Endocrinology Book

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Sitagliptin

Aka: Sitagliptin, Januvia, DPP-4 Inhibitor, Dipeptidyl Peptidase-4 Inhibitor, DPP-4, Gliptin
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  1. See Also
    1. Incretin Mimetic
    2. Byetta
  2. Indications
    1. Type II Diabetes Mellitus
    2. Insulin deficiency and Insulin Resistance
      1. Adjunct to Glucophage, Sulfonylureas, Glitazones
  3. Contraindications
    1. Type I Diabetes Mellitus
    2. Concurrent Insulin use
    3. Prior history of malignancy
      1. Due to increased risk of cancer invasion and metastases
    4. Women of child bearing age (relative contraindication)
      1. Teratogenicity risk
  4. Adverse Effects
    1. Acute Pancreatitis
      1. Incidence may be as high as 1 in 50 for two years
      2. Singh (2013) JAMA Intern Med 173(7):534-9
    2. Serious Allergic Reaction (Sitagliptin)
      1. Anaphylaxis
      2. Angioedema
    3. Hepatotoxicity (Vildagliptin)
  5. Mechanism
    1. Blocks Dipeptidyl Peptidase-4 Inhibitor (DPP-4) allowing 2-3x accumulation of GLP-1
    2. Differs from Byetta: Weight neutral, no Nausea
  6. Dosing: Sitagliptin
    1. May be dosed with or without food
    2. Standard dosing
      1. Creatinine Clearance >50 ml/min: 100 mg once daily
    3. Renal insufficiency
      1. Consider Tradjenda instead, as does not require Renal Dosing adjustment
      2. Creatinine Clearance 30-49 ml/min: 50 mg once daily
      3. Creatinine Clearance <30 ml/min: 25 mg once daily
  7. Efficacy
    1. Lowers HBA1C 0.6%
  8. References
    1. Jones (2007) Am Fam Physician 75:1831-5
Medication Costs
Januvia (on 2/9/2012 at DrugStore.com)
Januvia 50mg Tablets #30 for $228.98 ($7.63/unit)
Januvia 25mg Tablets #90 for $645.98 ($7.18/unit)
Januvia 100mg Tablets #30 for $223.99 ($7.47/unit)
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

sitagliptin (C1565750)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C496398
SnomedCT 424106006, 423307000
English 4-oxo-4-(3-(trifluoromethyl)-5,6-dihydro(1,2,4)triazolo(4,3-a)pyrazin-7(8H)-yl)-1-(2,4,5-trifluorophenyl)butan-2-amine, sitagliptin, Sitagliptin (product), Sitagliptin, Sitagliptin (substance), SITAGLIPTIN, sitagliptin [Chemical/Ingredient], sitaGLIPtin
Spanish sitagliptina (producto), sitagliptina, sitagliptina (sustancia)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Januvia (C1702177)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C496398
English Januvia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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