Drug Detail:Sitagliptin (Sitagliptin [ si-ta-glip-tin ])
Drug Class: Dipeptidyl peptidase 4 inhibitors
Usual Adult Dose for Diabetes Type 2
100 mg orally once a day
Comments:
- When used in combination with an insulin secretagogue (e.g. sulfonylurea) or insulin, a lower dose of the insulin secretagogue or insulin may be required to reduce the risk of hypoglycemia.
Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
Renal Dose Adjustments
Mild renal impairment (eGFR 45 mL/min/1.73 m2 or greater): No adjustment recommended
Moderate renal impairment (eGFR 30 mL/min/1.73 m2 to less than 45 mL/min/1.73 m2): 50 mg orally once a day
Severe renal impairment (eGFR less than 30 mL/min/1.73 m2): 25 mg orally once a day
Liver Dose Adjustments
Mild or moderate hepatic impairment: No adjustment recommended
Severe hepatic impairment: Use caution; no data available
Precautions
CONTRAINDICATIONS:
- Hypersensitivity to this drug or any of the product excipients
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Hemodialysis: 25 mg orally once a day
Peritoneal dialysis: 25 mg orally once a day
- May be administered without regard to timing of dialysis
Other Comments
Administration advice:
- May take with or without food
- Missed doses should be taken as soon as the patient remembers. More than one dose should not be taken on the same day.
General:
- In clinical trials, sitagliptin has not been shown to improve glycemic control in pediatric patients 10 to 17 years old with type 2 diabetes; this drug is not approved for use in pediatric patients.
- This drug should not be used in patients with type 1 diabetes.
- Has not been studied in patients with a history of pancreatitis; it is unknown whether these patients may be at an increased risk for the development of pancreatitis.
Monitoring:
- Assess renal function prior to initiating therapy and periodically thereafter
- Monitor for signs and symptoms of heart failure
- Blood glucose and hemoglobin A1C measurements should be measured periodically to assess efficacy
- Observe for signs and symptoms of pancreatitis
Patient Advice:
- Patients should be instructed to read the US FDA-approved patient labeling (Medication Guide).
- Instruct patient to report signs and symptoms of pancreatitis; if persistent, severe abdominal pain occurs, seek medical advice promptly.
- Serious allergic reactions may occur; if symptoms occur, seek medical advice promptly.
- Hypoglycemia may occur, more commonly when used in combination with insulin or a sulfonylurea.
- Patients should understand the importance of adhering to dietary instructions and regular physical activity; during periods of stress such as fever, trauma, infection, or surgery, management of diabetes may change and patients should be advised to seek medical advice.
- Instruct patients to contact their health care provider if they develop severe and persistent joint pain.
- Instruct patients to contact their health care provider if they develop signs or symptoms of heart failure.
Frequently asked questions
- Can Victoza and Januvia be used together?
