DPP-4 Inhibitor

Sitagliptin

Brand names: Januvia, Xelevia

Sitagliptin is a DPP-4 inhibitor (a gliptin) used in type 2 diabetes; it is weight-neutral and carries a low risk of hypoglycaemia when used alone.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Take ZITUVIMET orally twice daily with meals. ( 2.1 ) Individualize the dosage of ZITUVIMET on the basis of the patient's current regimen, effectiveness, and tolerability. ( 2.1 ) The maximum recommended daily dose is 100 mg of sitagliptin and 2,000 mg of metformin HCl. ( 2.1 ) The recommended starting dose in patients not currently treated with metformin is 50 mg sitagliptin and 500 mg metformin HCl twice daily, with gradual dose escalation recommended to reduce gastrointestinal side effects associated with metformin. ( 2.1 ) The starting dose in patients already treated with metformin should provide sitagliptin dosed as 50 mg twice daily (100 mg total daily dose) and the dose of metformin …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-06-09. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits dipeptidyl peptidase-4, prolonging the action of incretin hormones to enhance glucose-dependent insulin release and suppress glucagon.

Prescribing in practice

Reduce the dose in renal impairment.
Hypoglycaemia risk is low alone but rises when combined with a sulfonylurea or insulin.
Stop and investigate if severe, persistent abdominal pain suggests pancreatitis.

Monitoring

Monitor HbA1c for response and renal function for dose adjustment.

Counselling the patient

It is generally well tolerated and does not usually cause low blood sugar on its own.
Report severe, persistent abdominal pain.

Evidence & guidelines

DPP-4 inhibitors are an option to intensify type 2 diabetes treatment per NICE NG28, valued for weight-neutrality and low hypoglycaemia risk.

Reference: NICE NG28; TECOS trial; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways