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The Most Affordable Type 2 Diabetes Drugs-Wedica (Trelagliptin )

Wedica is a dipeptidyl peptidase-IV (DPP-4) inhibitor designed for weekly use. It manages blood glucose levels by consistently and selectively inhibiting DPP-4, an enzyme responsible for deactivating glucagon-like peptide-1 and glucagon-dependent insulinotropic polypeptide. These incretin hormones are crucial for regulating blood glucose. The inhibition of DPP-4 promotes insulin secretion based on blood glucose levels, effectively controlling blood glucose. Wedica is conveniently administered orally in tablet form.

What can does Wedica (Trelagliptin ) do?

Wedica, also known as Trelagliptin, is a medication that belongs to the class of dipeptidyl peptidase-IV (DPP-4) inhibitors. It is used to manage and control blood glucose levels in individuals with type 2 diabetes.

Wedica works by selectively inhibiting the DPP-4 enzyme, which would otherwise deactivate incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucagon-dependent insulinotropic polypeptide (GIP). These hormones play a vital role in regulating insulin release in response to blood glucose levels.

By inhibiting DPP-4, Wedica enhances the activity of incretin hormones, leading to increased insulin secretion. This mechanism helps to lower blood glucose levels and improve glycemic control in people with type 2 diabetes. Wedica is typically administered in tablet form for oral use, and its once-weekly dosing schedule provides a convenient option for individuals managing their diabetes.

Wedica (Trelagliptin)

Basic information of Wedica (Trelagliptin)

Composition

Wedica 50 Tablet: Each flm coated tablet contains Trelaglipfin Succinate INN equivalent to Trelagliplin 50 mg.

Wedica 100 Tablet: Each film coated tablet contains Trelagliptin Succinate INN equivalent to Trelagliplin 100 mg.

Therapeutic Class: Anti-Diabetic Drug.

Pharmacological Action

Mechanism of Action

By inhibiting the activity of dipeplidyl peptidase 4 Trelagliplin inactivates glucagonlike peptide I (GLP-1)from secretion from the intestines to the blood via stimulation from oral intake of food, increases GLP-1 blood concentralion and promotes blood glucose concentration-dependent insulin secrefion from the pancreas.

1.DPP-4 Inhibition

a)Selectively inhibits human plasma DPP-4 aclivity (IC50 value:4.2 nmol/L)(in vitro).Moreover, when IC50 value (nmol/L)was compared under similar conditions (in vitro)in order to compare Trelaglipfin and alogliptin DPP-4 inhibitory action,values were 1.3 and 5.3 respectively.

b)Type 2 diabetes patients who exhibit insufficient blood glucose control through dietary and exercise measures were given 100 mg of Trelagliptin (once weekly,before meall for 12 weeks. The results of the double blind,parallel group,placebo-controlled comparative study show that 7 daysaffer final treatment,the average DPP-A inhibition rate was 77.4%compared in the Trelagliplin 100 mg group.

2.Active Type GLP-1 Concentration Elevation

Type 2 diabetes patients who exhibit insufficient blood glucose control through dietary and

exercise measures were given 100mg of Trelagliptin orally (once weekly,before meal)for 12

weeks.The results of the double-blind,parallel group,placebo-controlled comparalive study

showed GLP-1 concentrations with meal load tests conducted 12 weeks after administration to be significantly elevated relative to the placebo group.

3.Glucose Tolerance lmprovement

A single,oral dose of Trelogliptin was given to obese type 2 dicbelic model organisms(Wister fatly rat)and non-obese type 2 diabetic model organisms(N-STZ-1.5 rat)after 1 night of fasting. Glucose was then given orally 1 hour afer drug administration to conduct a glucose load test. Results from the tests revealed a glucose tolerance-improving action.

