Jalra (Vildagliptin)

Vildagliptin is indicated for the management of type 2 diabetes mellitus, a chronic metabolic disorder characterized by insulin resistance and impaired insulin secretion.

• Monotherapy for type 2 diabetes mellitus: lowers blood glucose and HbA1c when used as a single oral agent.
• Combination therapy for type 2 diabetes mellitus: added to metformin, sulfonylureas, or insulin to achieve additional glycaemic reduction.
• Adjunct to diet and exercise: enhances the glucose‑lowering effect of lifestyle modifications in type 2 diabetes.

• Vildagliptin selectively inhibits the enzyme dipeptidyl peptidase‑4 (DPP‑4), which degrades the incretin hormones GLP‑1 and GIP. By blocking DPP‑4, endogenous GLP‑1 and GIP concentrations increase, leading to glucose‑dependent stimulation of insulin secretion from pancreatic β‑cells and suppression of glucagon release from α‑cells, thereby reducing hepatic glucose production and improving post‑prandial glucose control.

Adverse reactions reported with vildagliptin are generally mild to moderate in intensity.

Common Side Effects

• Nausea: mild gastrointestinal discomfort.
• Headache: transient cranial pain.
• Dizziness: occasional light‑headedness.
• Upper respiratory tract infection: mild cold‑like symptoms.
• Hypoglycaemia (when combined with insulin or sulfonylureas): low blood sugar episodes.

Serious or Rare Side Effects

• Pancreatitis: severe abdominal pain requiring medical attention.
• Severe allergic reactions: rash, angioedema, or anaphylaxis.
• Hepatic dysfunction: elevated liver enzymes.
• Severe hypoglycaemia: prolonged low blood glucose.
• Bullous skin reactions: blistering dermatoses.

Before initiating therapy, clinicians should evaluate patient‑specific factors and monitor for potential risks.

• Monitor renal function: adjust use in severe renal impairment.
• Assess hepatic function: use with caution in liver disease.
• Avoid in patients with a history of pancreatitis.
• Educate about hypoglycaemia risk when combined with insulin or sulfonylureas.
• Pregnancy and lactation: safety not established; weigh benefits against risks.
• Store at ambient temperature below 25 °C: keep in the original container, protect from moisture and light.

Vildagliptin may interact with other medicines, requiring attention to dosage and monitoring.

Major Interactions (Avoid)

• Concomitant use with strong CYP2C19 inhibitors: may increase vildagliptin exposure.
• Combination with insulin or sulfonylureas: heightened risk of hypoglycaemia.
• Co‑administration with other agents known to cause pancreatitis.

Moderate Interactions (Monitor Closely)

• Rifampin: may reduce vildagliptin plasma levels.
• Diuretics: may affect renal clearance of vildagliptin.
• ACE inhibitors: monitor blood pressure and renal function when used together.