Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Second gliptin launched

Vildagliptin (Galvus®), the second in a new class of hypoglycaemics has been launched.

Vildagliptin is available as a 50mg tablet with a dosage recommendation of 50mg daily when in combination with a sulphonylurea and 50mg twice daily when used in combination with other oral antidiabetic drugs.

In addition, this new drug is also available in a combination formulation with metformin. Marketed as Eucreas®, each tablet contains 50mg of vildagliptin and either 850mg or 1000mg of metformin hydrochloride.

Comparing the two gliptins, vildagliptin has the disadvantage of being a twice daily medicine and being contraindication in hepatic impairment (including patients with pre-treatment alanine aminotransferase (ALT) or aspartate aminotransferase (AST)> 3x the upper limit of normal) with the small benefit of a combination product.

Action: The launch of this drug was delayed by safety concerns. Current recommendations still apply; if a gliptin is an appropriate therapeutic option then sitagliptin would appear to be the agent to choose.

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