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Pharmacokinatics

1.Blood concentration

a)Single Dose

Healthy adults (8) were given Trelagliptin 100mg 30 minutes before meal,resulting in the following single does blood serum concentration and pharmacological parameters.168 hours after administration,serum blood concentration was an average of 2.1ng/mL.

b)Repeated Dose

Healhy aduls (9) were given Trelagliptin at 100mg 30 minutes before meal once daily. Afer 3 days,once daily repeat dosages were given 30 minutes before meal for 11 days.Day-1 Cmax and AUC (0-inf) were 544.3(122.0)ng/ml and 5,572.3(793.2)ng·h/mL respectively.Day-14 Cmox and AUC(0-tau) average values (standard deviation) were 602.6(149.5)ng/ml and 5,292.9 (613.8)ng·h/mL respecively.

(Approved administration and dosage for this drug consists of normally, 100 mg of Trelagliptin is administered to adults once weekly by mouth.

c)Dietary effects

Healhhy adults(12)were given Trelogliplin at 100mg 30 minutes before meal, resuling in a Cmox and AUC (0-inf) 16.8% and 2.5% greater compared to fasting administration,respectively.

2.Plasma Protein Binding Rate

Trelagliplin at a concentralion of 0.1~10yg/ml was added to human plasma, resulting in a plasma protein binding rate of 22.1%~27.6%(in vitro).

3.Metabolism

a)Trelagliptin is metabolized mainly by CYP2D6 N demethylation from the active metabolie M-1.Moreover, human plasma metabolite M-1 consisted of less than 1%unaltered Trelagliptin.

b)Trelogliptin demonstrates weak inhibifion of CYP3A4/5.

However, (direct inhibitory action IC50 value: 100μmol/L or more,metabolic inhibitory aclion IC50 value:12μmol/(L midazolam 1’hydroxylation activity)and 28μmol/(L testosterone 6β- hydroxylation activity)), CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19 and CYP2D6 were not inhibited,and CYP1A2, CYP2B6, and CYP3A4 were not induced [in vitro].

4.Elimination

a)Hedlthy aduls(12)were given a single dose of Trelagliplin 100mg in a fasted state or 30 minutes after the start of meal. Trelagliptin accumulation in the urine AUC were 76.6% and 76.1% respectively 168 hours after administration.

b)Trelagliplin is a P-glycoprotein substrate and sightly inhibits digoxin infusion via P-glycoprotein action (IC50:500μmol/l or more); Moreover,Trelagliptin demonstrates inhibitory action on organiccalion transporter OCT2 involved with mefformin processing(IC50 value:55.9μmol/L)(in

vitro).

wedica

5.Action with Kidney Disease

Individuals with kidney disease and healthy adults were given a single dose of Trelagliptin at 50mg, resulting in the following AUC(OHlac)and Cmaxvalues.When compared to healthy adults with respect to age,gender,ethnicity,and body weight,individuals with kidney disease(Ccr=50 ~80ml/min、6 cases)showed a 55.7%increase,36.3%increase,patients with moderate kidney funclion disorder(Ccr=30~50ml/min、6 cases)showed 105.7%increase,12.9%increase, patients with severe kidney functlion disorder(Ccr<30ml/min、6 cases)showed 201.4%increase, 9.1%increase,end stage kidney disease patients(6 cases)showed 268.1%increase,13.8% reduction. Moreover,9.2%of the Trelagliptin dosage was removed after 4 hours of dialysis.

Approved administration and dosage for this drug consists ofnormally,100mg of Trelagliptin is administered to adults once weekly by mouth.

6.Activity with Liver Disease

Individuals with moderate liver disease (Child-Pugh score of 7~9,8 cases) and healthy adults (8 were given a single dose of Trelagliptin at 50 mg, resulting in the following AUC (0-inf) and Cmax values. When compared to healthy adults with respect to age, gender, ethnicity, smoking, and body weight, AUC(0-inf) increased 5.1% and Cmax increased 4.3%.

Indication

Indicated for type 2 diabetes melitus. When the first line reatment of metformin is not achieving the expected glycemic goals.

