Nesina: Uses, Side Effects and Dosage

What NESINA is used for:

NESINA is used with diet and exercise to improve blood sugar levels in adult patients with type 2 diabetes. NESINA is used:

• alone in patients who cannot take metformin; or
• in combination with metformin; or
• in combination with a sulfonylurea; or
• in combination with pioglitazone; or
• in combination with insulin (with or without metformin); or
• in combination with pioglitazone and metformin.

How NESINA works:

NESINA contains the medicinal ingredient alogliptin. Alogliptin is a 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.

The ingredients in NESINA are:

Medicinal ingredients: Alogliptin benzoate

Non-medicinal ingredients: croscarmellose sodium, hydroxypropylcellulose, hypromellose 2910, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol (Macrogol 8000), printing ink (Gray F1), red iron oxide (E172) (present in 25 mg and 6.25 mg tablets), titanium dioxide (E171), yellow iron oxide (E172) (present in 12.5mg tablets).

NESINA comes in the following dosage forms:

Tablets: 6.25 mg, 12.5 mg, and 25 mg alogliptin (as alogliptin benzoate)

Do not use NESINA if:

• you are allergic to alogliptin or any of the other ingredients of this medicine

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

• have type 1 diabetes. This means your body does not produce insulin;
• have diabetic ketoacidosis. This is a complication of diabetes that happens when the body can’t breakdown glucose because there is not enough insulin. Symptoms include excessive thirst, frequent urination, loss of appetite, nausea or vomiting and rapid weight loss;
• are taking the anti-diabetic medicines pioglitazone, metformin, insulin (with or without metformin) or a sulfonylurea (e.g. glipizide, tolbutamide, glibenclamide). Your doctor may want to reduce your dose of these other medicines when you take any of them with NESINA. This is to avoid your blood sugar becoming too low.
• have or have had kidney problems;
• suffer from heart failure;
• have or have had liver problems;
• had an organ transplant;
• have human immunodeficiency syndrome (HIV) or an infection that lasted a long time;
• have had allergic reactions to any other medications that you take to control your blood sugar. Symptoms may include general itching and feeling of heat especially affecting the scalp, mouth, throat, palms of hands and soles of feet, as well as blistering (Stevens-Johnson Syndrome).
• 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 NESINA.

Other warnings you should know about:

Bullous pemphigoid is possible with NESINA 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).

Tests and check-ups: Before and during treatment with NESINA, your healthcare professional will do blood tests. These will be done regularly. The results will tell how well your kidneys and liver are working and will check how NESINA has affected your blood and blood sugar. 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 breast-feeding: 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 NESINA in pregnancy.

Do not breast-feed while taking NESINA since metformin passes into breast milk.

Driving and using machines: NESINA 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 NESINA:

There are no known relevant interactions with NESINA at this time.

How to take NESINA:

• Take NESINA exactly as your healthcare professional has told you. Check with your doctor or pharmacist if you are not sure.
• Take your tablet(s) once per day with or without food.
• Swallow your tablet(s) whole with water.
• Your doctor may prescribe NESINA together with another medicine to control your blood sugar levels.

Usual dose:

The recommended dose of NESINA is 25 mg once a day.

Your doctor will tell you if you need to change the amount of other medicines you take.

Your doctor may prescribe you a reduced dose if:

• you have kidney disease, or
• you are taking NESINA with a sulfonylurea drug or with insulin.

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 NESINA:

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

• cold or flu like symptoms such as sore throat, stuffy or blocked nose, feeling tired, fever, chills, body ache, dry cough
• fatigue
• rash or itchy skin
• headache
• abdominal pain
• stomach pain
• nausea
• vomiting
• diarrhea
• constipation
• indigestion, heartburn
• back pain
• muscle and/or bone pain (including of the chest)
• toothache
• cramp
• difficulty sleeping
• tiredness, weakness, dizziness or pale complexion due to low red blood cells (anaemia)
• swelling of extremities
• high blood pressure
• high cholesterol or fat in blood
• pain, numbness or sensation of “pins and needles” in extremities

NESINA can cause abnormal blood test results. Your healthcare professional 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 NESINA at 15 – 30° C.

Keep out of reach and sight 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.

NESINA 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 NESINA:

• 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 (Drug Product Database: Access the database); 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: 2026-09-23

NESINA is a registered trademark of Takeda Pharmaceutical Company Limited.

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