Vildagliptin

A DPP-4 inhibitor that improves glycemic control in type 2 diabetes.

What is Vildagliptin?

Vildagliptin is an oral antidiabetic drug from the DPP-4 inhibitor class, used to treat type 2 diabetes mellitus.

It works by enhancing the body’s natural incretin system.

History & Background

Vildagliptin was among the early DPP-4 inhibitors developed to offer effective glucose control with a low risk of hypoglycemia.

Chemical Structure & Properties

• IUPAC name: (2S)-1-[2-[(3-hydroxyadamantan-1-yl)amino]acetyl]pyrrolidine-2-carbonitrile
• Molecular formula: C₁₇H₂₅N₃O₂
• Molar mass: 303.40 g/mol
• Functional groups: Nitrile, amide, tertiary amine

Mechanism of Action

Vildagliptin lowers blood glucose by:

• Inhibiting DPP-4 enzyme
• Increasing GLP-1 and GIP levels
• Enhancing glucose-dependent insulin secretion
• Suppressing glucagon release

Pharmacokinetics

• Absorption: Rapid oral absorption
• Peak plasma time: 1–2 hours
• Metabolism: Hepatic (minor)
• Half-life: ~3 hours
• Excretion: Urine

Medical Uses

• Type 2 diabetes mellitus
• Combination therapy with metformin
• Patients intolerant to sulfonylureas

Dosage Guidelines

Adults: 50 mg once or twice daily

Max dose: 100 mg/day

⚠️ Monitor liver enzymes during therapy.

Side Effects

• Headache
• Dizziness
• Nausea
• Elevated liver enzymes (rare)

Warnings & Precautions

• Not recommended in severe liver disease
• Monitor ALT/AST levels
• Not for type 1 diabetes

Drug Interactions

• Insulin and sulfonylureas (↑ hypoglycemia risk)
• Minimal CYP interactions

Frequently Asked Questions

Does vildagliptin cause hypoglycemia? – Rare.

Is it safe long-term? – Yes, with monitoring.

Does it cause weight gain? – No.

Can it be combined with metformin? – Yes.

⚠️ Educational content only. Not a substitute for professional medical advice.