Home Drug Guide Sitagliptin Hydrochloride

Drug Guide

Generic Name

Sitagliptin Hydrochloride

Brand Names Brynovin

Classification

Therapeutic: Antidiabetic agent

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

FDA Approved Indications

  • Type 2 diabetes mellitus (as adjunct to diet and exercise)

Mechanism of Action

Inhibits DPP-4 enzyme, increasing incretin levels (GLP-1 and GIP), which enhances 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 children

Geriatric: Dose adjustment based on renal function; no initial dose adjustment needed in elderly with normal renal function

Renal Impairment: Adjust dose based on renal function: 50 mg if CrCl 30-50 mL/min, 25 mg if CrCl <30 mL/min

Hepatic Impairment: No specific adjustment recommended

Pharmacokinetics

Absorption: Rapidly absorbed, bioavailability ~87%

Distribution: Low protein binding (~38%)

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged in urine

Excretion: Excreted mainly via kidneys; renal clearance approximates plasma clearance

Half Life: 12.4 hours

Contraindications

  • Hypersensitivity to sitagliptin or any component

Precautions

  • Renal impairment—dose adjustment required; risk of pancreas-related adverse events; monitor pancreas enzymes; caution in patients with a history of pancreatitis

Adverse Reactions - Common

  • Headache (Common)
  • Nasopharyngitis (Common)
  • Upper respiratory infection (Common)
  • Diarrhea (Less common)

Adverse Reactions - Serious

  • Pancreatitis (Serious, rare)
  • Hypersensitivity reactions including anaphylaxis (Serious, rare)
  • Severe cutaneous adverse reactions (Rare)

Drug-Drug Interactions

  • None specifically identified, but caution with other agents affecting renal function

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose regularly; assess for signs and symptoms of pancreatitis; renal function tests at baseline and periodically

Diagnoses:

  • Risk for unstable blood glucose levels
  • Risk of pancreatitis

Implementation: Administer once daily, with or without food; reinforce diet and exercise recommendations; monitor renal function periodically

Evaluation: Assess blood glucose control; monitor for adverse effects, including pancreatitis

Patient/Family Teaching

  • Take medication exactly as prescribed; do not stop abruptly without consulting healthcare provider
  • Report symptoms of pancreatitis: severe abdominal pain, nausea, vomiting
  • Maintain recommended diet and exercise regimen
  • Be aware of signs of hypoglycemia, especially when used with other antidiabetic medications

Special Considerations

Black Box Warnings:

  • None currently

Genetic Factors: None specified for sitagliptin

Lab Test Interference: None known

Overdose Management

Signs/Symptoms: Potential hypoglycemia; unlikely to cause severe symptoms alone due to glucose-dependent mechanism

Treatment: Supportive care; glucose administration if hypoglycemia occurs; no specific antidote

Storage and Handling

Storage: Store at room temperature, away from moisture and heat

Stability: Stable as per manufacturer specifications

🛡️ 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.