Insulin
Moderate
Database
Additive hypoglycemia risk; vildagliptin dose reduced to 50 mg OD
Use 50 mg OD vildagliptin; monitor for hypoglycemia
Source: Kimi deep-research + Cla
Drug reference
Vildagliptin
Dipeptidyl peptidase-4 (DPP-4) inhibitor (gliptin) · Antidiabetic
Also known as Galvus, Zomelis, Eucreas (combination), Vildapin
START
50 mg BD (monotherapy or with metformin); 50 mg OD (with sulfonylurea or insulin); check baseline renal function and LFTs
TYPICAL MAX
100 mg/day (50 mg BD)
STOP IF
Signs of pancreatitis (severe abdominal pain, vomiting), jaundice, severe joint pain, eGFR <30 (in some markets)
WATCH
HbA1c at 3-monthly intervals, renal function annually, LFTs if symptoms, signs of pancreatitis
CDSCO approvedJan AushadhiATC A10BH02
KDIGO 2024 + manufacturer label
- ONSET
- 26min · absorption onset
- PEAK
- 1.8h · Peak plasma concentration
- t½
- 2h · Short half-life
- DURATION
- 1d · 24-hour glucose control with BD dosing
EXCRETION
Renal (85%)
route + CYP
INTERACTIONS
—
none in our sources
PREGNANCY
Avoid in pregnancy; limited data - animal studies show adverse effects
FDA category + note
Available in India
276 branded formulations and 61 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Inhibition of DPP-4 enzyme, which inactivates incretin hormones GLP-1 and GIP. This prolongs incretin activity, enhancing glucose-dependent insulin secretion from pancreatic beta cells and suppressing glucagon release, thereby reducing both fasting and postprandial glucose
Indications
Type 2 diabetes mellitus (monotherapy or combination)Can be used in renal impairment (dose-adjusted)
Dosing
- Adult
- 50 mg once or twice daily depending on combination. Monotherapy: 50 mg BD. With metformin: 50 mg BD. With sulfonylurea: 50 mg OD (morning). With insulin: 50 mg OD
- Pediatric
- Not recommended under 18 years
- Renal adjustment
- eGFR >/=50: 50 mg BD; eGFR 30-49: 50 mg OD; eGFR <30: contraindicated in some markets (check local label)
- Hepatic adjustment
- Not recommended in hepatic impairment (limited data)
- Geriatric
- No dose adjustment based on age; adjust for renal function
- Max dose
- 100 mg/day (50 mg BD)
Pharmacokinetics
Onset
Days (not immediate)
Peak effect
1.75 hours (Tmax)
Duration
24 hours
Half-life
1.5-2.5 hours (parent); active metabolite: ~2.5 hours
Bioavailability
85%
Protein binding
9.3% (low)
Metabolism
Hepatic hydrolysis to inactive metabolite (LAY151) primarily via CYP; some renal excretion unchanged
Excretion
Renal (85%, 23% unchanged); fecal (15%)
Contraindications
- Hypersensitivity to vildagliptin
- History of acute pancreatitis while on DPP-4 inhibitors
Side effects
Common
HeadacheDizzinessNasopharyngitisUpper respiratory tract infectionConstipationPeripheral edema
Serious
- Acute pancreatitis (rare but reported class effect)
- Hepatic dysfunction (elevated LFTs)
- Severe joint pain (class effect, DPP-4 inhibitors)
- Bullous pemphigoid (rare)
- Anaphylaxis (rare)
Pregnancy & lactation
Pregnancy
Avoid in pregnancy; limited data - animal studies show adverse effects
Lactation
Excreted in breast milk in animal studies; avoid during breastfeeding
Drug interactions
Sulfonylureas
Moderate
Database
Additive glucose lowering increases hypoglycemia risk; vildagliptin dose reduced to 50 mg OD
Use 50 mg OD vildagliptin; monitor for hypoglycemia
Source: Kimi deep-research + Cla
Metformin
Mild
Database
Complementary mechanisms; no direct pharmacokinetic interaction
Standard combination; beneficial synergistic effect
Source: Kimi deep-research + Cla
Ace Inhibitors
Mild
Database
Both can cause angioedema (rare); mechanistic link uncertain
Monitor for signs of angioedema
Source: Kimi deep-research + Cla
Cyp Inducers
Mild
Database
May reduce vildagliptin efficacy
Monitor glycemic control
Source: Kimi deep-research + Cla
5 additional unreviewed or low-confidence interactions hidden because their provenance or source detail is insufficient.
Related guidelines
Other Dipeptidyl peptidase-4 (DPP-4) inhibitor (gliptin) drugs
Ask House about Vildagliptin
Continue into a citation-backed clinical answer with the drug context already attached.
Textbook-sourced·Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Updated: 2026-05-19·Cockpit curated: 2026-05-19