Sitagliptin Medical Valley: Uses, Dosage & Side Effects

A DPP-4 inhibitor (dipeptidyl peptidase-4 inhibitor) used to lower blood sugar levels in adults with type 2 diabetes mellitus, alone or in combination with other antidiabetic medicines

Rx ATC: A10BH01 DPP-4 Inhibitor
Active Ingredient
Sitagliptin (as sitagliptin phosphate monohydrate)
Available Forms
Film-coated tablets
Strengths
25 mg
Marketing Authorisation Holder
Medical Valley Invest AB
Medically reviewed by iMedic Medical Team
Evidence Level 1A

Sitagliptin Medical Valley is a prescription medicine containing sitagliptin, a DPP-4 inhibitor used to control blood sugar levels in adults with type 2 diabetes. It works by increasing the body's own insulin production after meals and reducing excessive sugar production. Supplied as 25 mg film-coated tablets, this strength is specifically intended for patients with severe kidney impairment or end-stage renal disease, and it is taken once daily with or without food, either alone or alongside other diabetes treatments such as metformin, sulfonylureas, or insulin.

Quick Facts

Active Ingredient
Sitagliptin
Drug Class
DPP-4 Inhibitor
ATC Code
A10BH01
Common Uses
Type 2 Diabetes
Available Forms
Tablets
Prescription Status
Rx Only

Key Takeaways

  • Sitagliptin Medical Valley is a DPP-4 inhibitor that helps control blood sugar in type 2 diabetes by boosting your body's natural insulin response after meals.
  • The 25 mg strength is specifically indicated for adults with severe kidney impairment or end-stage renal disease, including those receiving haemodialysis or peritoneal dialysis.
  • It can be used alone or combined with metformin, sulfonylureas, pioglitazone, or insulin for better glucose control, with the same 25 mg once-daily dose in patients with reduced renal function.
  • Unlike sulfonylureas and insulin, sitagliptin alone has a low risk of causing hypoglycemia (low blood sugar).
  • Report severe abdominal pain immediately to your doctor, as rare cases of pancreatitis have been associated with DPP-4 inhibitors.

What Is Sitagliptin Medical Valley and What Is It Used For?

Quick Answer: Sitagliptin Medical Valley is an oral diabetes medicine belonging to the DPP-4 inhibitor class. It is prescribed for adults with type 2 diabetes to help lower blood sugar levels. It works by increasing insulin secretion after meals and reducing the amount of glucose produced by the liver.

Sitagliptin Medical Valley contains the active substance sitagliptin, which belongs to a class of medicines known as DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors). These medicines work by targeting the incretin system, a natural hormonal pathway that plays a key role in regulating blood sugar after eating. When you consume a meal, your gut releases incretin hormones—primarily glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)—that signal the pancreas to produce insulin. The enzyme DPP-4 normally breaks down these incretins within minutes. Sitagliptin inhibits this enzyme, allowing incretin hormones to remain active for longer and thereby enhancing insulin secretion in a glucose-dependent manner.

This glucose-dependent mechanism is particularly important because it means that sitagliptin primarily stimulates insulin release when blood sugar is elevated, such as after a meal. When blood sugar levels are normal or low, the incretin effect is reduced, which gives sitagliptin a lower intrinsic risk of causing hypoglycemia compared to older diabetes medications such as sulfonylureas. In addition to boosting insulin, sitagliptin also reduces glucagon secretion—a hormone that signals the liver to release stored glucose—which further helps to control post-meal blood sugar spikes.

Your doctor may prescribe Sitagliptin Medical Valley to help lower blood sugar that is too high due to type 2 diabetes. This medicine can be used in several ways: as monotherapy when diet and exercise alone are insufficient and metformin is not appropriate; in dual therapy alongside metformin, a sulfonylurea, pioglitazone (a thiazolidinedione), or insulin; or in triple therapy combining sitagliptin with metformin and a sulfonylurea, metformin and pioglitazone, or metformin and insulin. In all cases, it should be used alongside an appropriate diet and exercise programme recommended by your healthcare provider.

Understanding Type 2 Diabetes

Type 2 diabetes mellitus is a chronic metabolic condition characterised by insulin resistance and progressive beta-cell dysfunction. In this condition, the body either does not produce enough insulin or the cells become resistant to the effects of insulin, leading to elevated blood glucose levels. Over time, persistently high blood sugar can damage blood vessels and nerves, potentially leading to serious complications including cardiovascular disease, chronic kidney disease, retinopathy (vision loss), peripheral neuropathy, and impaired wound healing that may necessitate amputation.

