Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-27

Dosing schedule •

Monitoring • Assess renal function prior to initiation and periodically thereafter.

Initiate at 5 mg daily (or renally appropriate dose) • Does not require a dosage adjustment for people with eGFR >45 mL/min/1.73m 2 or in the elderly. Linagliptin (Trajenta®) • TDD: 5 mg • Frequency: QD • Administration: Taken in the morning, with or without food. Dosing schedule • Initiate at 5 mg daily. • Does not require a dosage adjustment for people with eGFR >15 mL/min/1.73m 2 , hepatic impairment or in the elderly. • Available: 5 mg Alogliptin (Nesina) (210) • TDD: 12.5 mg • Frequency: QD • Taken in the morning, with or without foo d. Dosing Schedule • Initiate at 25 mg QD • Available: 6.25 mg, 12.5 mg and 25 mg

Caution • Caution/reduce dose if eGFR <15 mL/min/1.73m 2 Contraindicated • In severe hepatic insufficiency. Monitor • Hepatic function before initiating therapy and periodically thereafter.

Caution • Not recommended for use in severe hepatic impairment or congestive heart failure (CHF). Dosage adjustment is recommended if: • eGFR <50 mL/min/1.73m 2 = 12.5 mg • eGFR <30 mL/min/1.73m 2 = 6.25 mg

Combination Products: • Sitagliptin/metformin (Janumet ® ) available in 50 mg/500 mg, 50 mg/850 mg, 50 mg/1,000 mg • Sitagliptin/metformin modified-release (JanumetXR ® ) available in 50 mg/500 mg, 50 mg/1,000 mg,100 mg/1,000 mg • Saxagliptin/metformin (Komboglyze ® ) available in 2.5 mg/500 mg, 2.5 mg/850 mg, 2.5 mg/1,000 mg • Linagliptin/metformin (Jentadueto ® ) available in 2.5 mg/500 mg, 2.5 mg/850 mg, 2.5 mg/1,000 mg • Alogliptin/ metformin (KAZANO®) available in 12.5 mg/500 mg, 12.5 mg/850 mg, 12.5mg/1,000 mg 2hPC = 2-hour postprandial; A1C = glycated hemoglobin; BG = blood glucose; DPP-4 = dipeptidyl peptidase-4; eGFR = estimated glomerular filtration rate; FBG = fasting blood glucose; GLP-1 = glucagon-like peptide-1; GIP = gastric inhibitory peptide; NYHA= New York Heart Association; QD = once daily; TDD = total daily dose; URI = upper respiratory infection