Alogliptin (Nesina) DPP4i

慢性腎病可使用
第一階, 第二階 不用降低劑量, 25 mg qd.
第三階 CCR 30-60 劑量減半 12.5 mg qd.
第四階 第五階 及洗腎病患, 劑量 6.25 mg qd.
Alogliptin (Nesina) 不會代謝, 以原型藥從腎臟排出 (佔藥物的70%), 少量的代謝物 M1 具生理活性, 但濃度相當低 (<1%), Alogliptin 經腎絲球過濾排出, 也會透過腎小管分泌系統排出體外

This DPP-4 inhibitor is not practically metabolized and is excreted unchanged in the urine. (More than 70% of the parent drug). One minor metabolite named M1 is active but its concentration remains quite low (< 1%)[30]. Alogliptin is excreted by glomerulus filtration as well as by active tubular secretion.

In patients with CKD stage 1 and 2 no dose adjustment is needed (25 mg × 1 daily). In patients with CKD stage 3 (CrCl ≥ 30 to < 60 mL/min), the recommended dose is 12.5 mg once daily and in patients with CKD stage ≥ 4 the recommended dose is 6.25 mg once daily. The same dose is required in patients with end-stage renal disease requiring dialysis.