Dipeptidyl peptidase-4 (DPP-4) inhibitor
ATC code: A10BH02 (Vildagliptin)
Brand names
Galvus, Jalra, Xiliarx, Eucreas (vildagliptin + metformin)
A selective DPP-4 inhibitor (like sitagliptin), raises active incretin GLP-1 and GIP levels, enhancing glucose-dependent insulin secretion and suppressing glucagon. Compared with sitagliptin, shorter 2-hour half-life requiring twice-daily dosing. Not -approved in the US due to hepatotoxicity cases in trials; widely used in Europe.
Second line
Second-line in T2D per / 2024 and SED 2023 as add-on or in triple therapy. Dose 50 mg twice daily. Reduces by 0.5–0.8% without hypoglycemia or weight effect. Compared with , no significant efficacy advantage; choice depends on cost and availability.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Vildagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor antidiabetic. It is prescribed for type 2 diabetes ( 2024, 2024). In people without diabetes, vildagliptin is not indicated for weight loss: the drug has a neutral effect on weight (no significant weight loss) and is not approved for obesity treatment. The drug has specific risks: pancreatitis (rare but dangerous), nasopharyngitis, and hepatotoxicity (requires liver enzyme monitoring). If vildagliptin was prescribed for weight loss without diabetes, consider seeking a second opinion.
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Limited data. In pregnant T2D patients, insulin is base therapy.
Not used during lactation.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Vildagliptin is evaluated for the following indications with varying evidence strength: Type 2 diabetes mellitus (evidence tier B), Weight loss (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Vildagliptin (≥ 1 in 100): Dizziness, Headache, Nausea, Constipation, Nasopharyngitis, Hypoglycemia with sulfonylureas. See the Safety section for uncommon and serious reactions.
FDA category B. Limited data. In pregnant T2D patients, insulin is base therapy.
Not used during lactation.
Vildagliptin is contraindicated in: Vildagliptin hypersensitivity; Type 1 diabetes; Diabetic ketoacidosis; Hepatic impairment or transaminase elevation over 3× upper limit; Pregnancy and lactation. Full list in the Safety section.