Home Drug Guide Sitagliptin

Drug Guide

Generic Name

Sitagliptin

Brand Names Zituvio

Classification

Therapeutic: Antidiabetic agent, DPP-4 inhibitor

Pharmacological: Dipeptidyl peptidase-4 (DPP-4) inhibitor

FDA Approved Indications

  • Type 2 diabetes mellitus as an adjunct to diet and exercise

Mechanism of Action

Inhibits dipeptidyl peptidase-4 enzyme, prolonging the action of incretin hormones, which increases insulin secretion and decreases glucagon levels in a glucose-dependent manner.

Dosage and Administration

Adult: 100 mg once daily, with or without food

Pediatric: Not approved for pediatric use

Geriatric: Start at usual dose, consider renal function in dose adjustments

Renal Impairment: Dose adjustment is recommended based on renal function; eGFR < 45 mL/min/1.73 m²: 50 mg daily; eGFR < 30 mL/min/1.73 m²: 25 mg daily

Hepatic Impairment: No dose adjustment necessary

Pharmacokinetics

Absorption: Rapidly absorbed, bioavailability approximately 87%

Distribution: Vd approximately 0.1 L/kg, primarily free drug in plasma

Metabolism: Minimal hepatic metabolism, primarily excreted unchanged

Excretion: Renal excretion (about 80%) and some fecal elimination

Half Life: ≈12.4 hours

Contraindications

  • History of hypersensitivity to sitagliptin or any component of the formulation

Precautions

  • Renal impairment, risk of pancreatitis, hypersensitivity reactions, severe gastrointestinal disease, monitor for signs of hypersensitivity or pancreatitis

Adverse Reactions - Common

  • Nasopharyngitis (Common)
  • Headache (Common)
  • Gastrointestinal discomfort (Common)

Adverse Reactions - Serious

  • Pancreatitis (Serious)
  • Hypersensitivity reactions (including anaphylaxis, angioedema) (Serious)
  • Severe cutaneous adverse reactions (e.g., Stevens-Johnson syndrome) (Rare)

Drug-Drug Interactions

  • Insulin and sulfonylureas: increased risk of hypoglycemia when used concomitantly

Drug-Food Interactions

  • None specifically noted

Drug-Herb Interactions

  • None well-characterized, caution with herbal supplements

Nursing Implications

Assessment: Monitor blood glucose levels, renal function, and for signs of pancreatitis

Diagnoses:

  • Risk for hypoglycemia when used with insulin or sulfonylureas

Implementation: Administer once daily at the same time each day, with or without food, adjust dose based on renal function

Evaluation: Assess glycemic control and renal function regularly

Patient/Family Teaching

  • Take medication as prescribed, monitor blood glucose levels, recognize symptoms of hypoglycemia and pancreatitis, report any allergic or severe skin reactions

Special Considerations

Black Box Warnings:

  • Risk of severe joint pain, pancreatitis

Genetic Factors: None significant for this drug

Lab Test Interference: None known

Overdose Management

Signs/Symptoms: Hypoglycemia, nausea, vomiting, pancreatitis symptoms

Treatment: Supportive care, monitor blood glucose, no specific antidote; for hypoglycemia, administer glucose as needed

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F)

Stability: Stable as per manufacturer instructions, typically 24 months

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.