Sitagliptin with insulin

MSD’s DPP-4 inhibitor sitagliptin (Januvia) has been approved as ‘add-on to insulin (with or without metformin) when diet and exercise plus stable dosage of insulin do not provide adequate glycaemic control for the treatment of type 2 diabetes’.

    This makes sitagliptin the only agent in its class to be approved for use with insulin. The recommended dose is, as for other indications, 100mg once daily; the dose of insulin may need to be reduced to avoid hypo­glycaemia.
    The combination of sitagliptin and insulin is associated with an increased risk of adverse effects compared with insulin alone.