According to the International Diabetes Federation (IDF), approximately 537 million adults worldwide were living with diabetes in 2021, with type 2 diabetes accounting for around 90% of all cases. The condition is closely linked to modifiable risk factors including obesity, physical inactivity, and unhealthy dietary patterns, as well as non-modifiable factors such as genetic predisposition, ethnicity, and age. Effective management of type 2 diabetes typically involves a combination of lifestyle modifications (diet, exercise, weight management) and pharmacological therapy to achieve and maintain glycaemic targets, which are generally set at an HbA1c level below 7% (53 mmol/mol) for most adults, as recommended by both the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).

How DPP-4 Inhibitors Fit Into Diabetes Treatment

DPP-4 inhibitors, sometimes called gliptins, occupy an important position in the treatment algorithm for type 2 diabetes. According to the 2022 ADA/EASD consensus report on the management of hyperglycaemia, DPP-4 inhibitors are considered a reasonable second-line option after metformin, particularly for patients who need additional glucose lowering but for whom weight neutrality and a low risk of hypoglycemia are priorities. They are generally well tolerated, weight-neutral, and have a convenient once-daily oral dosing schedule.

While newer drug classes such as SGLT2 inhibitors and GLP-1 receptor agonists have gained prominence due to demonstrated cardiovascular and renal benefits, DPP-4 inhibitors remain widely used globally. They are particularly useful for patients who cannot tolerate or have contraindications to other medication classes, and in healthcare settings where cost or access to injectable therapies may be a concern. Sitagliptin was the first DPP-4 inhibitor to receive regulatory approval, initially authorised by the U.S. FDA in 2006 and subsequently approved in the European Union and many other countries worldwide.

What Should You Know Before Taking Sitagliptin Medical Valley?

Quick Answer: Do not take Sitagliptin Medical Valley if you are allergic to sitagliptin or any of the other ingredients. Tell your doctor about any history of pancreatitis, kidney problems, or type 1 diabetes before starting treatment. This medicine is not recommended during pregnancy or breastfeeding.

Contraindications

You must not use Sitagliptin Medical Valley if you are allergic (hypersensitive) to sitagliptin or any of the other ingredients contained in the tablet formulation. Serious allergic reactions, including anaphylaxis, angioedema, and exfoliative skin conditions such as Stevens-Johnson syndrome, have been reported in post-marketing experience with sitagliptin. If you have previously experienced any allergic reaction to a DPP-4 inhibitor, you should inform your healthcare provider before starting treatment.

Sitagliptin Medical Valley is specifically indicated for type 2 diabetes and should not be used in patients with type 1 diabetes, as it will not be effective in this condition. It is also not appropriate for the treatment of diabetic ketoacidosis (DKA), a serious complication of diabetes characterised by high blood sugar, rapid weight loss, nausea, or vomiting, and elevated ketone levels in the blood and urine.

Warnings and Precautions

Before starting and during treatment with Sitagliptin Medical Valley, inform your doctor if you have or have had any of the following conditions:

  • Pancreatic disease: A history of pancreatitis increases the risk of recurrence. Your doctor will carefully evaluate whether sitagliptin is appropriate for you.
  • Gallstones, alcohol dependence, or very high triglyceride levels: These conditions can increase the risk of developing pancreatitis while taking DPP-4 inhibitors.
  • Kidney problems: If you have moderate to severe kidney impairment, your doctor will prescribe a lower dose of sitagliptin. Kidney function should be assessed before starting treatment and periodically thereafter.
  • Bullous pemfigoid: Cases of this blistering skin condition have been reported with DPP-4 inhibitors. If you develop blisters on the skin, contact your doctor, who may advise you to stop taking Sitagliptin Medical Valley.
Hypoglycemia Risk

Sitagliptin alone does not typically cause low blood sugar (hypoglycemia) because its mechanism of action is glucose-dependent. However, when used in combination with a sulfonylurea (such as glimepiride or gliclazide) or with insulin, the risk of hypoglycemia increases. Your doctor may reduce the dose of your sulfonylurea or insulin when adding sitagliptin to your treatment regimen. Learn to recognise the signs of low blood sugar: sweating, shakiness, fast heartbeat, hunger, dizziness, and confusion.

