Alogliptin (Nesina): Side Effects and How To Manage Them

Alogliptin (common brand names Nesina and Vipidia) is a medication used to treat type 2 diabetes. 

Vipidia is in a class of medications called DPP-4 inhibitors, which work to help boost insulin secretion and reduce the production of sugar from your liver.

Alogliptin is an oral medication with common dosages ranging from 12.5-25 milligrams per day. 

It’s primarily used for adults, as its safety hasn’t been established in children under the age of 18.

If you’ve been prescribed Nesina for your diabetes, you might be wondering what kind of side effects you could experience. 

We’ll review the common side effects of alogliptin and offer suggestions on ways to reduce these side effects in this article.

What are the side effects of Alogliptin?

1) Cold-like symptoms

One of the more common side effects of alogliptin (impacting more than 1 in 100 people) is cold-like symptoms, even if you don’t have a cold virus. 

Resting and taking over-the-counter medications like ibuprofen can help you feel more comfortable until your symptoms improve or resolve. 

If you still feel ill after several days or weeks of taking alogliptin, reach out to your healthcare provider for advice.

If you lose your appetite due to cold-like symptoms from alogliptin, choose foods like broth-based soups and homemade smoothies to help meet your nutrition needs until you feel better.

For a sore throat, try drinking herbal tea with some honey or sucking on throat lozenges. If you use several throat lozenges, be aware that your blood sugar level might increase from added sugar. 

Eating cold foods like frozen fruit can also temporarily reduce throat pain.

For a cough, stay hydrated and try breathing in warm mist, such as standing in a running shower. 

The use of humidifiers, especially at bedtime when coughs can be the worst, might also help.

2) Headache

If you experience a headache from taking alogliptin, try to keep your fluid intake up by drinking plenty of water and other unsweetened beverages.

Applying a cold washcloth to your head can help reduce pain from headaches. You can find freezable gel packs specifically for placing on your head to make it easier to apply a cold treatment for your headache.

Taking over-the-counter pain relievers can also help manage the pain until your headache reduces in intensity. 

If you have a severe headache that isn’t responding to OTC medications, reach out to your healthcare provider for suggestions.

3) Stomach ache

An upset stomach is a common side effect of medications like Vipidia. Choose easy-to-digest foods like broth-based soups, crackers, and smoothies made with fruit and plain yogurt to sip on throughout the day.

If you experience indigestion (heartburn), avoid high-fat and greasy foods and focus on bland foods instead. 

You might also want to avoid caffeine, alcohol, and mint, which are all known to worsen indigestion.

For stomach cramps, apply a warm heating pad to your stomach area and try to rest until the cramps resolve. 

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4) Diarrhea

Like stomach aches and indigestion, diarrhea can be a common side effect of Nesina. 

You’ll need to take care to prevent dehydration if you have persistent diarrhea, which can lead to fluid and electrolyte loss.

Sipping on bone broth or low-sugar electrolyte drinks can help replenish lost electrolytes from more severe diarrhea. 

Be careful not to drink large amounts of regular sports drinks, which are very high in added sugar and can spike your blood glucose levels.

If you take oral contraceptives and are experiencing severe diarrhea, they might not be effective, so speak with your healthcare provider about options for contraception until your diarrhea resolves.

If your diarrhea is severe for over a week, or you experience symptoms of dehydration (feeling lightheaded, having very dark, foul-smelling urine, etc), reach out to your healthcare provider.

5) Rash or itchy skin

You might develop a rash or itchy skin from taking alogliptin. If that’s the case, over-the-counter antihistamine medications can help reduce symptoms until your body gets used to the medication. 

Examples of over-the-counter antihistamines include diphenhydramine (Benadryl) and Cetirizine (Zyrtec), though there are several options.

Avoid applying scented creams or lotions if you have an itchy rash since some of these lotions contain irritating ingredients. 

Opt for a plain, unscented cream if you want to moisturize your itchy, irritated skin – or reach out to a dermatologist for specific recommendations.

6) Hypoglycemia (low blood sugar)

Low blood sugar isn’t a common side effect of alogliptin, but it’s possible, especially if you’re taking other medications like insulin or sulfonylureas.

Symptoms of hypoglycemia include dizziness, hunger, sweating, shaking, and a change in your mood, such as feeling irritable.

7) Pancreatitis

While it’s rare, there is a possibility of developing pancreatitis from alogliptin. 

If you have severe abdominal pain that spreads to your back or chest, especially when accompanied by nausea, vomiting, fever, and an increased heart rate, you might have pancreatitis (inflammation of your pancreas).

