Kazano: Uses, Side Effects and Dosage

Serious warnings and precautions box

What KAZANO is used for:

KAZANO is used with diet and exercise to improve control of blood sugar in adults with type 2 diabetes. KAZANO is used:

• in patients whose diabetes is not controlled on metformin alone; or
• in patients currently taking alogliptin and metformin; or
• in combination with pioglitazone for patients whose diabetes is not controlled with metformin and pioglitazone; or
• in combination with insulin for patients whose diabetes is not controlled with insulin and metformin.

How KAZANO works:

KAZANO contains the medicinal ingredients alogliptin and metformin. These two medicines work together to help control your blood sugar level.

Alogliptin is dipeptidyl peptidase-4 (DPP-4) inhibitor. It helps to improve the levels of insulin when blood sugar is high, especially after a meal. Alogliptin also helps to lower the amount of sugar made by the body.

Metformin is a biguanide medicine. It helps to lower the amount of sugar made by the liver.

The ingredients in KAZANO are:

Medicinal ingredients: alogliptin benzoate and metformin hydrochloride

Non-medicinal ingredients: crospovidone, hypromellose (2910), magnesium stearate, mannitol, microcrystalline cellulose (PH 101 and KG-1000), povidone, talc, titanium dioxide, yellow iron oxide.

KAZANO comes in the following dosage form:

Tablet: 12.5 mg/500mg, 12.5 mg/850 mg, 12.5mg/1000 mg alogliptin (as alogliptin benzoate) and metformin hydrochloride

Do not use KAZANO if:

• you have unstable and/or insulin-dependent (Type 1) diabetes mellitus.
• you are allergic to alogliptin, metformin or any of the other ingredients of this medicine.
• you recently had a heart attack or have severe circulatory problems including shock.
• you have severe breathing difficulties.
• you have severe kidney disease or are on dialysis.
• you have liver disease.
• you drink alcohol excessively (either every day or only from time to time).
• you have had lactic acidosis. This is a condition where there is too much acid in the blood.
• you have or have had diabetic ketoacidosis. This is a serious complication of poorly controlled diabetes which can lead to coma. Symptoms include excessive thirst, frequent urination, loss of appetite, nausea or vomiting and rapid weight loss.
• you have a severe infection or have recently had surgery.
• you are seriously dehydrated. This means you have lost a lot of water from your body. This can happen if you are sick with a fever, vomiting, or diarrhea. Dehydration can also happen when you sweat a lot with activity and don’t drink enough fluids.
• you are going to have a type of X-ray with an injectable dye. You will need to stop taking this medicine at the time of and for a couple of days after the procedure.
• you are pregnant or planning to become pregnant
• you are breastfeeding

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take KAZANO. Talk about any health conditions or problems you may have, including if you:

• are taking KAZANO with insulin. Your doctor may want to reduce your dose of insulin when you take it together with KAZANO in order to avoid too low blood sugar.
• are going to have an operation under general, spinal or epidural anesthetic. You may need to stop taking this medicine for a couple of days before and after the procedure.

• have risk factors for pancreatitis (inflammation of the pancreas) such as:

  • gallstones (solid particles that form in the gall bladder).
  • a history of alcoholism.
  • high triglyceride levels.
• have or have had kidney problems;
• had an organ transplant.
• have human immunodeficiency syndrome (HIV) or an infection that lasted a long time.
• have vitamin B12 deficiency or anemia.
• have hypothyroidism (low levels of thyroid hormones).
• are older than 65 years of age.
• have a history of angioedema, which is swelling of the tissues under the skin. This is because you may be more likely to have an allergic reaction to KAZANO.

Other warnings you should know about:

Low vitamin B12 is possible with metformin treatment. This can cause you to feel pins and needles in your hands and feet, which is called peripheral neuropathy. Your healthcare professional will check your B12 levels every one to two years.

Bullous pemphigoid is possible with KAZANO treatment. This is a serious skin reaction where the skin may blister and peel. If this happens to you, contact your healthcare professional right away. Your treatment may need to be stopped. You may also need to see a dermatologist (skin specialist).

Lactic Acidosis: This is a serious complication that can happen with KAZANO treatment. It happens when lactic acid builds up in the blood and can lead to death. It is a medical emergency that must be treated in a hospital.

Stop taking KAZANO if you get the following symptoms of lactic acidosis:

• feel very weak and tired.
• unusual (not normal) muscle pain.
• trouble breathing.
• stomach pain with nausea and vomiting, or diarrhea.
• feel cold, especially in your arms and legs.
• feel dizzy or lightheaded.
• slow or irregular heartbeat.
• Your medical condition suddenly changes.

You have a higher chance of getting lactic acidosis if you:

• have severe kidney problems.
• have liver problems.
• have congestive heart failure that requires treatment with medicines.
• drink a lot of alcohol (very often or short-term “binge” drinking).
• get dehydrated.
• have certain x-ray tests with injectable dyes or contrast agents used.
• have surgery.
• have a heart attack, severe infection, or stroke.
• have or think you have a mitochondrial disease (disease that is passed down at birth affecting mitochondria). For these patients taking KAZANO increases the risk for lactic acidosis and can lead to worsening of the mitochondrial disease.

