Renal Dose Adjustment (Based on CrCl):
- Mild renal insufficiency (
50 mL/min): No dose adjustments - Moderate renal insufficiency (30 mL/min - <50 mL/min): 50 mg PO qd
- Severe renal insufficiency (<30 mL/min)/end-stage renal disease: 25 mg PO qd
Hepatic Dose Adjustment:
- Mild to moderate hepatic insufficiency (Child-Pugh score 7-9): No dose adjustments
- Severe hepatic insufficiency (Child-Pugh score >9): Dose adjustments not defined
See Supplemental Patient Information
- Post-marketing reports of acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, have occurred in patients taking sitagliptin. Monitor patients for signs and symptoms of pancreatitis; and if pancreatitis is suspected, promptly discontinue sitagliptin and initiate appropriate therapy
- In patients with moderate or severe renal insufficiency and with ESRD requiring hemodialysis or peritoneal dialysis, a dose adjustment is recommended. Assess renal function prior to and regularly during treatment
- There is an increased risk of hypoglycemia when co-administered with an insulin secretagogue (e.g., sulfonylurea) or insulin therapy. Consider lowering the dose of the sulfonylurea or insulin to reduce the risk of hypoglycemia
- Post-marketing reports of serious hypersensitivity reactions such as anaphylaxis, angioedema, and exfoliative skin conditions including Stevens-Johnson syndrome have been reported during therapy. In such cases, promptly discontinue therapy, assess for other potential causes, institute appropriate monitoring and treatment, and initiate alternative treatment for diabetes
- There have been no clinical studies demonstrating conclusive evidence of macrovascular risk reduction with sitagliptin or any other anti-diabetic drug
Cautions: Use cautiously in
- Elderly patients
- History of pancreatitis
Supplemental Patient Information
- Inform patients about the importance of adherence to dietary instructions, regular physical activity, periodic blood glucose monitoring and A1C testing, recognition and management of hypoglycemia and hyperglycemia, and assessment for diabetes complications
Pregnancy Category:B
Breastfeeding: Because no information is available regarding its use during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 17 January 2011).As per manufacturer's data, caution should be exercised when administered to a nursing woman.
Pricing data from www.DrugStore.com in U.S.A.
- Januvia 100 MG TABS [Bottle] (MERCK SHARP & DOHME)
30 mg = $235
90 mg = $672.99 - Januvia 50 MG TABS [Bottle] (MERCK SHARP & DOHME)
30 mg = $228.98
90 mg = $659.99 - Januvia 25 MG TABS [Bottle] (MERCK SHARP & DOHME)
90 mg = $645.98
270 mg = $1825.92
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