Children and Adolescents

Sitagliptin Medical Valley is not recommended for use in children and adolescents under 18 years of age. Clinical studies in paediatric patients aged 10 to 17 years with type 2 diabetes did not demonstrate sufficient efficacy to support its use in this population. No data are available for children under 10 years, and safety and efficacy have not been established in this age group.

Pregnancy and Breastfeeding

If you are pregnant, think you may be pregnant, or are planning to have a baby, you should consult your doctor before taking Sitagliptin Medical Valley. This medicine should not be used during pregnancy due to insufficient human data regarding its safety. Animal studies have not indicated direct harmful effects on fertility or embryonic development, but as a precautionary measure, sitagliptin should be avoided in pregnancy.

It is not known whether sitagliptin passes into human breast milk. Studies in rats have shown that sitagliptin is secreted in breast milk. As a precautionary measure, you should not use Sitagliptin Medical Valley if you are breastfeeding or planning to breastfeed. Your doctor will help you decide on a suitable alternative diabetes treatment during this period.

Driving and Operating Machinery

Sitagliptin Medical Valley has no or negligible direct effect on the ability to drive and use machines. However, dizziness and drowsiness have been reported by some patients, which could affect your ability to drive or operate machinery safely. When used in combination with sulfonylureas or insulin, low blood sugar (hypoglycemia) may also impair your reaction time. Take care when driving or using machines, particularly when starting the medication or adjusting the dose.

Important Information About Ingredients

Sitagliptin Medical Valley film-coated tablets contain less than 1 mmol (23 mg) sodium per tablet, meaning they are essentially sodium-free. The tablets also contain hydrogenated castor oil, which may cause stomach upset and diarrhoea in some patients.

How Does Sitagliptin Medical Valley Interact with Other Drugs?

Quick Answer: Sitagliptin has relatively few significant drug interactions. The most important consideration is that when combined with sulfonylureas or insulin, the risk of hypoglycemia increases and dose adjustments may be necessary. Digoxin levels may need monitoring when used together with sitagliptin.

One of the advantages of sitagliptin compared to some other diabetes medications is its relatively low potential for drug-drug interactions. Sitagliptin is not a significant inhibitor or inducer of the cytochrome P450 enzyme system, which is the primary metabolic pathway for many commonly prescribed drugs. Nevertheless, some interactions do exist and should be taken into consideration:

Clinically Relevant Interactions

Known Drug Interactions with Sitagliptin Medical Valley
Interacting Drug Effect Clinical Action
Digoxin Sitagliptin may slightly increase plasma digoxin levels Appropriate monitoring of digoxin levels is recommended when co-administered
Sulfonylureas (e.g. glimepiride, gliclazide, glipizide) Increased risk of hypoglycemia due to additive glucose-lowering effects A lower dose of sulfonylurea may be required to reduce the risk of low blood sugar
Insulin Increased risk of hypoglycemia when used in combination A lower dose of insulin may be needed; monitor blood sugar more frequently
Metformin No clinically meaningful pharmacokinetic interaction No dose adjustment required; combination is widely used and well studied
Cyclosporin Cyclosporin (a potent P-glycoprotein inhibitor) may increase sitagliptin exposure The clinical significance is not expected to be major; no dose adjustment is recommended

Low Interaction Potential

Clinical studies have evaluated the pharmacokinetic interaction of sitagliptin with a number of commonly prescribed medicines, including metformin, rosiglitazone, glyburide, simvastatin, warfarin, and oral contraceptives (norethindrone and ethinyl estradiol). In these studies, sitagliptin did not meaningfully alter the pharmacokinetics of these drugs, and co-administration did not meaningfully alter the pharmacokinetics of sitagliptin. Based on this evidence, sitagliptin is considered unlikely to cause clinically relevant interactions with substrates of CYP3A4, CYP2C8, CYP2C9, or P-glycoprotein.

Always inform your doctor or pharmacist about all medicines you are currently taking, have recently taken, or might take, including herbal supplements and over-the-counter products. This ensures that your healthcare team can monitor for any potential interactions and make appropriate dose adjustments where needed.

What Is the Correct Dosage of Sitagliptin Medical Valley?

Quick Answer: Sitagliptin Medical Valley 25 mg is a renally adjusted strength prescribed once daily for adults with severe kidney impairment or end-stage renal disease (eGFR < 30 mL/min), including patients on haemodialysis or peritoneal dialysis. It is taken by mouth, with or without food. Sitagliptin Medical Valley is not recommended for children under 18 years.

