Medications listed are available on OH EPIC Formulary, unless otherwise noted. Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.
Dipeptidyl Peptidase IV (DPP IV) inhibitors • DPP-IV inhibitors are recommended as second-line agents by the American Diabetes Association (ADA) after metformin for the management of diabetes DPP-IV inhibitors have low A1C lowering effects, are weight-neutral and are available in combination with metformin, SGLT2 inhibitors, and thiazolidinediones. • Among five of FDA approved DPP-IV inhibitors, Ochsner Health System carries three on the formulary. Utilization data from 9/1/19 to 8/31/20 for OHS ranks the following DPP-IV from the most to least: sitagliptin > linagliptin > saxagliptin > sitagliptin-metformin (combination product). • The estimated cost savings for this recommendation is neutral.
linagliptin metformin-sitagliptin sAXagliptin
SITagliptin
Dose: 25 mg; 50 mg; 100 mg Oral
1. Sitagliptin shall be the designated formulary DPP-IV 2. In impaired renal function the following is recommended: eGFR ≥45 ml/min: No dosage adjustment necessary eGFR ≥30 to <45 ml/min: 50 mg once daily eGFR <30 ml/min: 25 mg once daily 3. Renal dose adjustments for sitagliptin shall be added to renal acuity – This addition has already been proposed and is currently in process. 4. Deleting from the formulary saxagliptin and linagliptin
Therapeutic Interchange:
Dipeptidyl Peptidase IV (DPP IV) inhibitors
• DPP-IV inhibitors are recommended as second-line agents by the American Diabetes Association (ADA) after metformin for the management of diabetes DPP-IV inhibitors have low A1C lowering effects, are weight-neutral and are available in combination with metformin, SGLT2 inhibitors, and thiazolidinediones.
• Among five of FDA approved DPP-IV inhibitors, Ochsner Health System carries three on the formulary. Utilization data from 9/1/19 to 8/31/20 for
OHS ranks the following DPP-IV from the most to least: sitagliptin > linagliptin > saxagliptin > sitagliptin-metformin (combination product).
• The estimated cost savings for this recommendation is neutral.
linagliptin
metformin-sitagliptin
sAXagliptin
SITagliptin
Dose: 25 mg; 50 mg; 100 mg Oral
1. Sitagliptin shall be the designated formulary DPP-IV
2. In impaired renal function the following is recommended:
eGFR ≥45 ml/min: No dosage adjustment necessary
eGFR ≥30 to <45 ml/min: 50 mg once daily
eGFR <30 ml/min: 25 mg once daily
3. Renal dose adjustments for sitagliptin shall be added to renal acuity – This addition has already been proposed and is currently in process.
4. Deleting from the formulary saxagliptin and linagliptin