Home Drug Guide Sitagliptin Phosphate

Drug Guide

Generic Name

Sitagliptin Phosphate

Brand Names Januvia

Classification

Therapeutic: Antidiabetic agent

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

FDA Approved Indications

  • Improved glycemic control in adults with type 2 diabetes mellitus as monotherapy or in combination with other hypoglycemic agents

Mechanism of Action

Sitagliptin inhibits DPP-4 enzyme, prolonging the activity of incretin hormones (GLP-1 and GIP), which increase insulin production and decrease glucagon levels in response to meals.

Dosage and Administration

Adult: 100 mg once daily, with or without food

Pediatric: Not approved for use in pediatric patients

Geriatric: No dosage adjustment necessary, but renal function should be monitored

Renal Impairment: Dose adjustment recommended for moderate to severe renal impairment (eGFR<60 mL/min/1.73m²)

Hepatic Impairment: No dose adjustment necessary

Pharmacokinetics

Absorption: Rapidly absorbed with peak plasma levels in 1-4 hours

Distribution: Approximately 38% bound to plasma proteins

Metabolism: Minimal hepatic metabolism; mostly excreted unchanged

Excretion: Primarily via the kidneys (~79% as unchanged drug), small amount in feces

Half Life: 12.4 hours

Contraindications

  • History of serious hypersensitivity to sitagliptin or any component

Precautions

  • Renal impairment, pancreatitis, hypersensitivity reactions, potential for immune-mediated disorders

Adverse Reactions - Common

  • Respiratory tract infection (Frequent)
  • Headache (Frequent)

Adverse Reactions - Serious

  • Pancreatitis (Uncommon)
  • Hypersensitivity reactions, including anaphylaxis (Rare)

Drug-Drug Interactions

  • Metformin (risk of lactic acidosis), insulins (risk of hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

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

Diagnoses:

  • Risk for unstable blood glucose levels

Implementation: Administer as prescribed; monitor for adverse effects and blood glucose response.

Evaluation: Assess blood glucose levels and patient adherence; monitor for adverse reactions.

Patient/Family Teaching

  • Take medication as prescribed, with or without food
  • Report symptoms of pancreatitis (severe abdominal pain, nausea, vomiting)
  • Maintain regular blood glucose monitoring
  • Avoid sudden discontinuation without medical advice

Special Considerations

Black Box Warnings:

  • None specifically for sitagliptin

Genetic Factors: Genetic variations in DPP-4 or incretin pathways may affect response

Lab Test Interference: May affect hematology and renal function tests

Overdose Management

Signs/Symptoms: Hypoglycemia, gastrointestinal symptoms

Treatment: Supportive care; monitor blood glucose levels; administer carbohydrate if needed; no specific antidote.

Storage and Handling

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

Stability: Stable up to the expiration date on the package

🛡️ 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.