Sitagliptin is a medication that has played a pivotal role in managing diabetes for adults over the years. With a wealth of experience as a licensed Pharmacist, I’m here to provide you with comprehensive information on its dosages for both adults and, when applicable, the pediatric population. Sitagliptin is available in various forms and strengths, making it a versatile option for diabetes management. Moreover, this article will also touch upon dosing recommendations for special medical categories, ensuring that you have a complete understanding of how to use this medication effectively and safely.
Sitagliptin Adult Dosing for Diabetes Type 2
The typical dosage for adults with Type 2 diabetes is 100 mg to be taken orally once daily. It’s important to note that when Sitagliptin is used in conjunction with an insulin secretagogue (such as a sulfonylurea) or insulin itself, it may necessitate a lower dose of the insulin secretagogue or insulin. This adjustment is made to reduce the risk of hypoglycemia, a potentially dangerous drop in blood sugar levels. Sitagliptin is prescribed as an adjunct to dietary and exercise regimens with the primary goal of enhancing glycemic control in patients who have been diagnosed with Type 2 diabetes mellitus. This combination therapy can be an effective approach to managing diabetes and improving overall health. Differences in dosing requirements tend to be more prevalent in older adults, mainly attributed to age-related alterations in kidney function.
It’s essential to note that Sitagliptin should not be prescribed for patients with type 1 diabetes. Furthermore, there is a lack of studies on patients with a history of pancreatitis, and it remains uncertain whether this specific patient group might be at an elevated risk for the onset of pancreatitis when using Sitagliptin. Caution and consultation with a healthcare provider are advisable for individuals falling into this category.
| Category | Dosage Strength | Dosage Frequency | Max Daily Dose | Course Duration |
| Geriatrics (65 years and older) | 25 mg, 50 mg, and 100 mg | 1 tablet | 100 mg | Determined by Healthcare Professional |
| Adult (18-64 years) | 25 mg, 50 mg, and 100 mg | 1 tablet | 100 mg | Determined by Healthcare Professional |
Sitagliptin Pediatric Dosing for Diabetes Type 2
In a randomized clinical trial designed to evaluate the pharmacokinetics (PK), pharmacodynamics (PD), and safety of sitagliptin in pediatric patients diagnosed with type 2 diabetes mellitus, it was noted that even at doses as high as 200 mg, single administrations of Sitagliptin were generally well-tolerated by male and female participants aged 10 to 17 years with type 2 diabetes.
Consequently, a daily dosage of 100 mg of Sitagliptin is deemed appropriate for further investigation in Phase III trials focusing on the safety and efficacy of this medication in pediatric patients with type 2 diabetes.
Renal Dose Adjustment
For individuals with mild renal impairment, characterized by an estimated glomerular filtration rate (eGFR) of 45 mL/min/1.73 m² or greater, there is typically no need for any dosage adjustment when taking Sitagliptin. In cases of moderate renal impairment, where the eGFR falls between 30 mL/min/1.73 m² and less than 45 mL/min/1.73 m², the recommended dose is 50 mg to be taken orally once a day. On the other hand, for those with severe renal impairment, where the eGFR is less than 30 mL/min/1.73 m², the advised dosage is 25 mg to be taken orally once daily.
These are the recommended Sitagliptin dosages based on the patient’s renal function, as measured by the estimated glomerular filtration rate (eGFR). It’s essential to tailor the dosage to the individual’s kidney function to ensure safe and effective use of the medication.
| Renal Function (eGFR) | Sitagliptin Dosage |
| Mild Renal Impairment (eGFR ≥ 45 mL/min/1.73 m²) | No adjustment recommended |
| Moderate Renal Impairment (eGFR 30 to < 45 mL/min/1.73 m²) | 50 mg orally once a day |
| Severe Renal Impairment (eGFR < 30 mL/min/1.73 m²) | 25 mg orally once a day |
Liver Dose Adjustments
For individuals with mild or moderate hepatic impairment, it is generally advisable to maintain the standard dosage without the need for adjustments. However, in the case of severe hepatic impairment, it is important to exercise caution as there is a lack of available data to provide specific dosage recommendations. In such situations, close monitoring and consultation with a healthcare professional are crucial to ensure the safe and appropriate use of the medication.
Dialysis
For patients undergoing dialysis, specific Sitagliptin dosing recommendations are as follows: in the case of hemodialysis, a daily oral dosage of 25 mg is recommended. Likewise, for individuals undergoing peritoneal dialysis, the recommended daily oral dosage is 25 mg. It’s important to note that Sitagliptin may be administered without concern for the timing of dialysis sessions. This flexibility in dosing allows for easier integration of the medication into the treatment regimen of patients who require dialysis, helping to manage their diabetes effectively. Always consult with a healthcare provider for personalized guidance on medication administration in the context of dialysis.
| Dialysis Type | Sitagliptin Dosage | Timing of Dialysis |
| Hemodialysis | 25 mg orally once a day | May be administered without regard to timing of dialysis |
| Peritoneal Dialysis | 25 mg orally once a day | May be administered without regard to timing of dialysis |
Administration Advice
- Sitagliptin may be taken with or without food, providing flexibility in its administration.
- In the event of a missed dose, it should be taken as soon as the patient remembers. However, it is important to note that taking more than one dose on the same day is not recommended.
Precautions
Contraindications
- Do not use Sitagliptin if you have a known hypersensitivity to this medication or any of the product excipients.
- It’s important to note that the safety and efficacy of Sitagliptin have not been established in patients younger than 18 years.
- For further precautions and detailed safety information, please refer to the WARNINGS section.
