Januvia (Sitagliptin Phosphate)
Also sold as: Januvia, Istamet (with metformin), Zita, Sitagrand
Pregnancy
Cat B
Lactation
Avoid
Schedule
H
Forms
Tablet 25/50/100mg +1
Indications
- Type 2 DM (add-on or monotherapy when metformin contraindicated)
Adult Dosing
T2DM
100 mg PO once daily
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| eGFR > 50 | 100 mg OD |
| eGFR 30-50 | 50 mg OD |
| eGFR < 30 / dialysis | 25 mg OD |
Pregnancy & Lactation
Pregnancy: Category B
Insufficient data; switch to insulin in pregnancy
Lactation: Avoid
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Insulin/sulfonylureas | Hypoglycemia — reduce dose of other agent | Moderate |
| Digoxin | Modest increase in digoxin levels | Minor |
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Side Effects
Common
- Generally well-tolerated
- Nasopharyngitis
- Headache
- Mild GI upset
Serious / Discontinue If
- Pancreatitis (rare but serious)
- Acute kidney injury
- Severe joint pain (FDA warning 2015)
- Heart failure exacerbation (controversial)
- Bullous pemphigoid
Contraindications
- Type 1 DM, DKA
- Hypersensitivity
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Januvia 100 | MSD | 14 tab ₹485 |
| Istamet 50/500 (with met) | MSD | 15 tab ₹235 |
| Zita 100 | Glenmark | 15 tab ₹385 |
Monitoring Required
- HbA1c, eGFR, watch for severe abdominal pain (pancreatitis)
Patient Counseling Points
- Can be taken any time of day
- Stop and report severe abdominal pain
- Inform doctor of joint pain
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References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- Specialty society guidelines (RSSDI/CSI/IAP)
Disclaimer: This information is for clinical reference only. It is not exhaustive and does not substitute clinical judgement. Always verify current dosing against the manufacturer's prescribing information and current treatment guidelines. Drug prices are approximate and may vary.