From the FDA Drug Label
History of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema. [See Warnings and Precautions (5.4); Adverse Reactions (6.2).] The FDA drug label does not answer the question.
From the Research
Sitagliptin can cause pruritus (itching) as a side effect in some patients, and if you're experiencing pruritus while taking sitagliptin, you should contact your healthcare provider to discuss your symptoms. They may recommend discontinuing sitagliptin and switching to another diabetes medication such as a different DPP-4 inhibitor (like linagliptin or saxagliptin) or a medication from another class. For temporary relief of itching, you can try over-the-counter antihistamines like cetirizine 10mg daily or diphenhydramine 25mg every 6 hours as needed, along with applying fragrance-free moisturizers to affected areas. Pruritus from sitagliptin is thought to be an allergic or hypersensitivity reaction related to how the medication affects certain inflammatory pathways in the body, as discussed in a review of sitagliptin 1. The reaction typically resolves after discontinuation of the medication. If you experience other symptoms alongside pruritus such as rash, difficulty breathing, or facial swelling, seek immediate medical attention as these could indicate a more serious allergic reaction requiring urgent treatment. According to a recent review on chronic pruritus 2, first-line treatment for inflammatory chronic pruritus includes topical anti-inflammatory therapies, and for neuropathic chronic pruritus, neuropathic topical treatments such as menthol, pramoxine, or lidocaine can be used. However, the most recent and highest quality study on the topic of chronic pruritus 2 should be considered for guiding treatment decisions, prioritizing the patient's morbidity, mortality, and quality of life. Some studies have explored the use of gabapentin and pregabalin for the treatment of chronic pruritus 3, but the most recent evidence should guide clinical decisions. In the context of sitagliptin-induced pruritus, the focus should be on managing the symptoms and considering alternative treatments for diabetes management, as outlined in recent reviews of sitagliptin 4 and chronic pruritus 2. Key points to consider include:
- Discontinuing sitagliptin if pruritus occurs
- Trying alternative diabetes medications
- Using over-the-counter antihistamines or topical moisturizers for temporary relief
- Seeking medical attention if symptoms worsen or indicate a serious allergic reaction
- Considering recent evidence on chronic pruritus treatment, such as the use of topical anti-inflammatory therapies or neuropathic topical treatments, as discussed in 2.