Teneligliptin is a novel third-generation DPP-4 inhibitor approved for the treatment of type II diabetes. The compound has a unique five-continuous ring structure that produces a potent and long-lasting effect. Currently, Teneligliptin is used in cases where glycemic control has not been adequately improved even after diet and exercise or a combination of diet, exercise, and sulfonylureas or thiazolidinediones. The oral dose of Teneligliptin for adults is 20 mg once daily, which can be increased to 40 mg daily. Since the metabolites of the drug are excreted through the kidneys and liver, no dose adjustment is required for patients with renal insufficiency.

Mechanism of Action

Teneligliptin acts like an insulin/glucagon modulator to control blood glucose over a 24-hour period. It works by increasing incretin levels (GLP-1 and GIP), thereby inhibiting the release of glucagon, which in turn increases insulin secretion, decreases gastric emptying, and lowers blood glucose levels. In addition, Teneligliptin has a long half-life (26.9 hours) and low IC50 values (0.889 nmol/L and 1.75 nmol/L).

Side Effects

Teneligliptin is well tolerated, and some common side effects include:

• Hypoglycemia

• Headache

• Upper respiratory tract infection

• Gastrointestinal symptoms

• Constipation

• Fatigue

• Kidney problems

• Nasopharyngitis

• Rash

• Itching

• Loss of appetite

• Abdominal pain

A case of teneligliptin-induced polyarthritis has been reported. Joint pain was relieved after stopping teneligliptin.

References:

[1] DANAO K, SHENDE M, GUPTA R A, et al. Teneligliptin: DPP-4 inhibitor in the treatment of type II Diabetes Mellitus[J]. International Journal of Phytopharmacy, 2017. DOI:10.7439/IJPP.V7I4.4347.

[2] P. AGRAWAL. Teneligliptin-induced polyarthritis: A case report[J]. Journal of Diabetology, 2021. DOI:10.4103/jod.jod\_23\_21.

[3] M. MALADKAR  K. K  Srividya Sankar. Teneligliptin: Heralding Change in Type 2 Diabetes[J]. Journal of Database Management, 2016. DOI:10.4236/JDM.2016.62012.