Sitagliptin and Dapagliflozin: Uses, Benefits and Key Features

ST-GLIPTIN DAPA is a prescription-only fixed-dose combination tablet for adults with type 2 diabetes mellitus. It combines Sitagliptin Phosphate (a DPP-4 inhibitor) with Dapagliflozin (an SGLT2 inhibitor) in two strengths: ST-GLIPTIN DAPA 100/10 (Sitagliptin 100mg + Dapagliflozin 10mg) and ST-GLIPTIN DAPA 50/5 (Sitagliptin 50mg + Dapagliflozin 5mg). One medicine works on the gut hormone (incretin) pathway and the other works on the kidneys, so the two together lower blood sugar through different routes in a single tablet.

Product Overview

ST-GLIPTIN DAPA is made for adults with type 2 diabetes who need two complementary medicines to reach their HbA1c target. The range has two strengths:

• ST-GLIPTIN DAPA 100/10: Sitagliptin 100mg + Dapagliflozin 10mg
• ST-GLIPTIN DAPA 50/5: Sitagliptin 50mg + Dapagliflozin 5mg

In the 50/5 variant the label may read “Dapagliflozin 5mg and Sitagliptin Phosphate 50 mg Tablets”, and the sitagliptin is usually present as sitagliptin phosphate (monohydrate). The strength printed on the pack decides your dose, so always check the strip and carton before use. Your doctor chooses the strength based on your blood sugar, kidney function, age, hydration status and other medicines.

Sitagliptin and dapagliflozin are both well known to Indian diabetes specialists. Sitagliptin was among the first DPP-4 inhibitors, and dapagliflozin is one of the most widely used SGLT2 inhibitors. A single tablet means fewer pills, more convenience and often better adherence.

Composition and How Each Ingredient Works

1. Sitagliptin (50mg or 100mg), a DPP-4 inhibitor

Sitagliptin blocks the enzyme dipeptidyl peptidase-4 (DPP-4). This enzyme normally breaks down incretin hormones such as GLP-1 and GIP, which the gut releases after meals. With DPP-4 blocked, incretin levels stay higher for longer. The pancreas then releases more insulin when blood sugar is high and less glucagon, the hormone that raises sugar. Because this effect depends on the glucose level, sitagliptin rarely causes low blood sugar when used without insulin or a sulfonylurea. It is generally weight-neutral.

2. Dapagliflozin (5mg or 10mg), an SGLT2 inhibitor

Dapagliflozin blocks the sodium-glucose co-transporter 2 (SGLT2) in the proximal tubule of the kidney. This transporter normally pulls most of the filtered glucose back into the blood. When it is blocked, the extra glucose leaves the body in the urine. This action does not depend on insulin. The loss of glucose, along with a mild diuretic effect, can lead to modest weight loss and a small fall in blood pressure.

Why combine them? The two drugs have different mechanisms, so their effects on HbA1c add up. Sitagliptin supports insulin and glucagon balance after meals, while dapagliflozin removes glucose through the kidneys. Neither usually causes weight gain, which is a practical advantage over some other combinations.

Indications: What Is ST-GLIPTIN DAPA Used For?

ST-GLIPTIN DAPA tablets are used as an adjunct to diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus when:

• Blood sugar is not adequately controlled on sitagliptin alone
• Blood sugar is not adequately controlled on dapagliflozin alone
• Blood sugar is not adequately controlled on metformin plus one of these medicines, as decided by the physician
• The patient is already taking both medicines as separate tablets and the doctor wants to switch to one fixed-dose tablet

It is not meant for type 1 diabetes or for treating diabetic ketoacidosis.

Sitagliptin Tablet Uses: Sitagliptin 50 mg and Sitagliptin 100 mg

The key points are:

• Sitagliptin 100 mg once daily is the standard dose for adults with normal or mildly reduced kidney function. It improves blood sugar control in type 2 diabetes.
• Sitagliptin 50 mg once daily is the dose generally used in moderate kidney impairment (eGFR roughly 30 to below 45), according to the product label. A 25 mg dose is used when kidney function is lower still.
• It can be used alone with diet and exercise, or together with metformin, a sulfonylurea, pioglitazone or insulin, as the doctor decides.
• It can be taken with or without food.
• It is not a treatment for type 1 diabetes.

Because the dose of sitagliptin depends on kidney function, a fixed-dose tablet is only suitable when the strength in the tablet matches what your doctor wants you to take. This is why the 100/10 and 50/5 strengths are prescribed according to your kidney function and blood sugar profile.

Sitagliptin price (50 mg and 100 mg): The price varies by brand, pack size, city and pharmacy, and it keeps changing as more generic versions enter the market. For the current price of ST-GLIPTIN DAPA 100/10 or 50/5, check the MRP printed on the pack or ask your pharmacist. A fixed-dose combination is often more economical than buying the two medicines separately, and Indian price control rules can also affect the price of some diabetes medicines.

