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DPP-4 inhibitors (Incretin) - gliptins (side effects (no hypoglycemia, GI…
DPP-4 inhibitors (Incretin) - gliptins
side effects
no hypoglycemia
GI side effect
wt neutral
decr. A1C by 0.7%
improves pc bs
drugs (OD)
Saxagliptin
Onglyza
start: 2.5 mg od
max: 5 mg od
Linagliptin
Trajenta
start: 5 mg od
total: 5 mg od
Sitagliptin
Januvia
Merck
start 25 mg od
max: 100 mg
Pathophysiology
augment incretin effect
increase postprandial insulin
decrease glucagon secretion
glucose-dependant manner
inhibits GLP-1
contraindication
hx of pancreatitis
renal failure
stop linagliptin at eGFR of 30
stop sitagliptin at eGFR of 50
Saxagliptin caution wtih EGFR less than 50
reduce dose to 2.5 mg
stop at eGFR of 15