TENGLYN

Indications

• Type 2 diabetes mellitus
• Hyperglycemia in adults with type 2 diabetes

Dosage

Adults: The usual recommended dose of teneligliptin is 20 mg once daily, taken orally. In patients with renal impairment, dose adjustments may be required according to renal function.

Mechanism of action

Teneligliptin inhibits the enzyme DPP-4, which is responsible for the degradation of incretin hormones, such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). By inhibiting DPP-4, teneligliptin increases the levels of these incretins, leading to enhanced insulin secretion from the pancreatic beta cells and reduced glucagon secretion from the alpha cells. This mechanism helps to lower blood glucose levels in a glucose-dependent manner, thus minimizing the risk of hypoglycemia.

Pharmacodynamics

Teneligliptin exhibits a prolonged duration of action and has a favorable pharmacodynamic profile, leading to improved glycemic control in patients with type 2 diabetes. The increase in incretin hormones contributes to improved beta-cell function and insulin sensitivity. Additionally, teneligliptin may also have beneficial effects on body weight and lipid metabolism, making it a suitable option for overweight patients with type 2 diabetes.

Pharmacokinetics

Teneligliptin is absorbed rapidly following oral administration, with peak plasma concentrations typically reached within a few hours. It has a bioavailability of approximately 60-70%. The drug is extensively metabolized in the liver, primarily via the CYP3A4 pathway, with its elimination occurring mainly through renal excretion. The half-life of teneligliptin is around 10-12 hours, which allows for once-daily dosing. Factors such as renal impairment may necessitate dosage adjustments.

Contra-indications

• Hypersensitivity to teneligliptin or any of its components
• Severe renal impairment (eGFR < 15 mL/min)
• Diabetic ketoacidosis

Adverse effects

• Hypoglycemia
• Gastrointestinal disturbances (nausea, vomiting, diarrhea)
• Headache
• Dizziness
• Pancreatitis
• Allergic reactions (rash, pruritus)

Interactions

• Caution with concomitant use of medications that affect glycemic control
• May interact with other antidiabetic agents, which can increase the risk of hypoglycemia
• Potential interaction with strong CYP3A4 inhibitors and inducers

Precautions

• Monitor renal function regularly
• Use with caution in patients with a history of pancreatitis
• Adjust dose in elderly patients or those with renal impairment

Pregnancy

There is limited data on the use of teneligliptin in pregnancy. It should only be used if the benefits outweigh the risks.

Breast-feeding

It is not known if teneligliptin is excreted in human milk. Caution should be exercised when administered to breastfeeding women.

Storage

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

Formulations

• Tablets of 20 mg