Drugs affected by change in gastric emptying, dipeptidyl peptidase 4 inhibitors

Type II diabetes inadequately controlled by diet and excercise 

Hypoglycemia, anorexia, nausea, diarrhea, vomiting, abdominal pain, decreased appetite,

dyspepsia, acute pancreatisis, fatigue, sinus tachycardia, 1st degree AV block

Diabetes ketoacidosis, e nd stagee renal disease (egfr < 15ML/MIN/1.73m2) 

Severe GI disease, History of ( personal or family) medulliary thyroid carcinoma,

Multiple endocrine neoplasia syndrome type 2 

Pregnancy,lactation

Special Precautions

Risk of pancreatitis, advice patient of symptoms,  discontinue if suspected

CHF - elderly(>75years) . Monitor renal functions in renally impaired reporting severe GI reactions. History of angioedema or anaphylaxis

Type II diabetes inadequately controlled by diet and excercise

Dosage

Monotherapy- 750mg by s.c. injection once weekly

Add on therapy- 1.5mg by s.c. iniection once weekly

Combination therapy- consider lower lowewr dose orf sulfonyl urea/insulin

Below 18 years- Not recommended