GLIPTINE

Lactation History of pancreatitis Insulin combination

Combination with another oral antidiabetic agent Pregnancy Severe hepatic impairment Renal impairment: creatinine clearance < 50 ml/min Peritoneal dialysis patient Hemodialysis patient Subject under 18.

Action mechanism

Sitagliptin belongs to a class of oral hypoglycemics called dipeptidylpeptidase-4 inhibitors (DPP-4).

Improvements in glycaemic control observed with this substance could be explained by increases in levels of active incretin hormones.

Incretin hormones, including glucagon -like peptide-1 (GLP-1) and glucose -dependent insulintropic polypeptide (GIP), are released by the intestine throughout the day and their levels increase in response to a meal.

Incretins are part of an endogenous system involved in the physiological regulation of glucose homeostasis.

When the glucose is normal or elevated, the GLP-1 and GIP-dependent insulin-like levels increase the synthesis and release of insulin by the beta cells of the pancreas by intracellular signalling pathways involving cyclic AMP.

The activity of

GLP-1 and GIP-like is limited by the enzyme DPP-4, which increases the active insulin-like concentrations of the insulin-like enzyme-depressant in the insulin-like processes.

• Hypoglycaemia (Common)
• Pruritus (Uncommon)
• Exfoliative dermatitis Stevens-Johnson Syndrome
• Rash Urticaria Bully pemphigoid Pain in the extremities Thrombocytopenia (Rare)
• Anaphylactic reaction
• Hypersensitivity Angioedema Feeling dizzy (Uncommon)
• Rhinophyryngitis Skin vasculitis
• Constipation (Uncommon)
• Vomiting Necrotizing pancreatitis Acute Pancreatitis Hemorrhagic pancreatitis
• Joint pain Arthropathy Sleeping Muscle pain Osteoarthritis Headache (Common)
• Upper respiratory tract infection
• Interstitial pneumopathy Renal impairment Acute renal impairment.