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

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

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

Angiotensin Converting Enzyme (ace) Inhibitors

Moderate

Database

Increased risk of angioedema

Monitor patients for signs and symptoms of angioedema, especially at the start of therapy. Consider alternative antihypertensive agents if angioedema occurs.

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

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