Vildagliptin, a DPP-4 class of medication, is now fully funded in NZ for type 2 diabetes. It is recommended as a second or third line oral anti-hyperglycaemic, added to metformin treatment.1
It is a 50 mg tablet and is also in combination with 850 mg or 1 gm of metformin. Metformin is the first choice. If contraindicated then consider Vildagliptin, a sulphonylurea or pioglitazone.
Vildagliptin:
- is not associated with weight gain
- has a low risk of hypoglycaemia
- is not recommended in pregnancy or breastfeeding
- is associated with a small increased risk of pancreatitis (0.13%)
- should not be started, and should be withdrawn if persisting levels of AST or ALT greater than 3x upper limit of normal
- is dosed twice daily but if eGFR < 50 ml/min/1.73m2 reduce to once daily
- side effects are mild – discontinuation rates ≤ 5%
- is not recommended in severe CHF (NYHA class IV).
This Gem has been checked by Dr Linda Bryant, Clinical Pharmacist.
