The recommended dose of sitagliptin is 100 mg once daily as monotherapy or as combination therapy with metformin, a sulfonylurea, insulin (with or without metformin), a PPARγ agonist (e.g., thiazolidinediones), metformin plus a sulfonylurea, or metformin plus a PPARγ agonist. Sitagliptin can be taken with or without food.
When sitagliptin is used in combination with a sulfonylurea or with insulin, a lower dose of sulfonylurea or insulin may be considered to reduce the risk of sulfonylurea or insulin induced hypoglycemia (see Precautions).
Patients with Renal Impairment: Because there is a dosage adjustment based upon renal function, assessment of renal function is recommended prior to initiation of sitagliptin and periodically thereafter.
For patients with mild renal impairment (estimated glomerular filtration rate [eGFR] ≥60 mL/min/1.73 m2 to <90 mL/min/1.73 m2), no dosage adjustment for sitagliptin is required.
For patients with moderate renal impairment (eGFR ≥45 mL/min/1.73 m2 to <60 mL/min/1.73 m2), no dosage adjustment for sitagliptin is required.
For patients with moderate renal impairment (eGFR ≥30 mL/min/1.73 m2 to <45 mL/min/1.73 m2), the dose of sitagliptin is 50 mg once daily.
For patients with severe renal impairment (eGFR ≥15 mL/min/1.73 m2 to <30 mL/min/1.73 m2) or with end-stage renal disease (ESRD) (eGFR <15 mL/min/1.73 m2), including those requiring hemodialysis or peritoneal dialysis, the dose of sitagliptin is 25 mg once daily. Sitagliptin may be administered without regard to the timing of dialysis.
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