Drug Action
Inhibits dipeptidylpeptidase-4 to increase insulin secretion and lower glucagon secretion.
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Drug reference
Inhibits dipeptidylpeptidase-4 to increase insulin secretion and lower glucagon secretion.
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Type 2 diabetes mellitus as monotherapy (if metformin inappropriate), or in combination with other antidiabetic drugs (including insulin) if existing treatment fails to achieve adequate glycaemic control ▶BY MOUTH ▶Adult: 100 mg once daily, for further information on use with other antidiabetic drugs—consult product literature
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DUE TO INTERACTIONS ▶Dose of concomitant sulfonylurea or insulin may need to be reduced.
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Ketoacidosis
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Scottish Medicines Consortium (SMC) decisions SMC No. 607/10 The Scottish Medicines Consortium has advised (July 2010) that sitagliptin (Januvia ®) is accepted for restricted use within NHS Scotland as monotherapy, to improve glycaemic control in patients with type 2 diabetes mellitus, for whom both metformin and sulfonylureas are not appropriate. SMC No. 1083/15 The Scottish Medicines Consortium has advised (September 2015) that sitagliptin (Januvia ®) is accepted for use within NHS Scotland as an add-on to insulin (with or without metformin) to improve glycaemic control in adults with type 2 diabetes mellitus.
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→Appendix 1: sitagliptin
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▶Common or very common Headache ▶Uncommon Constipation. dizziness. skin reactions ▶Frequency not known Angioedema. back pain. cutaneous vasculitis. interstitial lung disease. joint disorders. myalgia. pancreatitis acute. renal impairment. Stevens- Johnson syndrome. vomiting SIDE-EFFECTS, FURTHER INFORMATION Discontinue if symptoms of acute pancreatitis occur such as persistent, severe abdominal pain. Endocrine system
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Avoid—toxicity in animal studies.
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Avoid—present in milk in animal studies.
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Dose adjustments Manufacturer advises reduce dose to 50 mg once daily if eGFR 30–45 mL/minute/1.73 m2. Manufacturer advises reduce dose to 25 mg once daily if eGFR less than 30 mL/minute/1.73 m2.
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Januvia (Merck Sharp & Dohme Ltd) Sitagliptin (as Sitagliptin phosphate) 25 mg Januvia 25mg tablets | 28 tablet P £33.26 DT = £33.26 Sitagliptin (as Sitagliptin phosphate) 50 mg Januvia 50mg tablets | 28 tablet P £33.26 DT = £33.26 Sitagliptin (as Sitagliptin phosphate) 100 mg Januvia 100mg tablets | 28 tablet P £33.26 DT = £33.26
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100 mg once daily, for further information on
First-line fragment. Read the complete Indications and Dose section above.
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