sitagliptin and dapagliflozin

A10BD29

Forms & Strengths

Adult Dosing

One tablet (100 mg sitagliptin / 10 mg dapagliflozin or 100 mg sitagliptin / 5 mg dapagliflozin) orally once daily in the morning with or without food
Assess renal function prior to initiation and periodically thereafter; avoid use if eGFR is persistently <45 mL/min/1.73 m²

Pediatric Dosing

Safety and efficacy in pediatric patients (<18 years of age) have not been established

Indications

Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both sitagliptin and dapagliflozin is appropriate

Mechanism of Action

Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that slows the inactivation of incretin hormones, increasing insulin release and decreasing glucagon levels in a glucose-dependent manner
Dapagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that blocks renal glucose reabsorption, increasing urinary glucose excretion and osmotic diuresis

Contraindications

History of a serious hypersensitivity reaction to sitagliptin or dapagliflozin (e.g., anaphylaxis, angioedema)
Severe renal impairment (eGFR <30 mL/min/1.73 m²), end-stage renal disease, or patients on dialysis
History of diabetic ketoacidosis

Adverse Reactions

Upper respiratory tract infection
Nasopharyngitis
Hypoglycemia (especially when combined with insulin or secretagogues)
Urinary tract infections and genital mycotic infections
Volume depletion, hypotension, and dizziness
Acute kidney injury
Severe and disabling arthralgia
Acute pancreatitis
Hypersensitivity reactions including anaphylaxis, angioedema, and severe cutaneous adverse reactions
Fournier's gangrene

Drug Interactions

Insulin or insulin secretagogues (e.g., sulfonylureas): Increased risk of hypoglycemia; dose reduction of insulin or secretagogue may be required
Diuretics: Dapagliflozin may additive-enhance diuretic effects, increasing the risk of hypovolemia and hypotension
Strong CYP enzyme inducers (e.g., rifampin): May decrease exposure of dapagliflozin
Lithium: SGLT2 inhibitors may increase renal lithium clearance, leading to decreased serum lithium concentrations

Curated Content: Needs Vetting Before Put to Clinical Use