Experiences with
Sitagliptin

Sitagliptin is a medicine used to treat type 2 diabetes.

Type 2 diabetes is a condition where the body does not make enough insulin, or the insulin that it makes does not work properly. This can cause high blood sugar levels (hyperglycaemia).

Sitagliptin is prescribed for people who still have high blood sugar, even though they have a sensible diet and exercise regularly.

It works by increasing the amount of insulin that your body makes. Insulin is the hormone that controls sugar levels in your blood.

Sitagliptin is only available on prescription. It comes as tablets.

It also comes as tablets containing a mixture of sitagliptin and another diabetes medicine called metformin. This is known by the brand name Janumet.

Who can take sitagliptin

Most adults aged 18 years and older can take sitagliptin.

Who may not be able to take sitagliptin

This medicine is not used to treat type 1 diabetes (when your body does not produce insulin).

Sitagliptin is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

have ever had an allergic reaction to sitagliptin or any other medicine
have problems with your pancreas
have gallstones or very high levels of triglycerides (a type of fat) in your blood
are a heavy drinker or dependent on alcohol
have ever had any problems with your kidneys
are pregnant or breastfeeding, or trying to get pregnant

Dosage and strength

Sitagliptin comes as 25mg, 50mg and 100mg tablets.

The usual dose is 100mg a day.

Your doctor might prescribe a lower dose of 25mg or 50mg a day if you have problems with your kidneys.

How to take it

Take sitagliptin once a day. You can take it at any time, for example, in the morning or in the evening. But try to take it at the same time every day.

Take your tablet with a drink of water. Swallow the tablet whole, without breaking it.

You can take sitagliptin with or without food.

How long to take it for

Sitagliptin helps keep your blood sugar level as normal as possible to prevent health problems.

You'll probably have to take it for a long time, even for the rest of your life.

Over time it gets harder to control blood sugar levels, so your doctor might eventually recommend stopping sitagliptin and trying a different treatment.

Do not stop taking sitagliptin without speaking to your doctor.

If you forget to take it

Take the missed dose as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take your next dose at the usual time.

Do not take 2 doses to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember to take your medicines.

If you take too much

Talk to your doctor if you take more than your prescribed dose of sitagliptin and:

have stomach pains
are feeling or being sick (nausea or vomiting)
feel dizzy
are worried

Common side effects

The most common side effect of sitagliptin, which happens in more than 1 in 100 people, is headaches.

Talk to your doctor if headaches last longer than a week or are severe.

If taking sitagliptin gives you a headache, make sure you rest and drink plenty of fluids. Do not drink too much alcohol.

Ask your pharmacist to recommend a painkiller.

Low blood sugar

Sitagliptin does not usually cause low blood sugar (known as hypoglycaemia, or "hypos") when taken on its own.

But hypos can happen when you take sitagliptin with other diabetes medicines, such as insulin or gliclazide.

Early warning signs of low blood sugar include:

feeling hungry
trembling or shaking
sweating
confusion
difficulty concentrating

It's also possible for your blood sugar to go too low while you're asleep. If this happens, it can make you feel sweaty, tired and confused when you wake up.

Low blood sugar may happen if you:

take too much of some types of diabetes medicines
eat meals irregularly or skip meals
are fasting
do not eat a healthy diet and are not getting enough nutrients
change what you eat
increase your physical activity without eating more to compensate
drink alcohol, especially after skipping a meal
take some other medicines or herbal remedies at the same time
have a hormone disorder, such as an underactive thyroid (hypothyroidism)
have kidney or liver problems

It's important to have regular meals, including breakfast, to prevent hypoglycaemia. Never miss or delay a meal.

If you're planning to exercise more than usual, make sure you eat carbohydrates like bread, pasta or cereals before, during or after exercise.

Always carry a fast-acting carbohydrate with you, like sugar cubes, fruit juice or some sweets, in case your blood sugar level gets low. Artificial sweeteners will not help.

You may also need to eat a starchy carbohydrate, like a sandwich or a biscuit, to maintain your blood sugar for longer.

If taking in sugar does not help or the hypo symptoms come back, contact your doctor or the nearest hospital.

Make sure your friends and family know about your diabetes and the symptoms of low blood sugar levels so they can recognise a hypo if it happens.

Serious side effects

It happens rarely, but some people may have serious side effects after taking sitagliptin.

Call your doctor or call 111 straight away if:

you get severe stomach pains – this may be a sign of pancreatitis
the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems

Serious allergic reaction

It's possible to have a serious allergic reaction (anaphylaxis) to sitagliptin.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of sitagliptin. For a full list, see the leaflet inside your medicines packet.

Sitagliptin and pregnancy

Sitagliptin is not recommended in pregnancy as there is little information about whether it may affect a developing baby.

If you are pregnant or thinking of getting pregnant, talk to your doctor as they will need to review your treatment. They will be able to suggest a different medicine that is safer for you to take in pregnancy.

Sitagliptin and breastfeeding

Sitagliptin is not usually recommended while you're breastfeeding. We do not know how much of it passes into breast milk, but it is likely to be a fairly small amount.

If you are breastfeeding, or planning to breastfeed, talk to your doctor about what's best for you and your baby. They will need to review your treatment and may be able to suggest a different medicine for you, particularly if you're breastfeeding a newborn or premature baby.

If your doctor says it's OK to keep breastfeeding, contact your health visitor, midwife, pharmacist or doctor as soon as possible if:

your baby is not feeding as well as usual
your baby seems unusually sleepy or drowsy
your baby seems unusually restless or irritable
your baby is paler, or more sweaty, than usual
your baby seems hungrier than usual
your baby is peeing more
you have any other concerns about your baby

Sitagliptin and fertility

There's no evidence to suggest that taking sitagliptin reduces fertility in either men or women.

Speak to a pharmacist or your doctor if you're trying to get pregnant. They may want to review your treatment.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Some medicines and sitagliptin can affect each other. Taking them at the same time as sitagliptin can cause low blood sugar or increase your risk of getting side effects.

Tell your doctor or pharmacist if you're taking:

insulin or any other diabetes medicine – your doctor may want to lower the dose of these medicines when you start sitagliptin to reduce the risk of low blood sugar (hypoglycaemia)
ketoconazole or itraconazole, medicines for fungal infections
ritonavir, a medicine used to treat HIV and AIDS
clarithromycin, an antibiotic for treating pneumonia and ear infections
digoxin, a medicine for heart conditions, including heart failure

Make sure that your doctor and pharmacist know you're taking sitagliptin before starting or stopping any other medicine.

Mixing sitagliptin with herbal remedies and supplements

There's very little information about taking herbal remedies and supplements with sitagliptin. However, taking them at the same time as sitagliptin can cause low blood sugar.

Meds New IA (H2) - Cautions with other medicines alert