VILDISHAL 50MG TABLETS

Indications

• Type 2 diabetes mellitus
• Management of hyperglycemia in patients who are not adequately controlled on diet and exercise alone
• Used as monotherapy or in combination with other antidiabetic medications

Dosage

Children: Refer to the specific guidelines in the BNF for Children for appropriate paediatric dosing.

Adults: Refer to the specific guidelines in the BNF for detailed dosing recommendations.

Mechanism of action

Vildagliptin inhibits the enzyme dipeptidyl peptidase-4 (DPP-4), which is responsible for the degradation of incretin hormones such as GLP-1 (glucagon-like peptide-1) and GIP (gastric inhibitory polypeptide). By inhibiting DPP-4, vildagliptin increases the concentration of these hormones, leading to enhanced insulin secretion from pancreatic beta cells and decreased glucagon release from alpha cells, thereby resulting in reduced blood glucose levels.

Pharmacodynamics

Vildagliptin has a rapid onset of action, with effects seen within 1-2 hours after administration. The drug helps in regulating blood glucose levels by increasing insulin secretion in response to meals, and decreasing hepatic glucose production. It is considered to be weight neutral and has a low risk of causing hypoglycemia compared to other antidiabetic medications.

Pharmacokinetics

Vildagliptin is rapidly absorbed after oral administration, with peak plasma concentrations typically occurring within 1-2 hours. It has a bioavailability of approximately 85% and is primarily eliminated by renal excretion, with around 80% of the dose being excreted as unchanged drug in urine. Its half-life is approximately 2-3 hours, and it is not significantly metabolized by the liver.

Contra-indications

• Hypersensitivity to vildagliptin or any of its excipients
• Severe renal impairment
• History of pancreatitis

Adverse effects

• Hypoglycemia
• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Headache
• Dizziness
• Skin reactions such as rash

Interactions

• May enhance the hypoglycemic effect of other antidiabetic agents
• Co-administration with strong CYP3A4 inhibitors may increase vildagliptin levels
• Use with caution in patients taking medications that may affect renal function

Precautions

• Monitor renal function regularly
• Assess for signs and symptoms of pancreatitis
• Caution in patients with a history of heart failure
• Consider alternative therapies for patients with significant renal impairment

Pregnancy

Limited data on the use of vildagliptin in pregnancy. Use only if clearly needed and benefit outweighs risk.

Breast-feeding

Vildagliptin is excreted in milk; caution is advised if used during breastfeeding.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Tablets: 50 mg