Always take Sitagliptin Medical Valley exactly as your doctor has told you. Check with your doctor or pharmacist if you are unsure about your prescribed dosage. Your doctor will determine the appropriate dose based on your individual clinical situation, particularly your kidney function, and any other diabetes medicines you are taking.

Adults

Standard Dosage for the 25 mg Strength

The recommended dose of Sitagliptin Medical Valley 25 mg is one 25 mg tablet once daily, taken by mouth. You may take the tablet with or without food, at any time of day that is convenient for you. However, taking it at approximately the same time each day can help establish a consistent routine and improve adherence. For patients receiving haemodialysis, the tablet can be taken without regard to the timing of dialysis sessions.

Why 25 mg? Positioning This Strength in the Sitagliptin Range

Sitagliptin is marketed internationally in 25 mg, 50 mg, and 100 mg strengths. The 25 mg tablet—the only strength available as Sitagliptin Medical Valley—is the lowest strength and is reserved for adults with severely reduced kidney function. It delivers approximately the same total sitagliptin exposure (AUC) to a patient with severe renal impairment as the 100 mg dose does in a patient with normal renal function. If your kidney function improves or worsens, your prescriber may switch you to a different strength of sitagliptin from another manufacturer.

Dosage Adjustments Based on Kidney Function (Sitagliptin Range)
Kidney Function (eGFR) Recommended Sitagliptin Dose Notes
Normal or mild impairment (eGFR ≥ 45 mL/min) 100 mg once daily Standard dose; Sitagliptin Medical Valley 25 mg is not the correct strength for this group
Moderate impairment (eGFR 30–44 mL/min) 50 mg once daily Dose reduction due to reduced renal clearance; 25 mg strength is not indicated
Severe impairment or end-stage renal disease (eGFR < 30 mL/min), including dialysis 25 mg once daily (Sitagliptin Medical Valley) Can be taken without regard to the timing of dialysis sessions

Your doctor will assess your kidney function before prescribing Sitagliptin Medical Valley and may periodically re-evaluate it during treatment to ensure the dose remains appropriate. Sitagliptin is primarily excreted unchanged by the kidneys, so dose adjustments are essential for patients with reduced renal function to prevent excessive drug accumulation and associated adverse effects. In long-term clinical studies of sitagliptin 25 mg in patients with severe renal impairment and end-stage renal disease, the pharmacokinetic and safety profile was consistent with that of 100 mg dosing in patients with preserved renal function.

Children

Paediatric Use

Sitagliptin Medical Valley is not recommended for children and adolescents under 18 years of age. Clinical trials in children aged 10 to 17 years with type 2 diabetes did not show adequate efficacy. No data are available for children under 10 years of age.

Elderly

Use in Older Adults

No dose adjustment is needed based solely on age. However, since renal function tends to decline with age, elderly patients should have their kidney function monitored, and the dose should be adjusted accordingly using the guidelines above. Clinical studies have included patients aged 65 years and older, and the safety and efficacy profile was comparable to that observed in younger adults.

Missed Dose

If you forget to take a dose, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose on the same day to make up for a forgotten dose. If you frequently forget to take your medicine, speak with your doctor or pharmacist about strategies to help you remember.

Overdose

Stopping Treatment

Do not stop taking Sitagliptin Medical Valley without talking to your doctor first, even if you feel well. This medicine helps control your blood sugar levels on an ongoing basis, and stopping it may cause your blood sugar to rise to harmful levels. Continuation of treatment should be decided jointly by you and your healthcare provider based on your overall diabetes management plan.

What Are the Side Effects of Sitagliptin Medical Valley?

Quick Answer: Common side effects include low blood sugar (when combined with other diabetes medicines), headache, upper respiratory tract infections, and joint pain. Rare but serious side effects include pancreatitis, severe allergic reactions, and bullous pemfigoid. Contact your doctor immediately if you experience severe abdominal pain or skin blistering.

Like all medicines, Sitagliptin Medical Valley can cause side effects, although not everyone will experience them. The frequency and nature of side effects can vary depending on whether sitagliptin is used alone or in combination with other diabetes medicines. The information below summarises the known side effects based on clinical trials and post-marketing surveillance data.

