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Indication for NESINA (alogliptin) 6.25 mg, 12.5 mg, and 25 mg Tablets; OSENI (alogliptin and pioglitazone) 25 mg/15 mg, 25 mg/30 mg, 25 mg/45 mg, 12.5 mg/15 mg, 12.5 mg/30 mg, and 12.5 mg/45 mg Tablets; and KAZANO (alogliptin and metformin HCl) 12.5 mg/500 mg and 12.5 mg/1000 mg Tablets

NESINA, KAZANO, and OSENI are prescription medicines used with diet and exercise to improve blood sugar (glucose) control in adults with type 2 diabetes. NESINA, KAZANO, and OSENI are not for patients with type 1 diabetes or diabetic ketoacidosis (increased ketones in blood or urine).

Important Safety Information

WARNING for OSENI: RISK OF HEART FAILURE

OSENI can cause new or worsen heart failure. Pioglitazone, one of the medicines in OSENI, can cause your body to keep extra fluid (fluid retention), which leads to swelling (edema) and weight gain. Extra body fluid can make some heart problems worse or lead to heart failure. Heart failure means the heart does not pump blood well enough. Call your doctor right away if you experience swelling or fluid retention (especially in the ankles or legs), shortness of breath or trouble breathing (especially when you lie down), an unusually fast increase in weight, or unusual tiredness. Do not take OSENI if you have severe heart failure. If you have heart failure with symptoms (such as shortness of breath or swelling), even if these symptoms are not severe, OSENI may not be right for you.

WARNING for KAZANO: RISK OF LACTIC ACIDOSIS

Metformin, one of the medicines in KAZANO, can cause a rare but serious condition called lactic acidosis (a build-up of an acid in the blood) that can cause death. Lactic acidosis is a medical emergency and must be treated in a hospital. Stop taking KAZANO and call your doctor right away if you feel very weak or tired, have unusual (not normal) muscle pain, have trouble breathing, have unusual sleepiness or sleep longer than usual, have unexplained stomach or intestinal problems with nausea and vomiting or diarrhea, feel cold, especially in the arms or legs, feel dizzy or lightheaded, or have a slow or irregular heartbeat, as these could be symptoms of lactic acidosis. You have a higher chance of getting lactic acidosis if you have kidney problems (if your kidneys are not working properly you should not take KAZANO), have liver problems, have congestive heart failure that requires treatment with medicines, drink a lot of alcohol (very often or short-term "binge" drinking), get dehydrated (lose a large amount of body fluids, which can happen if you are sick with a fever, vomiting, or diarrhea, or when you sweat a lot with activity or exercise and do not drink enough fluids), have certain x-ray tests with injectable dyes or contrast agents that are injected into your body, have surgery, have a heart attack, severe infection, or stroke.

NESINA, KAZANO, or OSENI may not be right for everyone. NESINA, KAZANO, and OSENI can cause serious side effects.

Do not take KAZANO if you have kidney problems, have a condition called metabolic acidosis or have had diabetic ketoacidosis (increased ketones in the blood or urine), or are going to get an injection of dye or contrast agents for an x-ray procedure. If you are older than 80 years, you should not take KAZANO unless your kidneys have been checked and they are normal.

Do not take NESINA, KAZANO, or OSENI if you are allergic to any of their ingredients.

Stop taking NESINA, KAZANO, or OSENI and contact your doctor or go to the nearest hospital emergency room right away if you experience swelling of your face, lips, throat, or other areas on your skin, difficulty swallowing or breathing, raised red areas on your skin (hives), skin rash, itching, flaking, or peeling, as these may be symptoms of a serious allergic reaction.

Warnings and Precautions—for NESINA, KAZANO, and OSENI

Inflammation of the pancreas (pancreatitis), which may be severe, can happen to people taking NESINA, KAZANO, or OSENI. Tell your doctor if you have ever had pancreatitis, stones in your gallbladder (gallstones), a history of alcoholism, kidney problems, or liver problems. Stop taking NESINA, KAZANO, or OSENI and call your doctor right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis.

NESINA, KAZANO, or OSENI may cause liver problems. Call your doctor right away if you experience nausea, vomiting, stomach pain, unusual or unexplained tiredness, loss of appetite, dark urine, or yellowing of your skin or eyes.

If you take NESINA, KAZANO, or OSENI with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin, your risk of getting low blood sugar is higher. The dose of your sulfonylurea medicine or insulin may need to be lowered while you take NESINA, KAZANO, or OSENI. If you have symptoms of low blood sugar, you should check your blood sugar and treat if low, and then call your doctor. Signs and symptoms of low blood sugar include shaking or feeling jittery, sweating, fast heartbeat, change in vision, hunger, headache, change in mood, confusion, or dizziness.

Before taking NESINA, KAZANO, or OSENI, you should tell your doctor if you are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed. It is not known if NESINA, KAZANO, or OSENI can harm an unborn baby, or if it passes into breast milk.

Warnings and Precautions—for OSENI

Women are at a higher risk of having broken bones (fractures) while taking OSENI.

There may be an increased chance of having bladder cancer when you take OSENI. You should not take OSENI if you are receiving treatment for bladder cancer. Tell your doctor right away if you have blood or a red color in your urine, an increased need to urinate, or pain while you urinate as these may be symptoms of bladder cancer.

Tell your doctor right away if you have any changes in your vision. Your doctor should check your eyes regularly.

If you are a woman of childbearing age, but do not have monthly periods, talk to your doctor before taking OSENI, as it could increase your chance of becoming pregnant.

Side Effects

The most common side effects of NESINA were stuffy or runny nose and sore throat (4.4%), headache (4.2%), and cold-like symptoms (upper respiratory tract infection; 4.2%).

The most common side effects of KAZANO were cold-like symptoms (upper respiratory tract infection) (8.0%), stuffy or runny nose and sore throat (6.8%), diarrhea (5.5%), increase in blood pressure (5.5%), headache (5.3%), back pain (4.3%), and urinary tract infection (4.2%).

The most common side effects of OSENI were stuffy or runny nose and sore throat (4.9%), back pain (4.2%), and cold-like symptoms (upper respiratory tract infection; 4.1%).

Drug Interactions

Tell your doctor about all the medicines, vitamins, and supplements you take. Medicines can affect each other. You should contact your doctor before you start or stop other medicines. You may need to have your dose of KAZANO or OSENI, or certain other medicines, changed.

Talk to your doctor or healthcare professional.

Please see full Prescribing Information, including Medication Guide for NESINA (alogliptin).

Please see full Prescribing Information, including Medication Guide for OSENI (alogliptin and pioglitazone).

Please see full Prescribing Information, including Medication Guide for KAZANO (alogliptin and metformin HCl).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

*Eligibility Restrictions Apply: This offer cannot be used if you are a beneficiary of, or any part of your prescription is covered by: (1) any federal or state healthcare program (Medicare, Medicaid, TRICARE, etc) including a state pharmaceutical assistance program, (2) the Medicare Prescription Drug Program (Part D), or if you are currently in the coverage gap, or (3) insurance that is paying the entire cost of the prescription. Save up to $100 on NESINA, KAZANO, or OSENI and up to $10 on metformin each month when your prescriptions of OSENI and NESINA are filled at the same time. Depending on insurance coverage, savings and co-pay may vary.

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