DOSAGE &ADMINISTRATION

100 mg of Trelagliptin is administered to adults once weekly by mouth.

Cautions Related to Methods and Dose

1)For patients with moderate kidney function disease, given that blood drug concentration will elevate due to delayed elimination, reduce dosage with reference to the chart below.

Dosage for patients with moderate kidney function disease

2)Instruct the patient regarding the following points:

a)This medication is to betakenonce weekly,and on the same day every week.

b)If patient forgets to toke medicotion as scheduled, only take the quantilyintended for the time in which the forgotten dose was realized, and then continue dosage according to a newly decided schedule afterwards.

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Warnings

(provide cauious dosage to the following patients):The following palients or circumstances 1)Patients with moderate kidney function disorder

2)Palients undergoing treatment with sulfonylurea drugs or insulin medication [there are reports of severe hypotension with use in combination with other DPP-4 inhibitors]

3)Hypopituitarism or hypoadrenalism

4)Malhuriion,starvailion,irreguar eoting palterns, insuficient ealing,or hyposthenia 5) Vigorous exercise

6)Patients who consume excessive alcohol

Major Warnings

1)This drug may cause hypoglycemia when used in combination with other diabetes medications, so thoroughly explain and caufion the patient of such risks of hyoglycemia when combining with other medications. There is an increased risk of hypoglycemia paricularly when combined with sulfonylurea drugs and insulin medications. Consider reducing the dose of sulfonylurea drugs or insulin medication when used in combination with these drugs in order to lessen the risk of hypoglycemia.

2)This drug is to befoken orally once per week. Eftecls may persist even alfer dosage is ceased, so take sufficient notice of blood sugar values and side effects. Moreover, evaluate the starting period and dose based on the state of blood sugar management when using other diabetes medications after cessation of this medication.

3)Only consider applicalion for patients with established diagnosis of diabetes mellitus. Pay attention to conditions that show abnormal sugar resistance, glucosurea, and other symptoms resembling diabetes (renal glucosuriea,thyroid function abnormality,etc.)

4)Application of this drug should only be considered once diet and exercise-based diabetes treatments have already been implemented with unsatisfactory results.

5)During administration of this drug, progress should be sufficiently observed along with quanitative blood sugar measurements. If no results are seen afer 2 to 3 months of treatment, consider changing to a more appropriate treatment method.

6)During dosage maintenance, the medication may no longer become necessary, or the effects of the drug may diminish due to complications with poor nutrition or infectious disease. In such cases, evaluate continualion of normal does, medication seleclion,etc. upon consideration of dietary volume, blood sugar levels, and presence of infeclious symptoms.

7)Warn patients that work in high places,operate machinery,etc., as low blood sugar can occur. 8)Clinical results and safely regarding combination with insulin medication has not been investigated.

9)This drug and GLP-1 receptor agonists both possess the ability to lower blood sugar and assist GlP.1 receplor agonists.There are no clinical study results regarding the combination of these medications, and neither the efficacy nor the safety can be confirmed.

Drug Interactions

This drug is mainly eliminated by the kidneys in an unaltered form. Excretion has been observed to take place via the urine following the usual glomerular route (warning of possible side effects)

Drug Interactions

Side Effects of Wedica (Trelagliptin)

Among 901 domestic clinical tial cases up to the time of approval, 103 cases (11.4%) showed clinical results that included abnormalities and side effects. These mainly included hypoglycemia, nasopharyngilis, and elevated lipase.

1)Given the appearance of serious side effects such as hypoglycemia(0.1%~5%), administer medication in conjunction with close observation of patient status. Other DPP-4 inhibitors have been reported to present serious hypoglycemia in combination with Sulfonylurea medicatlions as well as some cases of loss of consciousness. Moreover, decreased blood sugar from the use of this medication, once confirmed, can be remedied by giving sucrose. However, hypoglycemia resulting from a combination with -glucosidaseinhibitors should be treated with fructose.

