Glipizide and Sitagliptin Can Cause Itching

Yes, both glipizide and sitagliptin can cause itching as an adverse effect, with glipizide having more documented evidence of this side effect. 1

Glipizide-Associated Itching

Allergic skin reactions including pruritus (itching) are reported in approximately 1 in 70 patients taking glipizide according to FDA labeling 1
These skin reactions may be transient and can sometimes disappear despite continued use of glipizide, but if persistent, the drug should be discontinued 1
Glipizide-induced skin reactions often present alongside other dermatologic manifestations such as erythema, morbilliform or maculopapular eruptions, urticaria, and eczema 1

While less common than with glipizide, sitagliptin has been documented to cause generalized skin eruptions with strong itching in some patients 2
In some cases, the itching reaction may develop months after initiating sitagliptin therapy, making it difficult to associate with the medication 2
Sitagliptin has a phenyl ring and carbonyl group that may contribute to photosensitive reactions causing itchy edematous plaques 2

Drug-induced pruritus can occur either with visible skin lesions or as generalized itching without skin manifestations 3
The mechanisms include direct drug or metabolite deposition in the skin and alteration of neural signaling pathways 4
For DPP-4 inhibitors like sitagliptin, postmarketing reports have noted cases of urticaria and bullous pemphigoid that may present with itching 5

Determine if itching is associated with visible skin changes or occurs without rash 5
Check for other symptoms that might indicate a more severe allergic reaction 5

For mild itching:
- Topical moderate-potency corticosteroids (mometasone furoate 0.1% or betamethasone valerate 0.1% ointment) 5
- Non-sedating antihistamines for daytime relief (loratadine 10 mg daily) 5
- Sedating antihistamines for nighttime itching (diphenhydramine 25-50 mg or hydroxyzine 25-50 mg) 5
For moderate to severe itching:
- Consider temporary interruption of the medication if clinically appropriate 5
- Oral antihistamines may be required for more widespread reactions 5
- Apply emollients to prevent or treat skin dryness that can exacerbate itching 5

If skin reactions persist despite symptomatic treatment, the causative drug should be discontinued 1
For severe or widespread reactions limiting self-care activities or sleep, prompt discontinuation is recommended 5
In cases where the medication cannot be stopped, vigorous symptomatic antipruritic treatment should be undertaken 3

Patients with a history of urticaria or other allergic skin conditions may be at higher risk for developing drug-induced itching 2
Monitor for signs of more serious reactions such as angioedema or bullous pemphigoid, which have been reported with DPP-4 inhibitors like sitagliptin 5
Document the reaction in the patient's medical record to inform future prescribing decisions 4

If itching occurs with glipizide, consider switching to another class of antidiabetic medication rather than another sulfonylurea, as cross-reactivity may occur 5
If itching occurs with sitagliptin, other classes of diabetes medications such as metformin, GLP-1 receptor agonists, or SGLT2 inhibitors may be considered as alternatives 5