Type 2 diabetes mellitus
Adult: As monotherapy or in combination with other hypoglycaemic agents: 20 mg once daily; may increase to 40 mg once daily if effect is inadequate.
Indications and Dosage
Oral
Type 2 diabetes mellitus Adult: As monotherapy or in combination with other hypoglycaemic agents: 20 mg once daily; may increase to 40 mg once daily if effect is inadequate.
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Administration
tab: May be taken with or without food. Preferably taken before meals.
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Contraindications
Severe ketosis, diabetic coma or precoma, type 1 diabetes mellitus, severe infections, surgery, severe trauma.
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Special Precautions
Patient with pituitary or adrenal insufficiency, poor nutritional state, starvation, irregular food intake, history of bowel obstruction or abdominal surgery, heart failure NYHA functional class III-IV, active or history of arrhythmia, bradycardia, low K levels, Torsades de pointes, QT prolongation. Intensive exercise or excessive alcohol intake. Debilitated patients. Severe hepatic impairment. Pregnancy and lactation.
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Adverse Reactions
Significant: Hypoglycaemia, hepatic impairment (accompanied by increased AST/ALT), intestinal obstruction, bullous pemphigoid, interstitial pneumonia, prolonged QT interval. Rarely, acute pancreatitis.
Gastrointestinal disorders: Abdominal distension, discomfort or pain; constipation, flatulence, nausea, stomatitis, gastric or colonic polyps, duodenal ulcer, reflux oesophagitis, diarrhoea. General disorders and administration site conditions: Malaise. Investigations: Elevated amylase, lipase, γ-GTP, creatine phosphokinase, serum K and uric acid. Metabolism and nutrition disorders: Decreased appetite. Renal and urinary disorders: Proteinuria, presence of ketones in urine, haematuria. Respiratory, thoracic and mediastinal disorders: Allergic rhinitis. Skin and subcutaneous tissue disorders: Eczema, rash, itching, allergic dermatitis. |
Patient Counseling Information
This drug may cause dizziness or weakness due to lowering of blood sugar, if affected, do not drive or operate machinery.
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Monitoring Parameters
Monitor plasma glucose, HbA1c (at least twice yearly in patients who have stable glycaemic control and are meeting treatment goals; quarterly in patients not meeting treatment goals or with therapy change), liver function. Monitor for signs/symptoms of pancreatitis (e.g. severe abdominal pain, anorexia, nausea, vomiting).
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Drug Interactions
Increased hypoglycaemic effects with other antidiabetics (e.g. sulfonylureas, insulins, biguanides), β-blockers, MAOIs, salicylic acid. Reduced hypoglycaemic effect with epinephrine, adrenocortical and thyroid hormones. Increased risk of QT prolongation with Class 1A (e.g. procainamide, quinidine) and Class III antiarrhythmics (e.g. amiodarone, sotalol).
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Action
Description:
Mechanism of Action: Teneligliptin inhibits dipeptidyl peptidase-4 (DPP-4), an enzyme involved in the degradation of the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) leading to increased and prolonged active incretin levels. These incretin hormones enhance insulin release and inhibit glucagon secretion resulting in reduced blood glucose level. Pharmacokinetics: Absorption: Rapidly absorbed. Time to peak plasma concentration: 1-1.3 hours. Distribution: Plasma protein binding: 77.6-82.2%. Metabolism: Metabolised in the liver by CYP3A4 and flavin monooxygenases (FMO) 1 and 3 to several metabolites. Excretion: Via urine (21-34%, as unchanged drug). Elimination half-life: 18.9-26.9 hours. |
Chemical Structure
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Storage
Store below 30°C.
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MIMS Class
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ATC Classification
A10BH08 - teneligliptin ; Belongs to the class of dipeptidyl peptidase 4 (DPP-4) inhibitors. Used in the treatment of diabetes.
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References
Anon. Teneligliptin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/01/2022. Buckingham R (ed). Teneligliptin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/01/2022. Glipten 20 mg Film-Coated Tablet (Ajanta Pharma Limited). MIMS Philippines. http://www.mims.com/philippines. Accessed 05/01/2022. Tenelia 20 mg Tablets (Mitsubishi Tanabe Pharma Factory Ltd). MIMS Thailand. http://www.mims.com/thailand. Accessed 05/01/2022.
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