Di-peptidyl peptidase 4 Inhibitors Flashcards
What is the brand name of sitagliptin?
Brand = Januvia
What is the brand name of saxagliptin?
Brand = Onglyza
What is the brand name of linagliptin?
Brand = Tradjenta
What is the brand name of alogliptin?
Brand = Nesina
What is the MOA of sitagliptin, saxagliptin, linagliptin, alogliptin?
DPP-4 inhibitors inhibit the DPP-4 enzyme that is known to metabolize the GLP-1 hormone leading GLP-1s to continue stimulating to enhance the release of insulin and decrease glucagon release from alpha cells
Are DPP-4i likely to cause hypoglycemia?
No, not really unless used concomitantly w/ sulfonylureas or insulin
What’s initial dosing for linagliptin and saxtagliptin?
Initially = 5 mg/day
What’s the initial dosing for sitagliptin?
Initially = 100 mg/day
What’s the initial dosing for alogliptin?
Initially = 25 mg/day
Does sitagliptin require dose adjustments for renal insufficiency?
Yes
CrCl 30-49 mL/min = 50 mg/day
CrCl < 30 mL/min = 25 mg/day
Does saxtagliptin require dose adjustments for renal insufficiency?
Yes
CrCl < 50 mL/min = 2.5 mg/day
Does alogliptin require dose adjustments for renal insufficiency?
Yes
CrCl 30-59 mL/min = 12.5 mg/day
CrCl < 30 mL/min = 6.25 mg/day
Does linagliptin require dose adjustments for renal insufficiency?
No, it does not
What are the top 5 contraindications for DPP-4i’s?
- Acute pancreatitis (very rare)
- Type 1 DM
- Diabetic ketoacidosis
- Heart failure
- Hypersensitivity
What are the 3 main adverse effects for DPP-4i’s?
- Upper respiratory tract infections (URTIs)
- Hypoglycemia (only if used with sulfonylureas or insulin)
- GI side effects
