Drug Side Effects
Sitagliptin Side Effects (also called DPP-4 Inhibitors or Gliptins)
Nov 25, 2016How Does Sitagliptin Work
Sitagliptin is a conventionally-used medication that is used to lower blood sugar levels in people suffering from type 2 diabetes. Sitagliptin is in a class of medications called dipeptidyl peptidase-4 (DPP-4) inhibitors. Like all medications, Sitagliptin side effects are caused by the way the drug works in the body.
Diabetics have high blood sugar because they either
- Don’t produce enough insulin to deliver the sugar into the cells
- OR the cells ‘resist’ the insulin, causing sugar to back up in the blood
Sitagliptin lowers blood sugar in the body by:
- Slowing down ‘gastric emptying’ or reducing the speed at which food leaves the stomach. This reduces the speed at which sugar reaches the blood after a meal.
- Reducing the amount of sugar released from the liver by acting on a chemical called glucagon.
When we have just eaten, chemicals called Incretins stimulate the pancreas to produce more insulin. After Incretins have done their job, an enzyme called DPP-4 acts to break them down. Sitagliptin inhibits DPP-4, allowing incretins to stimulate the pancreas to produce insulin for longer. It also slows down digestion and decreases appetite for longer. This results in a more gradual absorption of glucose from the food and lowering blood sugar levels.
Sitagliptin and other DPP-4 inhibitors are a new class of drugs, often used only as the second or third line of attack. They are chosed only when metformin or sulfonylureas have been found to be ineffective in reducing blood sugar. They are considered by by many doctors to be an alternative to thiazolidinediones or TZDs.
Most Prescribed Names In This Category of Drugs Include
Januvia, Galvus, Onglyza, Icandra and Jalra
How Should Sitagliptin be Used?
- Take the sitagliptin tablet at the same time each day.
- You can take sitagliptin tablets with or without food, as prescribed by your doctor.
- Swallow the tablets whole with a glass of water.
Sitagliptin Side Effects: What Could Happen as Soon as You Start
Sitagliptin can cause several side effects and the severity differs from person to person.
Commonly occurring Sitagliptin side effect symptoms include:
- Digestive Issues like diarrhea, nausea and abdominal pain
- Low Blood Sugar symptoms like confusion, palpitations, shaking, nausea, excessive sweating and hunger
- Allergic Skin Reactions like dark colored patches
- Flu-like Symptoms; sniffling, cold, sneezing, etc.
Digestive Issues
Digestive issues are some side effects of Sitagliptins
The most common Sitagliptin side effects include diarrhea, nausea and abdominal pains. Slower passage of food from the stomach to the colon can lead to heaviness, improper digestion and pains in the digestive tract, especially in the colon.
Low Blood Sugar or Hypoglycemia
One of the major Sitagliptin side effects, and of other gliptins, is due to its action on glucagon. Glucagon is a hormone that increases blood sugar levels. Sitagliptin reduces the action of glucagon. Since this medication is often used in combination with metformin or sulfonylureas to control blood sugar, the combined action of all the medicines may reduce reduce your blood sugar levels dangerously. This condition is called hypoglycemia. Confusion, palpitations, shaking, nausea, excessive sweating and hunger are classic symptoms of hypoglycemia.
Other Common Symptoms
Some allergic skin reactions may also be observed, including purple patches on the skin. Symptoms of the flu, such as stuffy nose, sneezing and sore throat are also seen in patients who are on Sitagliptin.
What Can You Do?
By fine-tuning your dosage, the doctor can take care of your initial digestive distress.
Should You Be Using Sitagliptin for a Long Term?
Many prescription drugs interfere with the way nutrients are absorbed from food in the human body. This is called drug-nutrient depletion. Since Gliptins are relatively new to the market, they have not been studied for nutrient depletion that they may cause over a longer period of use.
Sitagliptin: Precautions to Follow
- Tell your doctor or pharmacist if you are allergic to Sitagliptin or any other medications.
- Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
If you are taking any of the drugs below, be sure to inform the doctor:
- Digoxin (Lanoxicaps, Lanoxin)
- Insulin
- Other oral medications for diabetes including acetohexamide, chlorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol, in Metaglip), glyburide (Diabeta, Glycron, Micronase), tolazamide (Tolinase), and tolbutamide.
Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- Tell your doctor if you drink or have ever consumed large amounts of alcohol and if you have or have ever had diabetes, diabetic ketoacidosis (a serious condition that may occur when blood sugar is too high), pancreatitis (swelling of the pancreas), gallstones, high levels of triglycerides (fatty substances) in your blood, or kidney disease.
- Tell your doctor if you are pregnant , plan to become pregnant, or are breastfeeding. If you become pregnant while taking sitagliptin, call your doctor.
- If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking sitagliptin.
- Talk to your doctor about what you should do if you get hurt or if you develop a fever or infection. These conditions may affect your blood sugar.
- Talk to your doctor about the symptoms of high and low blood sugar and other complications of diabetes, what to do if you develop these symptoms, and how to prevent these conditions.
What Should I Do if I Forget a Dose?
- As soon as you realize that you have missed a dose, take that missed dose.
- However, if you only remember very late and it is almost time for the next dose, skip the missed dose and follow your regular dosing plan/schedule as prescribed by the healthcare practitioner.
- It is not recommended to take double dose to compensate the missed one.
What Should I Know About Storage and Disposal of This Medication?
- Tightly close the container after every dosing schedule.
- Keep it out of reach of children.
- Store the medicine container at room temperature. Protect the Sitagliptin container from excessive heat and moisture.
Dietary Considerations, While Taking Medicine
Make sure to follow all diet and exercise recommendations made by your doctor or dietician.
Drug Interactions
Sitagliptin, like other drugs, interacts with other prescription drugs that you may be taking at that time. Some of these could be harmful. Please inform your healthcare practitioner about your medication history and prescription / over-the-counter drugs they have taken in past or are currently taking.
Digoxin is a drug which which should be cautiously used while taking Januvia. Sitagliptin may slightly increase the concentration of digoxin (Lanoxin) in the body when both drugs are being taken. Digoxin concentrations should be monitored appropriately.
Who Should Not Take Januvia?
You are allergic to any of the ingredients in Januvia. Symptoms of a serious allergic reaction to Januvia may include rash, raised red patches on your skin (hives), or swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing.
What Are The Ingredients in Januvia?
Active ingredient: Sitagliptin
Inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, and sodium stearyl fumarate. The tablet film coating contains the following inactive ingredients: polyvinyl alcohol, polyethylene glycol, talc, titanium dioxide, red iron oxide, and yellow iron oxide.
Sitagliptin: Summary
Today, M.D.s like Dr.Jason Fung are saying that type 2 diabetes is reversible. On of the key components of this is eating the right diabetic diet. Despite being on medications, you could suffer from complications.
Living well with diabetes takes emotional strength. Building in a little bit of exercise into your life can help you sleep better and control your diabetes too.
Dietary supplements that have been studied to help with controlling blood sugar could assist you in reducing the burden of your prescription drugs.
Research is increasingly showing that diet and lifestyle changes – including intermittent fasting, yoga, meditation, weight loss and moderate exercise – can have a huge positive impact on diabetes. You should explore all of these avenues, to get the best results for yourself.
Nachiket holds a first class degree in Pharmacy and is passionate about writing. He believes that subject experts must simplify medical concepts to make them interesting and accessible to everyone.
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