DPP-4 Inhibitors

Summary

DPP-4 inhibitors help treat type 2 diabetes mellitus. They are commonly called the “gliptins” because the drug names all end in -gliptin. Sitagliptin, Linagliptin, and Saxagliptin are all examples of DPP-4 inhibitors. These drugs work by increasing insulin release and decreasing glucagon release. Side effects of DPP-4 inhibitors may include headache, upper respiratory infections, pancreatitis, and serious skin reactions.

Key Points

• DPP-4 Inhibitors (Dipeptidyl peptidase 4 Inhibitors)
  • Drug Name
    • -gliptin Ending
      • Sitagliptin (Januvia)
      • Linagliptin (Tradjenta)
      • Saxagliptin (Onglyza)
  • Mechanism
    • Promotes insulin release
      • Stimulates beta cells in the pancreas to release more insulin
    • Decreases glucagon release
      • The hormone glucagon raises blood glucose levels, so by decreasing glucagon release, pramlintide helps lower blood glucose levels
  • Clinical Use
    • Treats Type 2 Diabetes Mellitus (DM)
      • The end result of DPP-4 Inhibitors is a decrease in blood glucose levels in patients with type 2 diabetes mellitus
  • Side Effects
    • Causes pancreatitis
      • Notify provider of abdominal pain
    • Causes headache
      • Common side effect
    • Causes serious skin reactions
      • E.g. urticaria, Stevens-Johnson Syndrome (SJS), hypersensitivity, rash
    • Causes upper respiratory infections (URI)
      • E.g. nasopharyngitis
    • Hypoglycemia when combined with other antidiabetic medications
      • On its own, DPP-4 inhibitors don’t have a high risk of hypoglycemia. But when combined with other diabetes drugs (i.e. insulin, sulfonylureas) the risk of hypoglycemia goes up significantly