Major side effects (drug type)

1)Acute pancrealifis can occur, so careful observafion is called for and sustained, intense abdominal pain, vomiting, and other abnormal symptoms should be followed up with cessation of the drug followed by appropriate measures.

2)Intestinal Obsructfions can occur, so conduct careful observation. If severe constipation, abdominal swelling,sustained abdominal pain,vomiting, or other symptoms are observed, stop treatment and take appropriate measures.

3)Oher Side Effects:Toke appropriate actions depending on the situation if the following side.

Between 0.1 and 5%
1)HypersensitivityRash,itch
2)Circulatory systemAtrial fibrillation
3)LiverElevated ALT(GPT),AST (GOT),and y-GTP
4)OtherElevated serum amylase,lipase,CK (CPK), presence of blood in urine,or nasopharyngitis

4)Administration to Elderly Patients:Since many geriatric patients generally have lowered kidney function, take note of side effects and administer a cautious dose while sufficiently observing treatment progress.

5) Administration to pregnant women,lactating women,or for gynecological use

a)For women who are pregnant or may be pregnant, only administer drug upon fully evaluating he risks and benefits of treatment. The safety of use during pregnancy is not established. There are reports of the drug crossing the placenta in animal (rat)tests.

b)Avoid giving drug to women who are breasffeeding, and stop breasffeeding if drug must be administered.

6) Administration to children:The safely of this drug in infants with low birth weight, newborn

infants, nursing infants, babies, and children under the age of 13 is not established.

7)Overdose safety information regarding overdose has not been sufficiently collected, for dietary and exercise treatments, as well as mefformin-only treatments, or for type 2 diabetes patients in which blood sugar control is not ideal. However, there have been overseas studies in which 100mg of this drug, was taken orally every day over 12 consecufive weeks and side effects did  not differ from the placebo group.

8)Oher warnings overseas clinical studies involving single Trelogliptin doses of 800mg reported QT elongation.

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How much Wedica (Trelagliptin)?

The specific dosage of Wedica (Trelagliptin) can vary depending on individual patient needs and the recommendations of a healthcare professional. Trelagliptin is typically prescribed in tablet form, and the dosage is often expressed in milligrams (mg). Common dosage strengths for Trelagliptin tablets include 50 mg and 100 mg.

Wedica (Trelagliptin) Alternatives

Semaglutide Tablets RYBELSUS®

Semaglutide tablets are a type of medication used to treat type 2 diabetes. They belong to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. Semaglutide works by mimicking the effects of a naturally occurring hormone called GLP-1, which helps regulate blood sugar levels.

GLP-1 receptor agonists like semaglutide stimulate the release of insulin from the pancreas and reduce the amount of glucose produced by the liver. Additionally, they slow down the rate at which food is absorbed in the stomach, leading to a decrease in post-meal blood sugar levels. This class of medications also helps in promoting a feeling of fullness, which can contribute to weight loss.

Semaglutide is often prescribed to people with type 2 diabetes when lifestyle changes and other medications have not effectively controlled blood sugar levels.

Weight Management: In addition to its use in diabetes, Semaglutide has also been found to be effective in weight management. It can help reduce body weight in individuals when used alongside a reduced-calorie diet and increased physical activity.

Semaglutide Tablets

Ozempic semaglutide

Ozempic is a brand name for a medication called semaglutide. It is a prescription medication used to treat type 2 diabetes in adults. Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg is an injectable prescription medicine used:

along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes.

to reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes with known heart disease.

OZEMPIC

In conclusion, Wedica (Trelagliptin) stands out as one of the most affordable and effective medications for managing Type 2 diabetes. With its once-weekly dosing schedule and proven ability to control blood glucose levels, Wedica offers both convenience and efficacy in diabetes management. The affordability of Wedica makes it a viable option for individuals seeking an accessible solution for their healthcare needs. However, it’s essential for patients to consult with healthcare professionals to determine the most suitable treatment plan based on their individual health circumstances and considerations.

Reference: https://wedica.com.bd/why-wedica/