Short answer: Kazano is taken by mouth twice daily with food, and the tablets are not split. The starting dose is set by current medicines and raised gradually to reduce stomach side effects from metformin. The maximum is 25 mg alogliptin and 2,000 mg metformin a day. It is not used with an eGFR below 30 and is not recommended at 30 to 59. The Medication Guide says a missed dose is taken when remembered unless the next dose is due.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Kazano is approved for: Kazano combines alogliptin, a DPP-4 inhibitor, with metformin, a biguanide. It is approved, along with diet and exercise, to improve blood sugar control in adults with type 2 diabetes (section 1). It is not recommended for type 1 diabetes.
Source
KAZANO (alogliptin and metformin hydrochloride) tablets, for oral use, prescribing information and Medication Guide. Takeda Pharmaceuticals America. DailyMed, version published August 21, 2026. DailyMed setid 83cb7914-a683-47bb-a713-f2bc6a596bd2
Kazano is a tablet taken by mouth twice daily with food. Tablets are not split (section 2.1).
It comes as alogliptin 12.5 mg with metformin 500 mg, and alogliptin 12.5 mg with metformin 1,000 mg (section 3).
The starting dose is set by the current regimen, and the dose is adjusted for effectiveness and tolerability (section 2.1).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Item | Kazano label |
|---|---|
| Starting dosage | Individualize based on the patient's current regimen |
| How taken | Orally twice daily with food, with gradual dose escalation to reduce the GI side effects due to metformin. Do not split tablets. |
| Maximum recommended daily dose | 25 mg alogliptin and 2000 mg metformin hydrochloride (HCl) |
Kidney function is assessed before starting and periodically after. Kazano is contraindicated with an eGFR below 30 mL/min/1.73 m2 and not recommended at 30 to 59, because those people need a lower alogliptin dose than the combination has. No dose change is needed at 60 or above.
It is stopped at the time of, or before, an iodinated contrast scan with an eGFR of 30 to 60, a history of liver disease, alcoholism or heart failure, or intra-arterial contrast. eGFR is rechecked 48 hours after, and it is restarted if kidney function is stable.
Kazano is stopped for a time while food and fluid intake is restricted for surgery or other procedures.
With insulin or a sulfonylurea, a lower dose of those medicines may be needed to reduce the risk of low blood sugar.
Tablets are stored at 25 C (77 F), with excursions from 15 to 30 C allowed.
The dosing section has no missed-dose rule. Section 17 says patients who miss a dose do not double the next dose. The Medication Guide says: if you miss a dose, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose, and take the next dose at your regular time. Do not take 2 doses of Kazano at the same time.
More on this: missed a dose of Kazano.
In Dose Track you set up Kazano as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.