Drug Action
Inhibits dipeptidylpeptidase-4 to increase insulin secretion and lower glucagon secretion.
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Drug reference
Inhibits dipeptidylpeptidase-4 to increase insulin secretion and lower glucagon secretion.
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Type 2 diabetes mellitus as monotherapy (if metformin inappropriate), or in combination with other antidiabetic drugs (including insulin) if existing treatment fails to achieve adequate glycaemic control ▶BY MOUTH ▶Adult: 50 mg twice daily, reduce dose to 50 mg once daily in the morning when used in dual combination with a sulfonylurea. For further information on use with other antidiabetic drugs—consult product literature
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DUE TO INTERACTIONS ▶Dose of concomitant sulfonylurea or insulin may need to be reduced.
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Ketoacidosis
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History of pancreatitis. manufacturer advises avoid in severe heart failure—no information available
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Scottish Medicines Consortium (SMC) decisions SMC No. 435/07 The Scottish Medicines Consortium has advised (April 2008) that vildagliptin (Galvus ®) is accepted for restricted use within NHS Scotland for the treatment of type 2 diabetes mellitus in combination with metformin when addition of a sulfonylurea is inappropriate. SMC No. 571/09 The Scottish Medicines Consortium has advised (October 2009) that vildagliptin (Galvus ®) is accepted for use within NHS Scotland for the treatment of type 2 diabetes mellitus in combination with a sulphonylurea for those patients where the maximal dose of a sulphonylurea as monotherapy is insufficient, or if metformin is inappropriate. SMC No. 826/12 The Scottish Medicines Consortium has advised (January 2013) that vildagliptin (Galvus ®) is accepted for restricted use within NHS Scotland as monotherapy for the treatment of type 2 diabetes mellitus in adults when treatment with metformin or a sulfonylurea is inappropriate. SMC No. 875/13 The Scottish Medicines Consortium has advised (December 2013) that vildagliptin (Galvus ®) is accepted for restricted use within NHS Scotland for the treatment of type 2 diabetes mellitus in adults as triple therapy in combination with metformin and a sulfonylurea, as an alternative to existing dipeptidyl peptidase-4 inhibitors, when treatment with metformin and a sulfonylurea is inadequate.
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→Appendix 1: vildagliptin
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▶Common or very common Dizziness ▶Uncommon Arthralgia. constipation. headache. hypoglycaemia. peripheral oedema ▶Rare or very rare Increased risk of infection ▶Frequency not known Hepatitis. myalgia. pancreatitis. skin reactions SIDE-EFFECTS, FURTHER INFORMATION Pancreatitis Discontinue if symptoms of acute pancreatitis occur, such as persistent severe abdominal pain. Liver toxicity Rare reports of liver dysfunction; discontinue if jaundice or other signs of liver dysfunction occur.
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Avoid—toxicity in animal studies.
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Avoid—present in milk in animal studies.
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Manufacturer advises avoid.
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Dose adjustments Reduce dose to 50 mg once daily if eGFR less than 50 mL/minute/1.73 m2.
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Monitor liver function before treatment and every 3 months for first year and periodically thereafter.
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Galvus (Novartis Pharmaceuticals UK Ltd) Vildagliptin 50 mg Galvus 50mg tablets | 56 tablet P £33.35 DT = £33.35
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Liver toxicity Patients should be advised to seek prompt medical attention if symptoms such as nausea, vomiting, abdominal pain, fatigue, and dark urine develop.
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50 mg twice daily, reduce dose to 50 mg once
First-line fragment. Read the complete Indications and Dose section above.
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