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What is Sitagliptin
Sitagliptin is an oral dipeptidyl peptidase-4 (DPP-4) inhibitor and is used in the treatment of adults with type 2 diabetes mellitus (DM) in adults. DPP-4 inhibitors potentiate the effects of the incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), by inhibiting their breakdown by DPP-4.
Clinical studies of sitagliptin demonstrated mean hemoglobin A1C reductions of 0.6% to 1.05%; in patients with an A1C of 9% or more at baseline, the reduction can be as high as 1.5%.
Metformin is first-line in the treatment of type 2 DM. In patients with established cardiovascular (CV) disease, heart failure (HF), or chronic kidney disease (CKD), a sodium-glucose co-transporter 2 (SGLT2) inhibitor or GLP-1 receptor agonist (GLP-1 RA) with proven CV benefit and reduction of CKD progression is recommended for add-on therapy, independent of baseline A1C or individualized A1C target.
In patients without indicators of high-risk or established CVD, HF, or CKD, DPP-4 inhibitors are a therapeutic option which are generally well tolerated, have a neutral effect on weight, and have minimal risk of hypoglycemia when used as monotherapy
Brand Name
Januvia
Indications
- type 2 diabetes mellitus
For the treatment of type 2 diabetes mellitus in combination with diet and exercise
Side Effects
- abdominal pain
- anaphylactoid reactions
- angioedema
- arthralgia
- back pain
- bullous rash
- constipation
- diarrhea
- elevated hepatic enzymes
- exfoliative dermatitis
- headache
- heart failure
- hypoglycemia
- infection
- myalgia
- nausea
- oral ulceration
- pancreatitis
- pemphigus
- peripheral edema
- pharyngitis
- pruritus
- rash
- renal failure (unspecified)
- rhabdomyolysis
- Stevens-Johnson syndrome
- stomatitis
- urticaria
- vasculitis
- vomiting
Monitoring Parameters
- blood glucose
- glycosylated hemoglobin A1c (HbA1c)
- serum creatinine/BUN
Contraindications
- adrenal insufficiency
- arthralgia
- breast-feeding
- burns
- children
- diabetic ketoacidosis
- diarrhea
- exfoliative dermatitis
- fever
- gastroparesis
- geriatric
- GI obstruction
- heart failure
- history of angioedema
- hypercortisolism
- hyperglycemia
- hyperthyroidism
- hypoglycemia
- hypothyroidism
- ileus
- infection
- malnutrition
- pancreatitis
- pituitary insufficiency
- pregnancy
- renal failure
- renal impairment
- serious rash
- surgery
- trauma
- type 1 diabetes mellitus
- vomiting
Interactions
- Acebutolol
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Pseudoephedrine
- Acrivastine; Pseudoephedrine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amprenavir
- Androgens
- Articaine; Epinephrine
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- atypical antipsychotic
- Azelastine; Fluticasone
- Beclomethasone
- Bendroflumethiazide; Nadolol
- Benzphetamine
- Beta-blockers
- Betamethasone
- Betaxolol
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bortezomib
- Brimonidine; Timolol
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Bumetanide
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carbonic anhydrase inhibitors
- Carteolol
- Carvedilol
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chloroquine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorthalidone; Clonidine
- Chromium
- Ciclesonide
- Clarithromycin
- Clonidine
- Codeine; Phenylephrine; Promethazine
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Daclatasvir
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Desloratadine; Pseudoephedrine
- Dexamethasone
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Diazoxide
- Dienogest; Estradiol valerate
- Diethylpropion
- Diethylstilbestrol, DES
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dobutamine
- Dopamine
- Dorzolamide; Timolol
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Ephedrine
- Epinephrine
- Erythromycin; Sulfisoxazole
- Esmolol
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estrogens
- Estropipate
- Ethanol
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Fenofibrate
- Fenofibric Acid
- Fexofenadine; Pseudoephedrine
- Fibric acid derivatives
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Fosamprenavir
- Furosemide
- Garlic, Allium sativum
- Gemfibrozil
- Glecaprevir; Pibrentasvir
- Green Tea
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Hydantoins
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydrocortisone
- Hydroxychloroquine
- Ibuprofen; Pseudoephedrine
- Indapamide
- Indinavir
- Isoproterenol
- Labetalol
- Lanreotide
- Ledipasvir; Sofosbuvir
- Levobetaxolol
- Levobunolol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lomefloxacin
- Lomitapide
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Lorcaserin
- Lovastatin; Niacin
- Mecasermin rinfabate
- Mecasermin, Recombinant, rh-IGF-1
- Mepivacaine; Levonordefrin
- Mestranol; Norethindrone
- Methamphetamine
- Methylphenidate
- Methylprednisolone
- Metoprolol
- Metyrapone
- Midodrine
- Mometasone
- Monoamine oxidase inhibitors
- Nadolol
- Naproxen; Pseudoephedrine
- Nebivolol
- Nebivolol; Valsartan
- Nelfinavir
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nicotine
- Norepinephrine
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Orlistat
- Pasireotide
- Pegvisomant
- Pemoline
- Penbutolol
- Pentamidine
- Pentoxifylline
- Phendimetrazine
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Pindolol
- Ponatinib
- Prednisolone
- Prednisone
- Prilocaine; Epinephrine
- Progestins
- Propranolol
- Protease inhibitors
- Pseudoephedrine
- Pyrimethamine; Sulfadoxine
- Quinolones
- Racepinephrine
- Reserpine
- Ritodrine
- Ritonavir
- Salicylates
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Sofosbuvir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Somatropin, rh-GH
- Sotalol
- Sparfloxacin
- Sulfadiazine
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfasalazine
- Sulfisoxazole
- Sulfonamides
- Sympathomimetics
- Tacrolimus
- Tegaserod
- Thiazide diuretics
- Thyroid hormones
- Timolol
- Tipranavir
- tobacco
- Torsemide
- Triamcinolone
- Triamterene
- Trovafloxacin, Alatrofloxacin