From the Guidelines
Sitagliptin (Januvia) should be dosed at 100 mg once daily for patients with type 2 diabetes who have normal renal function, with dose adjustments necessary for those with kidney impairment: 50 mg daily for moderate renal insufficiency (eGFR 30-45 mL/min) and 25 mg daily for severe renal insufficiency (eGFR <30 mL/min) 1. The dosing of Sitagliptin is crucial in managing type 2 diabetes, and its adjustment based on renal function is essential to minimize potential adverse effects.
- For patients with normal renal function, the standard dose is 100 mg once daily.
- For those with moderate renal insufficiency (eGFR 30-45 mL/min), the dose should be reduced to 50 mg daily.
- For severe renal insufficiency (eGFR <30 mL/min), the dose should be further reduced to 25 mg daily. This guidance is supported by the most recent evidence from the Diabetes Care journal 1, which emphasizes the importance of adjusting the dose of Sitagliptin based on kidney function to ensure safe and effective use. Additionally, the Kidney International journal also provides dose adjustment recommendations for Sitagliptin in patients with chronic kidney disease 1, reinforcing the need for careful consideration of renal function when prescribing this medication. It is essential for healthcare providers to monitor patients' renal function and adjust the Sitagliptin dose accordingly to minimize the risk of adverse effects and optimize glycemic control.
From the Research
Sitagliptin Dosing
- The usual adult dose of sitagliptin is 100 mg once daily 2.
- For patients with moderate-to-severe renal impairment, a dose of 25-50 mg once daily is recommended 2, 3.
- In patients with severe renal insufficiency, including those with end-stage renal disease on dialysis, a dose of 25 mg once daily is recommended 3.
- For elderly patients with type 2 diabetes, the dose of sitagliptin is 100 or 50 mg once daily, depending on renal function 4.
Renal Impairment Considerations
- Downward dose adjustment is recommended in patients with moderate or severe renal insufficiency 2, 5.
- The dose of sitagliptin should be adjusted based on the estimated glomerular filtration rate (GFR) 5.
- Patients with severe renal impairment should be closely monitored for adverse reactions 3, 6.