DPP-4 Inhibitors

DPP-4 Inhibitors 

 

  • DPP-4 Inhibitors are used int the treatment of type 2 diabetes
  • MOA: inhibits (DPP-4) enzymes (inhibits breakdown of incretin hormones)
  • DPP-4 is in the GI tract, respiratory system & nasal passages
  • Incretin hormones stimulate a decrease in blood glucose levels
  • DPP-4 breaks down uncertain hormones
  • Inhibiting DPP-4 will promote insulin secretion and depresses glucagon secretion
  • Small reduction in A1C (0.5-1%) when used as monotherapy
  • Can take medication¬†anytime of the day without regard to meals
  • Given orally, once a day
  • No hypoglycemia occurs when used as monotherapy
  • Not for use with insulin

 

Drug Names

linagliptin-Tradjenta

Alogliptin-Nesina

Saxagliptin-Onglyza

Sitagliptin-Januvia

 

Side effects

  • Acute pancreatitis
  • Hypersensitivity
  • Headache
  • Nasopharyngitis
  • Liver failure
  • Long-term safety is unknown

 

Key Notes

  • GP-1 Receptor Agonists & DPP-4 Inhibitors have been linked to acute pancreatitis
  • Decrease dosage of sulfonylureas and insulin when adding a DPP-4 inhibitor¬†
  • DPP-IV inhibitors are effective adjuncts to metformin or the thiazolidinediones

 

References

Edmunds, M. W., & Mayhew, M. S. (2014). Pharmacology for the primary care provider (4th ed.). St. Louis, MO: Elsevier Mosby.

Harvey, R. A., Clark, M. A., Finkel, R., Rey, J. A., & Whalen, K. (2012). Pharmacology (5th ed.). Baltimore, MD: Lippincott.