugar levels rise after eating, and tells the liver to produce less sugar, maintaining healthy glucose balance without causing sudden low blood sugar crashes.
Clinical Mechanism of Action (MoA)
Vildagliptin is a potent, selective, substrate-like dipeptidyl peptidase-4 (DPP-4) inhibitor that binds covalently to the catalytic site of the DPP-4 enzyme, forming a slow-dissociating complex. By sustaining DPP-4 inhibition throughout the day, it elevates postprandial and fasting concentrations of GLP-1 and GIP. This enhances insulin biosynthesis and secretion from pancreatic beta cells in a glucose-dependent manner while reducing inappropriate glucagon secretion from alpha cells, significantly reducing postprandial glucose surges and fasting glycemia.
Dosage & Administration Guidelines
50 mg orally once or twice daily (morning and evening). When combined with metformin or insulin, 50 mg twice daily. When combined with a sulfonylurea, 50 mg once daily in the morning.
Not recommended for children and adolescents under 18 years of age.
50 mg once or twice daily; no dose adjustment needed based solely on age.
100 mg daily.
Mild renal impairment (eGFR >=50): 50 mg twice daily. Moderate or severe renal impairment (eGFR <50) or ESRD on hemodialysis: 50 mg once daily in the morning.
Contraindicated in patients with hepatic impairment or baseline ALT/AST >3 times the upper limit of normal.
Side Effects & Safety Warnings
Nausea, dizziness, headache, peripheral edema, tremor (mainly with sulfonylurea).
Hepatotoxicity / elevated liver transaminases (rare), acute pancreatitis, bullous pemphigoid.
Hypersensitivity to vildagliptin; hepatic impairment; diabetic ketoacidosis.
Monitor liver function tests before starting and every 3 months during the first year of therapy. Discontinue if ALT or AST increases to 3x ULN.
Interactions (Drugs, Food & Alcohol)
Combination with sulfonylureas increases hypoglycemia risk (consider lowering sulfonylurea dose). ACE inhibitors may increase risk of angioedema.
Can be taken with or without food.
Avoid heavy alcohol use to reduce hypoglycemia risk.
Pregnancy & Breastfeeding Safety
Not recommended during pregnancy; use insulin.
Not recommended while breastfeeding.
Patient Counseling & Practical Advice
Take your tablet with or without food. Have routine liver blood tests as scheduled by your doctor.
Take as soon as remembered unless it is time for your next scheduled dose.
Liver function tests (LFTs) before initiation and periodically; HbA1c; renal function.
Frequently Asked Questions
Related Medicines in Antidiabetic (DPP-4 Inhibitor)
When to Seek Urgent Medical Attention
Severe persistent abdominal pain (pancreatitis) or symptoms of severe hypoglycemia.
Content for Vildagliptin was synthesized from standardized public health monographs, official pharmacopoeias, and health authorities:
- European Medicines Agency (EMA) — Galvus (Vildagliptin) Summary of Product Characteristics
- CDSCO — CDSCO Approved DPP-4 Inhibitor Formulations
The information provided on this website is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.