Jaglix (Sitagliptin)

Sitagliptin is used to manage blood glucose in the type 2 diabetes therapeutic pathway.

• Type 2 diabetes mellitus (monotherapy): lowers fasting and post‑prandial glucose as a single agent.
• Type 2 diabetes mellitus (combination therapy): used together with metformin or other antidiabetics to achieve additional HbA1c reduction.
• Type 2 diabetes mellitus (renal impairment): can be employed with dose adjustment to maintain glycaemic control in patients with reduced kidney function.

• Sitagliptin selectively inhibits the dipeptidyl peptidase‑4 (DPP‑4) enzyme, preventing the breakdown of endogenous incretin hormones such as GLP‑1 and GIP. Elevated incretin levels enhance glucose‑dependent insulin secretion from pancreatic β‑cells and suppress glucagon release from α‑cells, resulting in improved post‑prandial and overall glycaemic control.

Sitagliptin is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nasopharyngitis: mild upper‑respiratory tract infection symptoms.
• Headache: transient mild to moderate headache.
• Upper respiratory infection: cough, sore throat, or congestion.
• Nausea: occasional mild stomach upset.
• Diarrhoea: loose stools that are usually self‑limiting.

Serious or Rare Side Effects

• Pancreatitis: severe abdominal pain requiring immediate medical attention.
• Severe hypersensitivity: rash, angioedema, or anaphylaxis.
• Bullous pemphigoid: blistering skin disorder.
• Hepatic injury: elevated liver enzymes or jaundice.
• Severe joint pain: unexplained arthralgia that may indicate underlying inflammation.

Before initiating sitagliptin, consider the following safety measures.

• Renal function: assess creatinine clearance and adjust dose if necessary.
• Hepatic function: monitor liver enzymes in patients with existing liver disease.
• Pancreatitis: discontinue if persistent severe abdominal pain occurs.
• Hypersensitivity: stop therapy at first sign of rash, swelling, or breathing difficulty.
• Cardiovascular risk: evaluate patients with a history of heart failure.
• Store at ambient temperature: keep below 25 °C, protect from moisture and light.

Sitagliptin may interact with several drug classes; monitor patients accordingly.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole): may increase sitagliptin exposure.
• Strong CYP2C8 inhibitors (e.g., gemfibrozil): can raise plasma concentrations.
• Insulin secretagogues (e.g., sulfonylureas): heightened risk of hypoglycaemia.
• Rifampin: may reduce sitagliptin effectiveness.

Moderate Interactions (Monitor Closely):\n- ACE inhibitors: watch for additive blood‑pressure effects.

• Diuretics: monitor renal function and electrolytes during combined use.