Nesina is an oral diabetes medicine that helps control blood sugar levels. It works by regulating the levels of insulin your body produces after eating.

Nesina is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. This medicine is not for treating type 1 diabetes.

Nesina is sometimes used in combination with other diabetes medications.

Nesina can cause serious side effects on your heart or pancreas, especially if you have ever had similar problems, or if you have kidney or liver disease.

Call your doctor right away if you have: signs of pancreatitis - severe pain in your upper stomach spreading to your back; or signs of heart failure - shortness of breath while lying down, weight gain, swelling in your legs or feet.

Nesina is not for treating type 1 diabetes.

Take Nesina exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

You may take Nesina with or without food. Follow your doctor's instructions.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.

You may ay have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Nesina is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Store at room temperature away from moisture, heat, and light.

Usual Adult Dose for Diabetes Type 2:

Usual dose: 25 mg orally once a day

Comments: When used in combination with insulin or insulin secretagogues such as sulfonylureas, a lower dose of insulin or the insulin secretagogue may be required to minimize the risk of hypoglycemia.

Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus; may be used as monotherapy or in combination therapy .

You should not use Nesina if you are allergic to alogliptin, or if you have diabetic ketoacidosis (call your doctor for treatment).

To make sure Nesina is safe for you, tell your doctor if you have ever had:

• liver disease;

• heart disease;

• kidney disease (or if you are on dialysis);

• pancreatitis;

• gallstones; or

• alcoholism.

Follow your doctor's instructions about using Nesina if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby.

It may not be safe to breastfeed while using Nesina. Ask your doctor about any risk.

Nesina is not approved for use by anyone younger than 18 years old.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. You may have signs of low blood sugar, such as extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

Avoid drinking alcohol.

Get emergency medical help if you have signs of an allergic reaction to Nesina: (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Stop taking Nesina and call your doctor right away if you have symptoms of pancreatitis: severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, or fast heartbeats.

Call your doctor at once if you have:

• severe or ongoing pain in your joints;

• heart problems - shortness of breath (even while lying down), rapid weight gain, swelling (especially in your feet, legs, or midsection);

• liver problems - nausea, upper stomach pain, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

• a severe autoimmune reaction - itching, blisters, breakdown of the outer layer of skin.

Common Nesina side effects may include:

• headache; or
• cold symptoms such as stuffy nose, sinus pain, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may increase or decrease the effects of Nesina on lowering your blood sugar. Tell your doctor about all medications you use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.