Tests and check-ups: Before and during treatment with KAZANO, your healthcare professional will do blood tests. These will be done regularly. The results will tell how well your liver, kidneys and thyroid are working and will check how KAZANO has affected your blood and blood sugar. Blood tests and tests for your kidneys will be done at least once a year. They may be done more often if you are elderly or if you have kidney problems that could get worse.

Pregnancy and breastfeeding: If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. You should not use KAZANO in pregnancy.

Do not breastfeed while taking KAZANO since metformin passes into breast milk.

Driving and using machines: KAZANO can cause low blood sugar when it is taken with some other medications. Do not drive or use machines if you develop low blood sugar.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with KAZANO:

• medicines to treat diseases that involve inflammation like asthma and arthritis called corticosteroids including hydrocortisone and prednisolone.
• other medicines to treat diabetes such as glyburide or sulfonylurea. This is particularly important if you are also taking other medicines that may increase the effects of sulfonylureas. Such medicines include long-acting sulfonamides, tuberculostatics, phenylbutazone, clofibrate, monoamine oxidase inhibitors, salicylates, probenecid and propranolol.
• diuretic medicines like furosemide. These are also called “water pills”.
• medicines to treat high blood pressure including nifedipine, ramipril, lisonopril and enalapril (ACE inhibitors).
• medicines that slow down the speed that metformin is removed from your body such as ranolazine, vandetanib, dolutegravir.

• other medicines that may cause high blood sugar and lead to a loss of control of your blood sugar including:

  • Phenothiazines
  • Thyroid products
  • Estrogens or estrogens plus progestogen
  • Oral birth control
  • Phenytoin
  • Nicotinic Acid
  • Sympathomimetics
  • Calcium channel blocking drugs
  • Isoniazid
• a medicine used to treat stomach problems called cimetidine.
• medicines used to treat asthma called bronchodilators such as beta-2 agonists.
• substances containing iodine used to increase contrast during body scans.
• medicines containing alcohol.
• medicines used to treat glaucoma and epilepsy called carbonic anhydrase inhibitors such as topimarate, zonisamide, acetazolamide, or dichlorphenamide.

How to take KAZANO:

• Take KAZANO exactly as your healthcare professional has told you. Check with them if you are not sure.
• Swallow your tablet(s) whole with water.
• Take with food to reduce your chance of an upset stomach.

Usual dose:

The usual adult dose is one tablet twice a day.

Your doctor will tell you exactly how much KAZANO you need to take. Your dose of KAZANO will depend on:

• your condition,
• the doses you currently take of metformin alone, metformin in combination with pioglitazone, insulin and/or individual tablets of alogliptin and metformin,
• whether you have kidney problems, and
• whether you are taking other medicines that can affect your kidneys.

Overdose:

Missed dose:

If you forget to take a dose, take it as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose. Do not take two doses at the same time to make up for a forgotten dose.

Possible side effects from using KAZANO:

These are not all the possible side effects you may have when taking KAZANO. If you experience any side effects not listed here, tell your healthcare professional.

• nausea, diarrhea, stomach upset, abdominal bloating, gas and appetite loss
• constipation
• vomiting
• indigestion, heartburn
• abdominal pain
• stomach pain
• shortness of breath
• cold or flu-like symptoms such as sore throat, stuffy or blocked nose, feeling tired, fever, chills, body aches, dry cough
• coughing, wheezing shortness of breath, difficulty breathing, with or without fever
• headache
• difficulty sleeping
• fatigue
• itchy and red eye(s), with or without discharge (pink eye)
• dry, itchy skin, with or without hives, rash
• swollen or irritated blood vessels in the anus and rectum (hemorrhoids)
• gallstones
• kidney stones
• bruise
• back pain
• muscle and/or bone pain (including of the chest)
• cramp
• a metallic taste in your mouth
• toothache
• swelling of extremities
• sensation of “pins and needles” or numbness usually in the hands, arms, legs or feet
• pain, weakness, numbness, or tingling in the leg (sciatica)
• high blood pressure

KAZANO can cause abnormal blood test results. Your doctor will decide when to perform tests and will interpret the results.

Serious side effects and what to do about them

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting Side Effects

Storage:

Store KAZANO at 15-30°C.

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and bottle or blister after EXP. The expiry date refers to the last day of that month.

This medicinal product does not require any special storage conditions.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

If you want more information about KAZANO:

• Talk to your healthcare professional
• Find the full product monograph that is prepared for healthcare professionals and includes the Patient Medication Information by visiting the Health Canada Drug Product Database website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website (www.takeda.com/en-ca), or by calling 1-800-268-2772.

Takeda Canada Inc.

22 Adelaide Street West, Suite 3800

Toronto Ontario M5H 4E3

Date of Authorization: 2026-09-21

KAZANO® is a registered trademark of Takeda Pharmaceutical Company Limited.

TAKEDA™ and the TAKEDA Logo® are trademarks of Takeda Pharmaceutical Company Limited, used under license.