As monotherapy or as combination therapy with metformin, a sulfonylurea, insulin (with or without metformin), a Peroxisome Proliferator-Activated (PPARγ agonist) (e.g., thiazolidinedione), metformin plus a sulfonylurea or metformin plus a PPARγ agonist: 100 mg once daily.
When Sitagliptin is used in combination with a sulfonylurea or with insulin, a lower dose of sulfonylurea or insulin may be considered to reduce the risk of sulfonylurea- or insulin-induced hypoglycemia.
For patients with mild renal insufficiency (Creatinine Clearance [CrCl] ≥50 mL/min, approximately corresponding to serum creatinine levels of ≤1.7 mg/dL in men and ≤1.5 in women), no dosage adjustment for Sitagliptin phosphate is required.
For patients with moderate renal insufficiency (CrCl ≥30 to <50 mL/min, approximately corresponding to serum creatinine levels of >1.7 to ≤3 mg/dL in men and >1.5 to ≤2.5 mg/dL in women): 50 mg once daily.
For patients with severe renal insufficiency (CrCl <30 mL/min, approximately corresponding to serum creatinine levels of >3 mg/dL in men and >2.5 mg/dL in women) or with End Stage Renal Disease (ESRD) requiring hemodialysis or peritoneal dialysis: is 25 mg once daily.
Sitagliptin may be administered without regard to the timing of hemodialysis.
Sitagliptin can be taken orally with or without food.