sitagliptin phosphate

sitagliptin phosphate

Januvia

Pharmacologic class: Dipeptidyl peptidase 4 (DPP-4) inhibitor

Therapeutic class: Hypoglycemic

Pregnancy risk category B

Action

Inhibits DPP-4 and slows inactivation of incretin hormones, helping to regulate glucose homeostasis through increased insulin release and decreased glucagon levels

Availability

Tablets: 25 mg, 50 mg, 100 mg

⊘Indications and dosages

➣ Adjunct to diet and exercise to improve glycemic control in type 2 diabetes mellitus

Adults: 100 mg P.O. once daily as monotherapy, or as combination therapy with metformin or a thiazolidinedione (such as pioglitazone or rosiglitazone) when monotherapy plus diet and exercise don't achieve adequate glycemic control

Dosage adjustment

• Moderate to severe renal insufficiency

Contraindications

None

Precautions

Use cautiously in:
• concurrent administration of drugs that cause hypoglycemia (such as sulfonylureas or insulin)
• renal impairment
• pregnant or breastfeeding patients
• children younger than age 18 (safety and efficacy not established).

Administration

• Assess renal function before starting therapy.
• Give with or without food.

Route	Onset	Peak	Duration
P.O.	Rapid	1-4 hr	Unknown

Adverse reactions

CNS: headache

EENT: nasopharyngitis

GI: abdominal pain, nausea, vomiting, diarrhea

Respiratory: upper respiratory tract infection

Interactions

Drug-drug. Digoxin: minimally increased digoxin effect and blood level

Insulin, sulfonylureas: possible increased hypoglycemia risk

Patient monitoring

• Monitor renal function periodically.
• Measure patient's weight and body mass index periodically during therapy.
• Monitor blood glucose and hemoglobin A_1c levels periodically during therapy.
• Check for diabetes signs and symptoms and disease progression routinely during therapy.

Patient teaching

• Instruct patient to take drug with or without food.
• Teach patient about signs and symptoms of hypoglycemia (such as blurred vision, confusion, tremor, sweating, excessive hunger, drowsiness, and fast heart rate).
• Instruct patient to routinely monitor blood glucose levels at home.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.