Vildagliptin-Induced Thrombocytopenia: A Case Report with Pharmacovigilance Perspective

Abstract

Vildagliptin, a Dipeptidyl Peptidase-4 (DPP-4) inhibitor widely used in type 2 diabetes mellitus, is generally considered well-tolerated. We report a case of a 62-year-old woman who developed progressive, isolated thrombocytopenia approximately ten months after initiating vildagliptin 50 mg twice daily as an add-on to her existing antidiabetic regimen. Extensive haematological evaluation excluded alternative aetiologies including immune thrombocytopenic purpura, viral infections, haematological malignancies, and drug interactions with concurrent medications. Discontinuation of vildagliptin led to sustained platelet recovery within twelve weeks without any haematological intervention. The Naranjo Adverse Drug Reaction Probability Scale yielded a score of 6, indicating a probable causal relationship, corroborated by WHO-UMC causality assessment. A search of the VigiBase pharmacovigilance database identified 20 reports of vildagliptin-associated thrombocytopenia globally. This case reinforces the need for periodic platelet monitoring in patients receiving vildagliptin.

Keywords: Vildagliptin; DPP-4 Inhibitors; Thrombocytopenia; Adverse Drug Reaction; Pharmacovigilance

Citation

Rahul Garg. Vildagliptin-Induced Thrombocytopenia: A Case Report with Pharmacovigilance Perspective. WebLog J Clin Case Rep. wjccr.2026. h0504. https://doi.org/10.5281/zenodo.21852173