If this occurs, seek urgent medical attention for an accurate diagnosis and proper treatment. 

You might require a brief hospitalization if your pancreatitis becomes severe enough, so it’s important not to “wait out” severe symptoms.

If you have pancreatitis, you’ll need to avoid all alcohol as well as fatty foods until your symptoms resolve. 

A bland, low-fat diet can help reduce pancreatitis pain as the inflammation improves.

8) Allergic reaction

While rare and not as common as the other side effects, you may be allergic to alogliptin or its ingredients. 

Watch out for signs of an allergy, such as:

  • Hives
  • Itching of your skin or eyes
  • Skin rash
  • Trouble breathing
  • Swelling of your lips, tongue, or face

If you develop a severe allergic reaction and are having difficulty breathing, seek emergency medical attention right away.

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How long do Nesina’s side effects last?

Side effects from new medications are typically the most severe soon after you start the medication. Side effects typically reduce in severity and gradually go away over a few weeks.

Everyone is different, so it’s impossible to estimate exactly how long side effects will last. Some people have side effects the entire time they take medication, too.

If your side effects aren’t improving after a month at your target dose, or they are so severe that they are interfering with your quality of life, reach out to your prescribing provider to discuss options.

Research on alogliptin’s safety indicates its effectiveness and generally good tolerance. However, individual responses may vary, and it is essential to consult with your healthcare provider about potential side effects.

Are there any long-term side effects of Vipidia?

Heart failure

Studies are being conducted on the impact of DPP-4 medications (like alogliptin) on heart function. 

Some studies link long-term use of DPP-4 inhibitors with new onset heart failure when taken for 29 weeks or longer.

Another study concluded that DPP-4 inhibitors don’t appear to offer any cardiovascular benefits compared to other classes of medications like GLP-1 receptor agonists and SGLT2 inhibitors. 

The study also found that DPP-4 inhibitors can increase the likelihood of atrial flutter, a type of abnormal heart rhythm (arrhythmia). 

If you have a history of heart failure, your healthcare provider will carefully assess the suitability of Nesina for your specific condition.

If you have a history of cardiovascular disease or have risk factors for heart problems, your doctor will suggest a medication with the most potential benefits compared to potential risks.

Side effects of Alogliptin in elderly patients


Side effects like dehydration from diarrhea might be more apparent in the elderly. 

Studies show that elderly people are already at greater risk of dehydration due to reduced thirst, which can also cause dizziness and increase the risk of falls.


Older adults are at higher risk of getting low blood sugar (hypoglycemia). Monitor for signs of low blood sugar in elderly patients taking Vipidia, especially with the use of other diabetes medications.

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Side effects of stopping Alogliptin

Increased blood sugar

The most likely side effect of stopping alogliptin is a rise in blood sugar. This is especially likely if you don’t replace Vipidia with another diabetes medication.

Resolving side effects

A positive side effect of stopping alogliptin is the resolution of any side effects you were experiencing. 

You’ll likely notice an improvement in side effects a few days after completely stopping alogliptin.


  • Alogliptin is an oral type 2 diabetes medication. It’s in a drug class called DPP-4 inhibitors, which help to increase insulin secretion when needed and reduce the production of sugar in your liver when it’s not needed.
  • Some of the most common side effects of alogliptin include symptoms of a common cold, headache, stomach problems, and an itchy rash.
  • There aren’t many known long-term side effects of alogliptin. One of the main concerns with the long-term use of Nesina is the potential for worsening heart failure in patients with existing heart failure, as well as possible new-onset heart failure from taking alogliptin.

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  2. Li L, Li S, Deng K, Liu J, Vandvik PO, Zhao P, Zhang L, Shen J, Bala MM, Sohani ZN, Wong E, Busse JW, Ebrahim S, Malaga G, Rios LP, Wang Y, Chen Q, Guyatt GH, Sun X. Dipeptidyl peptidase-4 inhibitors and risk of heart failure in type 2 diabetes: systematic review and meta-analysis of randomised and observational studies. BMJ. 2016 Feb 17;352:i610. doi: 10.1136/bmj.i610. PMID: 26888822; PMCID: PMC4772781.
  3. Patoulias DI, Boulmpou A, Teperikidis E, Katsimardou A, Siskos F, Doumas M, Papadopoulos CE, Vassilikos V. Cardiovascular efficacy and safety of dipeptidyl peptidase-4 inhibitors: A meta-analysis of cardiovascular outcome trials. World J Cardiol. 2021 Oct 26;13(10):585-592. doi: 10.4330/wjc.v13.i10.585. PMID: 34754403; PMCID: PMC8554356.
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