Updated throughout, the book also addresses other important issues such as the legal and ethical considerations of providing information, how to respond to requests for information, and how to determine what information should be made available. Onset Reduction in postprandial plasma glucose excursion: Approximately 60 minutes. Carefully titrate dosage to minimum dosage necessary for adequate glycemic control. Its emphasis on assisting people with multiple conditions, which is ever present in health care today, moves beyond primary and secondary prevention to focus on how patients and clients can be kept physically active and functionally fit. In either case, the drug should be used during pregnancy only when clearly needed.
When the drug is administered during pregnancy or if the patient becomes pregnant while receiving the drug, the patient should be informed of the potential hazard to the fetus. Sitagliptin in combination with metformin and glimepiride: Hypoglycemia, headache. Use of combination therapy initially or as maintenance therapy may not be appropriate in all patients; use according to clinician discretion. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. Hermansen K, Kipnes M, Luo E et al. Worsening of Renal Function Worsening of renal function, including acute renal failure that sometimes required dialysis, reported in some patients during postmarketing experience. Pharmacotherapy: A Pathophysiologic Approach is written to help you advance the quality of patient care through evidence-based medication therapy derived from sound pharmacotherapeutic principles.
Applicable comparative information on doses, dosage forms, and routes of administration may be included. Adults Describes specific dosages for adults. Lactation Distributed into milk in rats; not known whether distributed into human milk. Effect of the dipeptidyl peptidase-4 inhibitor sitagliptin as monotherapy on glycemic control in patients with type 2 diabetes. The rate of injection or infusion of the drug is described, as well as any precautions associated with administration.
Information in the compatibility section summarizes complex information from multiple sources in an easy-to-use, reliable format. More specific brief descriptions of important pharmacologic activities and effects follow. Synonyms Lists common synonyms, acronyms, former names, and other names for the drug. Organization of Full-length Monographs Information within each drug monograph is divided into the sections and subsections listed below. Special Populations Renal impairment results in increased terminal elimination half-life. Specific Populations Pregnancy Describes the safety of the drug in pregnant women.
The Elimination subsection describes key information on the biotransformation and excretory characteristics of the drug. It generally is important that all patients be advised to inform their clinicians about concomitant therapies and diseases and for women of childbearing potential if they are or plan to become pregnant or plan to breast-feed. If missed dose is remembered at time of next dose, skip missed dose and resume regular schedule. Adults Diabetes Mellitus Monotherapy Oral 100 mg once daily. Concomitant Therapy with Hypoglycemic Agents Greater incidence of hypoglycemia when sitagliptin used in combination with a sulfonylurea or insulin. Dosage The Dosage subsection describes recommended and alternative dosage schedules for each dosage form and route of administration, age of the patient, and condition being treated. Does not appear to inhibit p-glycoprotein transport system.
Management of hyperglycemia in type 2 diabetes: a consensus algorithm for initiation and adjustment of therapy. Distribution Extent Describes distribution of the drug into various tissues e. The mechanism of the interaction, associated clinical importance, precautions to be observed, and management of the interaction may be described briefly in the accompanying tables. Pediatric Patients Describes age-specific dosages from the neonatal period through adolescence. If the drug were used during pregnancy, the possibility of fetal harm appears remote. Pharmacokinetic interactions with drugs metabolized by these isoenzymes unlikely. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhbitors in type 2 diabetes.
Early communication: reports of possible increased risk of pancreatitis and pre-cancerous findings of the pancreas. Bolen S, Feldman L, Vassy J et al. Potential pharmacokinetic interaction increased absorption and renal clearance of sitagliptin with p-glycoprotein inhibitors. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin added to ongoing metformin therapy in patients with type 2 diabetes inadequately controlled with metformin alone. The Distribution subsection describes key information on the usual distribution of the drug into body tissue and fluids. Not just for professional support, but for the clinical and business information they need most.
Renal Impairment Sitagliptin Monotherapy Oral Moderate renal impairment Cl cr of 30 to 1. Individual monographs may not contain all of the information described below, and the absence of specific information within an individual monograph does not imply that such information is unavailable. Drugs Secreted by Renal Tubular Cationic Transport Substrate of organic anion transport system; pharmacokinetic interaction unlikely with substrates of organic cationic transport system. Evidence-informed guidelines, suggested websites, and additional readings further encourage practical use of information and identify further learning opportunities. When available and applicable, maximum recommended dosages are described under the Prescribing Limits subsection of Dosage and Administration.