Sitagliptin

It is used in type 2 diabetes mellitus. Glucagon-like peptide-1(GLP-1), an incretin hormone, stimulates insulin secretion, decreases glucagon secretion, improves beta-cell function and slows gastric emptying. GLP-1 production is reduced in patients with type 2 diabetes. Furthermore, once GLP-1 is produced. It is rapidly degraded by the dipeptidyl peptidase IV (DPP-IV) enzyme. Sitagliptin inhibits dipeptidyl peptidase IV (DPP-IV), resulting in prolonged active incretin levels. Incretin hormones increases insuling synthesis and release from pancreatic b-cells and reduces glucagon secretion from pancreatic a-cells. Reduced glucagon secretion leads to decreased hepatic glucose production.

Indications

Type 2 diabetes mellitus

Dosage

Oral; 100mg once daily.

Contra-Indications

Hypersensitivity, Type 1 diabetes, Ketoacidosis

Special Precautions

Renal impairment; dose adjustment may be needed. Paediatric: Safety and efficacy not established. Pregnancy: Category B. Safe in animals but human studies not conclusive. Lactation: Excreted in milk. Elderly: safe to use.

Side Effects

Headache, diarrhoea, upper respiratory tract infection, nasopharyngitis. Angioedema exfoliative dermatitis, hypoglycaemia.

Drug Interactions

Digoxin and other hypoglycemic drugs.