Jidinum (Sitagliptin)

Sitagliptin is used to treat disorders of glucose metabolism, primarily type 2 diabetes mellitus.

• Type 2 diabetes mellitus: improves glycemic control when combined with diet, exercise and other antidiabetic agents.
• Monotherapy in type 2 diabetes: can be prescribed as initial oral therapy for patients inadequately controlled with lifestyle alone.
• Combination therapy with metformin: used together to achieve additional reductions in HbA1c in patients requiring dual oral treatment.

• Sitagliptin selectively inhibits the enzyme dipeptidyl peptidase‑4 (DPP‑4), preventing the breakdown of the incretin hormones glucagon‑like peptide‑1 (GLP‑1) and glucose‑dependent insulinotropic polypeptide (GIP). Elevated incretin levels enhance glucose‑dependent insulin secretion from pancreatic β‑cells and suppress glucagon release from α‑cells, leading to reduced post‑prandial glucose excursions and overall improved glycemic control.

Sitagliptin may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Nausea: mild stomach upset reported in some patients.
• Headache: transient cranial discomfort.
• Upper respiratory tract infection: symptoms such as sore throat or nasal congestion.
• Nasopharyngitis: inflammation of the nasal passages and throat.
• Dizziness: occasional light‑headedness.

Serious or Rare Side Effects

• Pancreatitis: severe abdominal pain requiring immediate medical attention.
• Severe allergic reactions: rash, swelling, or anaphylaxis.
• Joint pain: unexplained arthralgia that may be disabling.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Hypoglycemia: especially when combined with insulin or sulfonylureas.

Before initiating sitagliptin therapy, several safety considerations should be reviewed.

• Renal function: assess creatinine clearance and adjust use in moderate to severe impairment.
• Hepatic impairment: use with caution in patients with liver disease.
• Hypersensitivity: discontinue if signs of allergic reaction appear.
• Pregnancy: safety not established; avoid unless benefits outweigh risks.
• Elderly patients: monitor for adverse events due to possible comorbidities.
• Store at ambient temperature: keep below 25 °C in the original packaging, protected from moisture and light.

Sitagliptin can interact with other medicines, influencing its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole): may increase sitagliptin exposure.
• Insulin: concurrent use raises risk of hypoglycemia.
• Sulfonylureas (e.g., glipizide): combined therapy can lead to severe low blood sugar.

Moderate Interactions (Monitor Closely)

• ACE inhibitors: may affect renal function when used together.
• Diuretics: can alter glucose control and electrolyte balance.
• Rifampin: induces metabolism, potentially reducing sitagliptin effectiveness.