Side Effect Frequency Overview

Very Common

May affect more than 1 in 10 people

  • Low blood sugar (hypoglycemia) — when used with a sulfonylurea and metformin

Common

May affect up to 1 in 10 people

  • Low blood sugar (hypoglycemia) — when used alone or with metformin
  • Headache
  • Upper respiratory tract infection
  • Stuffy or runny nose and sore throat (nasopharyngitis)
  • Osteoarthritis (joint disease)
  • Pain in arms or legs
  • Nausea
  • Flatulence (gas)
  • Vomiting
  • Constipation
  • Swollen hands or legs (peripheral oedema) — when used with pioglitazone
  • Influenza-like symptoms — when used with insulin

Uncommon

May affect up to 1 in 100 people

  • Dizziness
  • Constipation
  • Itching (pruritus)
  • Dry mouth
  • Drowsiness (somnolence)
  • Stomach pain
  • Diarrhoea

Rare

May affect up to 1 in 1,000 people

  • Decreased platelet count (thrombocytopenia)

Not Known

Frequency cannot be estimated from available data

  • Kidney problems (sometimes requiring dialysis)
  • Vomiting
  • Joint pain (arthralgia)
  • Muscle pain (myalgia)
  • Back pain
  • Interstitial lung disease
  • Bullous pemfigoid (a type of skin blistering)
  • Severe allergic reactions (anaphylaxis, angioedema)

Side Effects in Combination Therapy

The side effect profile of sitagliptin can vary depending on the combination therapy used. When added to metformin, the most commonly reported additional effects are nausea, flatulence, and gastrointestinal discomfort, which are largely attributable to metformin rather than sitagliptin itself. When combined with pioglitazone, peripheral oedema (swelling of hands and feet) is more commonly observed. When used with insulin, influenza-like symptoms and dry mouth have been reported.

It is worth noting that in large cardiovascular outcome trials, particularly the TECOS trial (Trial Evaluating Cardiovascular Outcomes with Sitagliptin), sitagliptin demonstrated cardiovascular safety with no increased risk of major adverse cardiovascular events, heart failure hospitalisation, or pancreatitis compared to placebo, when added to standard diabetes care.

Reporting Side Effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed above. You can also report side effects directly to your national pharmacovigilance authority. By reporting side effects, you help provide more information on the safety of this medicine.

How Should You Store Sitagliptin Medical Valley?

Quick Answer: Store Sitagliptin Medical Valley at room temperature, away from children's reach. No special storage conditions are required. Do not use after the expiry date on the packaging.

Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date stated on the blister and carton after "EXP". The expiry date refers to the last day of that month.

There are no special storage conditions for Sitagliptin Medical Valley film-coated tablets. They should be stored at room temperature, protected from excessive heat and moisture. Keep the tablets in the original packaging (blister or bottle) until you are ready to take them, as this protects them from environmental degradation.

Do not dispose of medicines in wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures help protect the environment and prevent accidental exposure to unused medications.

What Does Sitagliptin Medical Valley Contain?

Quick Answer: The active ingredient is sitagliptin (as sitagliptin phosphate monohydrate), supplied as 25 mg film-coated tablets. Inactive ingredients include microcrystalline cellulose, calcium hydrogen phosphate, croscarmellose sodium, magnesium stearate, sodium stearyl fumarate, and film-coating agents.

Active Ingredient

Each film-coated tablet of Sitagliptin Medical Valley contains sitagliptin phosphate monohydrate equivalent to 25 mg of sitagliptin (the free base). Sitagliptin is chemically described as (3R)-3-amino-1-[3-(trifluoromethyl)-5,6,7,8-tetrahydro-1,2,4-triazolo[4,3-a]pyrazin-7-yl]-4-(2,4,5-trifluorophenyl)butan-1-one. It is a highly selective, orally active inhibitor of the dipeptidyl peptidase-4 (DPP-4) enzyme.

Inactive Ingredients (Excipients)

Tablet core: microcrystalline cellulose (E460), calcium hydrogen phosphate anhydrous (E341), croscarmellose sodium (E468), magnesium stearate (E470b), sodium stearyl fumarate.

Film coating: poly(vinyl alcohol) (E1203), titanium dioxide (E171), macrogol 3350 (E1521), talc (E553b), red iron oxide (E172), yellow iron oxide (E172).

The tablet is essentially sodium-free (contains less than 1 mmol, i.e. 23 mg, of sodium per tablet). It does not contain gluten, lactose, or ingredients of animal origin.

Tablet Appearance

Tablet Identification Guide
Strength Colour Shape & Size Appearance
25 mg Light pink Round, biconvex, approximately 6 mm in diameter Film-coated, plain on both sides

Sitagliptin Medical Valley 25 mg film-coated tablets are supplied in aluminium/aluminium blister packs. Common pack sizes include 28 and 98 film-coated tablets. Not all pack sizes may be marketed in every country. The tablets should be stored in the original packaging until use to protect them from moisture.

