Metformin/Sitagliptin Dosage
This dosage information may not include all the information needed to use Metformin/Sitagliptin safely and effectively. See additional information for Metformin/Sitagliptin.
The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Diabetes Mellitus Type II
The starting dose of metformin-sitagliptin should be individualized based on the patient's current regimen, while not exceeding the maximum recommended dose of 2000 mg metformin and 100 mg of sitagliptin.
Metformin-sitagliptin immediate release:
For patients not adequately controlled on metformin alone, the usual starting dose of metformin-sitagliptin should be equal to 100 mg total daily dose (50 mg twice daily) of sitagliptin plus the dose of metformin already being taken. For patients taking metformin 850 mg twice daily, the recommended starting dose of metformin-sitagliptin is 50 mg sitagliptin/1000 mg metformin hydrochloride twice daily.
For patients not adequately controlled on sitagliptin alone, the usual starting dose of metformin-sitagliptin is 50 mg sitagliptin/500 mg metformin hydrochloride twice daily. Patients may be titrated up to 50 mg sitagliptin/1000 mg metformin hydrochloride twice daily. Patients taking sitagliptin monotherapy with the dose adjusted for renal insufficiency should not be switched to metformin-sitagliptin.
For patients switching from sitagliptin administrated with metformin, metformin-sitagliptin may be initiated at the dose of sitagliptin and metformin already being taken.
Metformin-sitagliptin should be given twice daily with meals, with gradual dose escalation, to reduce the gastrointestinal (GI) side effects due to metformin.
Metformin-sitagliptin extended release:
In patients not currently treated with metformin, the recommended total daily starting dose is 1000 mg metformin/100 mg sitagliptin. Patients with inadequate glycemic control on this dose of metformin can be titrated gradually, to reduce gastrointestinal side effects associated with metformin, up to the maximum recommended daily dose.
In patients already treated with metformin, the recommended total daily starting dose is 100 mg sitagliptin and the previously prescribed dose of metformin.
For patients taking metformin immediate-release 850 mg twice daily or 1000 mg twice daily, the recommended starting dose is two 1000 mg metformin/50 mg sitagliptin extended-release tablets taken together once daily.
Maintain the same total daily dose of metformin and sitagliptin when changing between immediate-release and extended release.
Patients with inadequate glycemic control on this dose of metformin can be titrated gradually, to reduce gastrointestinal side effects associated with metformin, up to the maximum recommended daily dose.
Renal Dose Adjustments
Metformin-sitagliptin is contraindicated in patients with renal disease or dysfunction as suggested by serum creatinine levels of 1.5 mg/dL or greater for males, 1.4 mg/dL or greater for females or abnormal creatinine clearance.
Liver Dose Adjustments
Avoid metformin-sitagliptin use in patients with evidence of hepatic disease.
Dose Adjustments
The dosage may be adjusted based on effectiveness and tolerability while not exceeding the maximum recommended daily dose of 100 mg sitagliptin and 2000 mg metformin.
Precautions
Before initiation of therapy with metformin-sitagliptin and at least annually thereafter, renal function should be assessed and verified as normal. In patients in whom development of renal dysfunction is anticipated, particularly in elderly patients, renal function should be assessed more frequently and metformin-sitagliptin discontinued if evidence of renal impairment is present.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Dialysis
Data not available.
