Sitagliptin

About Sitagliptin

Sitagliptin blocks DPP-4, the enzyme that breaks down the incretin hormones GLP-1 and GIP, so they last longer, raising insulin release and lowering glucagon when blood sugar is high. It is labeled, with diet and exercise, for blood sugar control in adults with type 2 diabetes; it is not for type 1 diabetes, it has not been studied in people with a history of pancreatitis, and its safety and effectiveness in children have not been established. The dose is 100 mg once a day, with or without food; it is 50 mg when eGFR is 30 to under 45, and 25 mg below 30, including people on dialysis, who can take it at any time relative to dialysis. Kidney function is checked before starting and periodically after.

There is no boxed warning; it must not be taken after a serious allergic reaction to sitagliptin, such as anaphylaxis or angioedema. Pancreatitis, including fatal hemorrhagic or necrotizing cases, has been reported, so sitagliptin is stopped if it is suspected. Heart failure has been linked to two other DPP-4 inhibitors in trials, so the risks are weighed in people at risk of it. Worsening kidney function, sometimes needing dialysis, has been reported. Serious allergic reactions, including Stevens-Johnson syndrome, have begun within the first three months, sometimes after the first dose; severe, disabling joint pain has started from a day to years after starting and can return with another DPP-4 inhibitor; and bullous pemphigoid, a blistering skin disease, has needed hospital care. With insulin or a sulfonylurea, low blood sugar is more likely, so their doses may be lowered. Upper respiratory infections, a stuffy or runny nose with sore throat, and headache are the most common side effects.

Januvia contains sitagliptin phosphate. Zituvio, approved in 2023, contains sitagliptin as the free base and is sold under its own name and unbranded; it is a separate product, not a generic of Januvia. Brynovin, approved in January 2025, is an oral solution of 25 mg per mL, so a 100 mg dose is 4 mL; it is kept in the refrigerator and thrown away 90 days after opening. Combinations with metformin (Janumet, Janumet XR, Zituvimet, Zituvimet XR and generics) and with ertugliflozin (Steglujan) are separate products with their own labels. Human data in pregnancy are too limited to determine whether it carries a risk, and it is not known whether sitagliptin passes into breast milk.

Taking Sitagliptin

How to take it

Once a day at about the same time, with or without food. Measure Brynovin with an oral syringe or dosing cup marked in milliliters, not a household teaspoon.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

Tablets at room temperature, away from excess heat and moisture (not in the bathroom). Brynovin in the refrigerator, protected from light and never frozen, and thrown away 90 days after first opening. Keep all out of reach of children.

Interactions to know about

Insulin and sulfonylureas such as glipizide raise the risk of low blood sugar, so their doses may be lowered. Stop it and call the prescriber right away about ongoing stomach pain that may spread to the back, shortness of breath or swollen ankles, blistering skin, or joint pain.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Sitagliptin differs from pharmacy to pharmacy

Generic sitagliptin rated equivalent to Januvia is recent, first approved in December 2025, and quotes for the same generic tablet can differ between pharmacies. A prescription that names Januvia and blocks substitution is priced as a brand.

Zituvio is a separate product rather than a generic of Januvia, so a prescription for one is not filled with the other without the prescriber. Brynovin has no generic, needs refrigeration and comes in one bottle size.

Ways to pay less for Sitagliptin without insurance

• Ask for generic sitagliptin rated equivalent to Januvia, and make sure the prescription does not block substitution.
• If Zituvio is prescribed, or Brynovin for someone who can swallow tablets, ask the prescriber whether generic sitagliptin rated to Januvia would suit you.
• Once your dose is stable, ask the prescriber for a ninety-day supply, and compare more than one pharmacy.
• If you also take metformin, ask the prescriber whether a combination tablet or two separate tablets would suit you, and ask for quotes on each.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Sitagliptin

1. 1.Is my tablet a generic rated equivalent to Januvia, or is it Zituvio?
2. 2.Is my dose right for my kidney function?
3. 3.Which stomach, breathing or skin symptoms mean I should stop it and call?
4. 4.Should my insulin or sulfonylurea dose be lowered?

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