Meliglix 100 Mg (Sitagliptin)

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

• Type 2 diabetes mellitus (monotherapy): lowers fasting and post‑prandial glucose levels when added to diet and exercise.
• Type 2 diabetes mellitus (combination therapy): improves overall glycaemic control when used with metformin, sulfonylureas, or insulin.
• Type 2 diabetes mellitus (adjunct therapy): helps achieve target HbA1c in patients inadequately controlled on other agents.

• Sitagliptin selectively inhibits the enzyme dipeptidyl‑peptidase‑4 (DPP‑4), which is responsible for degrading the incretin hormones GLP‑1 and GIP. By blocking DPP‑4, sitagliptin increases endogenous GLP‑1 and GIP levels, leading to glucose‑dependent stimulation of insulin secretion and suppression of glucagon release from pancreatic α‑cells. This results in reduced hepatic glucose production and improved post‑prandial glucose control without causing hypoglycaemia in the absence of other secretagogues.

Sitagliptin may cause a range of adverse reactions, which are grouped by frequency and severity.

Common Side Effects

• Nasopharyngitis: mild inflammation of the nasal passages and throat.
• Headache: transient mild to moderate headache.
• Upper respiratory tract infection: symptoms such as cough and sore throat.
• Gastrointestinal discomfort: nausea, abdominal pain or dyspepsia.

Serious or Rare Side Effects

• Pancreatitis: severe abdominal pain possibly indicating inflammation of the pancreas.
• Severe allergic reactions: including anaphylaxis, angioedema, or urticaria.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis: rare life‑threatening skin reactions.
• Hepatic injury: marked elevation of liver enzymes or hepatitis.

When prescribing sitagliptin, clinicians should consider several precautionary measures to ensure safe use.

• Renal function: assess baseline renal function and adjust dose in moderate to severe impairment.
• Hypoglycaemia risk: monitor for low blood glucose when combined with insulin or sulfonylureas.
• Pancreatitis monitoring: educate patients to report persistent abdominal pain.
• Elderly patients: use caution as they may have reduced renal clearance.
• Hypersensitivity: discontinue if signs of allergic reaction appear.
• Store at room temperature: keep in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Concomitant use with high‑dose sulfonylureas or insulin: may cause severe hypoglycaemia.
• Strong CYP2C8 inhibitors (e.g., gemfibrozil): can increase sitagliptin plasma concentrations significantly.

Moderate Interactions (Monitor Closely)

• Rifampin: induces metabolism and may reduce sitagliptin exposure.
• Digoxin: may increase digoxin levels; monitor serum concentrations.
• Warfarin: potential alteration of INR; check coagulation status regularly.
• NSAIDs or diuretics: may affect renal function, requiring dose adjustment.