Can I take Alogliptin and Rybelsus together?

Why this happens

Both drugs target the 'incretin' system. Alogliptin (a DPP-4 inhibitor) prevents the breakdown of natural hormones that lower blood sugar, while Rybelsus (a GLP-1 receptor agonist) mimics those same hormones. Using both is like 'doubling up' on the same biological process, which can lead to an over-correction of blood sugar levels.

What you should do

You should speak to your doctor or pharmacist before taking these together. Clinical guidelines usually recommend stopping the DPP-4 inhibitor (alogliptin) when starting a GLP-1 medicine like Rybelsus. If your doctor has specifically told you to take both, be very alert for signs of low blood sugar, such as feeling shaky, sweaty, dizzy, or hungry.

Important precautions

Pancreatitis

Stop taking these medicines and seek immediate medical help if you develop severe, persistent stomach pain which may reach through to your back. These drugs are linked to a risk of inflamed pancreas (pancreatitis).

Diabetic retinopathy

If you have a history of diabetic eye problems, you must have regular eye checks. Rapid improvement in blood sugar levels with Rybelsus can lead to a temporary worsening of diabetic retinopathy.

Heart failure

Contact your doctor immediately if you experience increasing shortness of breath, tiredness, or swelling of the ankles, as alogliptin may increase the risk of heart failure.

Food and drink warnings

Food, drink, and other oral medicines

Rybelsus must be taken on an empty stomach with a small sip of plain water (no more than 120ml). You must wait at least 30 minutes before eating, drinking anything else, or taking other oral medicines. If you eat or drink too soon, the medicine will not be absorbed properly and will not work.

Alcohol

While there is no direct chemical interaction, alcohol can affect blood sugar levels and increase the risk of hypoglycaemia (low blood sugar). Excessive drinking can also increase the risk of pancreatitis, a rare but serious side effect associated with these types of diabetes medications.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.