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Vildagliptin (brand name Galvus) is an oral DPP-4 inhibitor, a 'gliptin,' used for type 2 diabetes; its structure includes an adamantyl group. Like other gliptins it blocks the enzyme DPP-4 so the gut incretin hormones GLP-1 and GIP persist longer, improving the pancreas's insulin and glucagon responses to glucose and lowering blood sugar. It reduces HbA1c with little effect on body weight and a low risk of hypoglycemia. It is marketed in many countries but is not FDA-approved in the United States.
- Lowers HbA1c alone or with other agents
- Weight-neutral
- Low risk of hypoglycemia on its own
- Low drug-interaction potential (not CYP-metabolized)
- Liver enzyme elevations (monitoring advised)
- Headache or nasopharyngitis
- Rare pancreatitis and joint pain (class effect)
- Higher hypoglycemia risk with sulfonylureas or insulin
Mechanism
Vildagliptin is a potent, selective inhibitor of dipeptidyl peptidase-4 (DPP-4), the enzyme that quickly inactivates the incretin hormones -1 and GIP [2][6]. Blocking DPP-4 keeps active incretin levels higher after meals, which improves the responsiveness of pancreatic beta-cells (-releasing) and alpha-cells (glucagon-releasing) to glucose; the result is more glucose-dependent insulin secretion, less glucagon and endogenous glucose production, and lower fasting and post-meal glucose [1][6]. It is rapidly absorbed, cleared largely by hydrolysis rather than the CYP450 enzyme system (so it has low drug-interaction potential), and has a duration that supports once- or twice-daily dosing [3]. Effects on HbA1c are similar whether used alone or added to metformin, glitazones, sulfonylureas, or , and it is weight-neutral with low hypoglycemia risk [1][4].
receptor fingerprint
DPP-4 enzymeselective inhibitor
-1 / GIP incretinsraises active levels
Blood glucoselowers fasting and post-meal glucose
Safetyrisks and cautions, not medical advice
Vildagliptin is a prescription medicine used under medical supervision and is not approved in the United States. It is generally well tolerated, with a low rate of hypoglycemia and gastrointestinal effects lower than metformin in trials [1][3]. Liver enzyme elevations have been reported, so it is not recommended in hepatic (liver) impairment and periodic liver monitoring is advised; dose adjustment is recommended in moderate-to-severe kidney impairment [3]. As with the whole class, rare pancreatitis and joint pain can occur, and hypoglycemia risk increases when combined with sulfonylureas or insulin. Not medical advice.
Subjective profileweighing the evidence above
A reasonable, weight-neutral option for type 2 diabetes in the countries that sell it, with a low hypoglycemia rate on its own and few drug interactions. It is not FDA-approved in the US, liver enzymes need periodic checks, and it belongs under a prescriber.
Resources
This entry is here for reference.
Research
- 2006first citedVildagliptin.
- 2014most recentVildagliptin, a dipeptidyl peptidase-4 inhibitor, for the treatment of type 2 diabetes.
- 1.The DPP-4 inhibitor vildagliptin: robust glycaemic control in type 2 diabetes and beyond.
- 2.Vildagliptin.
- 3.Vildagliptin, a dipeptidyl peptidase-4 inhibitor, for the treatment of type 2 diabetes.
- 4.Novel combination treatment of type 2 diabetes DPP-4 inhibition + metformin.
- 5.Vildagliptin: a novel DPP-4 inhibitor with pancreatic islet enhancement activity for treatment of patients with type 2 diabetes.
- 6.Dipeptidyl peptidase 4 inhibition and vildagliptin therapy for type 2 diabetes.
6 listed here; entry last updated July 2026
Reviews
My notesprivate to this device
FAQ
Is vildagliptin available in the United States?
No. It is marketed as Galvus in many countries but was never FDA-approved in the US, partly over liver-enzyme signals seen in development.
How does it lower blood sugar?
It blocks DPP-4, the enzyme that destroys the incretin hormones GLP-1 and GIP, so those hormones last longer and improve the pancreas's glucose-dependent insulin and glucagon responses.
Does it cause weight gain?
No; in trials it was weight-neutral, one of the practical advantages of the gliptin class.
Adverse effects
- Liver enzyme elevations (monitoring advised)
- Headache or nasopharyngitis
- Rare pancreatitis and joint pain (class effect)
- Higher hypoglycemia risk with sulfonylureas or insulin