<p><strong>Pancreatitis:</strong>&nbsp;Acute pancreatitis has been reported in patients receiving alogliptin therapy. Patients should be monitored for signs and symptoms of pancreatitis, and therapy should be discontinued if pancreatitis is suspected. It is unknown whether patients with a history of pancreatitis have an increased risk of developing pancreatitis while receiving alogliptin.<br />
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<strong>Hypersensitivity Reactions:</strong>&nbsp;Serious hypersensitivity reactions, including anaphylaxis, angioedema, and severe cutaneous reactions including Stevens-Johnson syndrome, have been observed in patients receiving alogliptin therapy. It is unknown whether patients with a history of angioedema with another DPP-4 inhibitor will be predisposed to angioedema with alogliptin.<br />
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<strong>Heart Failure:&nbsp;</strong>Consider the risks and benefits of alogliptin prior to initiating treatment in patients at risk for heart failure, such as those with a prior history of heart failure and a history of renal impairment, and observe these patients for signs and symptoms of heart failure during therapy. Patients should be advised of the characteristic symptoms of heart failure and should be instructed to immediately report such symptoms. If heart failure develops, evaluate and manage according to current standards of care and consider discontinuation of alogliptin.<br />
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Insulin and insulin secretagogues, such as sulfonylureas, are known to cause hypoglycemia. Therefore, a lower dose of insulin or insulin secretagogue may be required to minimize the risk of hypoglycemia when used in combination with angioedema.</p>