Siglivia Drug Interactions

Sitagliptin does not inhibit CYP isozymes 1A2, 2B6, 2C8, 2C9, 2C19, 2D6, or 3A4 or induce CYP3A4. Pharmacokinetic interactions with drugs metabolized by these isoenzymes (including metformin, thiazolidinediones (e.g., rosiglitazone), sulfonylureas (e.g., glyburide), simvastatin, warfarin, or oral contraceptives) did not have clinically meaningful. Co-administration of multiple twice-daily doses of metformin with Sitagliptin did not meaningfully after the pharmacokinetics of Sitagliptin in patients with type 2 diabetes.
Concomitant administration of Sitagliptin with digoxin resulted in a slightly increase in peak plasma concentrations and area under the concentration-time curve (AUC) of digoxin (18% and 11%, respectively). While these increases are not considered clinically important, patients receiving digoxin should be monitored appropriately; however, no digoxin or Sitagliptin dosage adjustment is needed.
Concomitant administration of cyclosporin (a potent probe inhibitor of p-glycoprotein) and Sitagliptin may increase absorption and plasma concentrations of Sitagliptin. However, this interaction is not considered clinically important and no dosage adjustment for Sitagliptin is recommended when co-administered with cyclosporin or other p-glycoprotein inhibitors (e.g., ketoconazole).
Population pharmacokinetic analyses have been conducted in patients with type 2 diabetes. Concomitant medications did not have a clinically meaningful effect on the pharmacokinetics of Sitagliptin. Medication assessed were those that are commonly administered to patients with type 2 diabetes including cholesterol-lowering agents (e.g., statins, fibrates, ezetimibe), anti-platelet agents (e.g., clopidogrel), antihypertensives (e.g., ACE inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, hydrochlorothiazide), analgesics and non-steroidal anti-inflammatory agents (e.g., naproxen, diclofenac, celecoxib), anti-depressants (e.g., bupropion, fluoxetine, sertraline), antihistamines (e.g., cetirizine), proton-pump inhibitors (e.g., omeprazole, lansoprazole), and medications for erectile dysfunction (e.g., sildenafil).