Marketing Authorisation Holder

Medical Valley Invest AB. For manufacturer information specific to your country, consult the patient information leaflet supplied with your medicine or your local medicines regulator.

Frequently Asked Questions

Sitagliptin Medical Valley is used to treat type 2 diabetes mellitus in adults. It belongs to the DPP-4 inhibitor class and works by increasing insulin levels produced after a meal and reducing the amount of sugar made by the body. It can be used alone or in combination with other diabetes medications such as metformin, sulfonylureas, pioglitazone, or insulin, alongside diet and exercise.

Sitagliptin Medical Valley is supplied as 25 mg film-coated tablets. The recommended dose is one 25 mg tablet once daily, taken by mouth with or without food. This strength is specifically intended for adults with severe kidney impairment (eGFR < 30 mL/min) or end-stage renal disease, including those receiving haemodialysis or peritoneal dialysis. Take it at the same time each day to help maintain a consistent routine, and always follow your doctor's instructions alongside any recommended diet and exercise programme.

Yes, rare cases of pancreatitis (inflammation of the pancreas) have been reported in patients taking sitagliptin. You should stop taking the medication and contact your doctor immediately if you experience severe and persistent pain in the abdomen that may radiate to the back, with or without nausea and vomiting. If pancreatitis is confirmed, treatment with sitagliptin should not be restarted.

No, Sitagliptin Medical Valley should not be used during pregnancy. It is also not recommended during breastfeeding as it is unknown whether sitagliptin passes into breast milk. If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor who will prescribe a suitable alternative treatment for your diabetes.

Sitagliptin Medical Valley contains the same active ingredient (sitagliptin) as Januvia and is considered a bioequivalent generic alternative. Both medicines work in exactly the same way as DPP-4 inhibitors to lower blood sugar in type 2 diabetes. The main practical difference is that Sitagliptin Medical Valley is supplied only in the 25 mg strength—the renally adjusted dose for patients with severe kidney impairment—whereas Januvia is marketed in 25 mg, 50 mg, and 100 mg. The choice between brand and generic is typically based on cost, availability, and which strength your prescription calls for.

Sitagliptin is generally considered a weight-neutral medication. Unlike some other diabetes medicines (such as sulfonylureas, insulin, or thiazolidinediones) which can cause weight gain, clinical studies have shown that sitagliptin does not typically lead to significant changes in body weight. This weight-neutral profile is one of its clinical advantages in managing type 2 diabetes.

Sitagliptin Medical Valley is marketed specifically as the 25 mg film-coated tablet because this is the renally adjusted strength used in adults with severe kidney impairment (eGFR below 30 mL/min) or end-stage renal disease, including those on haemodialysis or peritoneal dialysis. At this reduced dose, sitagliptin exposure (AUC) in patients with severely reduced kidney function is approximately equivalent to the exposure achieved by a 100 mg dose in someone with normal renal function. Patients who need a higher sitagliptin dose (50 mg or 100 mg) will be prescribed an alternative sitagliptin product that is available in those strengths.

No. The 25 mg dose can be taken without regard to the timing of haemodialysis sessions. Sitagliptin is only modestly removed by haemodialysis (approximately 13.5% over a 3–4 hour session), so there is no need to take a supplemental dose after dialysis. Simply take your tablet at the same convenient time each day, with or without food, as prescribed by your nephrologist or diabetes team.

References

  1. European Medicines Agency (EMA). Sitagliptin – Summary of Product Characteristics. Last updated 2025. Available at: www.ema.europa.eu
  2. American Diabetes Association (ADA). Standards of Care in Diabetes – 2025. Diabetes Care. 2025;48(Supplement 1).
  3. Davies MJ, Aroda VR, Collins BS, et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753–2786.
  4. Green JB, Bethel MA, Armstrong PW, et al. Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes (TECOS). N Engl J Med. 2015;373(3):232–242.
  5. World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List, 2023. Geneva: WHO; 2023.
  6. U.S. Food and Drug Administration (FDA). Sitagliptin Prescribing Information. Revised 2024. Available at: www.fda.gov
  7. International Diabetes Federation (IDF). IDF Diabetes Atlas, 10th Edition. Brussels: IDF; 2021.
  8. British National Formulary (BNF). Sitagliptin. National Institute for Health and Care Excellence (NICE). Accessed 2025.

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