Dapagliflozin 5 mg and Dapagliflozin 10 mg Uses

• Dapagliflozin 10 mg is the standard adult dose. It is used to improve blood sugar control in type 2 diabetes. As a standalone product, it is also approved to reduce the risk of hospitalisation for heart failure in adults with type 2 diabetes and cardiovascular disease or risk factors, to treat heart failure with reduced ejection fraction, and to slow the decline of kidney function in selected adults with chronic kidney disease.
• Dapagliflozin 5 mg is a lower strength. Doctors may use it as a starting dose in some patients, for example older adults, people at risk of dehydration or people who need gradual titration.

Please note that the heart failure and kidney indications belong to the single-ingredient dapagliflozin product. In a fixed-dose combination such as ST-GLIPTIN DAPA, the labelled indication is blood sugar control in type 2 diabetes. Your doctor decides whether the extra heart and kidney benefits matter in your case.

Efficacy and Clinical Evidence

The evidence for this combination comes from trials of each ingredient and from studies of dapagliflozin added to sitagliptin.

Sitagliptin evidence: Phase 3 trials (for example Aschner et al., 2006, and Charbonnel et al., 2006) showed that sitagliptin 100 mg once daily significantly lowered HbA1c compared with placebo, both as monotherapy and as add-on to metformin. The TECOS trial, a large cardiovascular outcomes study in people with type 2 diabetes and established cardiovascular disease, showed that sitagliptin did not increase the risk of major cardiovascular events compared with placebo. It also did not increase hospitalisation for heart failure.

Dapagliflozin evidence: In randomised trials, dapagliflozin added to metformin lowered HbA1c, fasting glucose and body weight (Bailey et al., Lancet 2010). A 52-week comparison with glipizide added to metformin (Nauck et al., Diabetes Care 2011) showed similar HbA1c reductions but weight loss and far fewer hypoglycaemic episodes with dapagliflozin. DECLARE-TIMI 58 showed a lower rate of hospitalisation for heart failure or cardiovascular death. DAPA-HF and DAPA-CKD extended the evidence to heart failure and chronic kidney disease.

Combination evidence: In a 24-week randomised placebo-controlled study (Jabbour et al., Diabetes Care 2014), dapagliflozin 10 mg added to sitagliptin, with or without metformin, produced a greater fall in HbA1c and a greater loss of body weight than placebo, with a low rate of hypoglycaemia. Broader reviews of SGLT2 inhibitor plus DPP-4 inhibitor combinations also show additive HbA1c lowering. Small Indian studies of fixed-dose sitagliptin and dapagliflozin report good glycaemic control and acceptable tolerability, though many of these are short or observational.

Key Benefits of ST-GLIPTIN DAPA

• Dual-pathway glucose control: It works on incretin hormones and on kidney glucose excretion together.
• Low hypoglycaemia risk: Neither ingredient usually causes low blood sugar on its own, unless combined with insulin or a sulfonylurea.
• Weight-friendly: Dapagliflozin may produce modest weight loss, and sitagliptin is generally weight-neutral.
• Possible mild blood pressure reduction: This is seen with dapagliflozin.
• Cardiovascular safety data for sitagliptin: TECOS showed no increase in major cardiovascular events.
• Once-daily convenience: One tablet replaces two, which supports adherence.
• Insulin-independent action: The dapagliflozin effect does not rely on beta-cell function.
• Two strengths: The 100/10 and 50/5 options help doctors individualise treatment.

Dosage and How to Take

Follow your doctor’s prescription exactly. General guidance:

• Take one tablet once daily, usually in the morning, with or without food.
• Swallow the tablet whole with water.
• Stay well hydrated unless your doctor has restricted fluids.
• Keep the genital area clean and dry to reduce the chance of fungal infections.
• Keep taking it at the same time each day.
• Do not change the dose or stop the medicine without medical advice.

Side Effects

Common: increased urination, genital fungal infections, urinary tract infections, nasopharyngitis (cold-like symptoms), headache, upper respiratory tract infection, thirst, nausea, dizziness.

Less common but important:

• Dehydration or low blood pressure, especially in older adults or people on diuretics
• Diabetic ketoacidosis, including a form with near-normal blood sugar (euglycaemic DKA)
• Reduced kidney function
• Pancreatitis (reported with DPP-4 inhibitors such as sitagliptin)
• Severe joint pain (reported with DPP-4 inhibitors)
• Bullous pemphigoid, a blistering skin condition (reported with DPP-4 inhibitors)
• Serious allergic reactions
• Fournier’s gangrene, a very rare but serious genital infection

Seek urgent medical care for severe stomach pain that does not go away, persistent vomiting, rapid breathing, unusual tiredness, severe joint pain, skin blisters, swelling of the face or throat, or pain, redness and swelling around the genitals with fever.

Precautions and Who Should Avoid It

• Do not use in type 1 diabetes or diabetic ketoacidosis.
• Do not use if you are allergic to sitagliptin, dapagliflozin or any ingredient.
• The blood sugar lowering effect of dapagliflozin falls as kidney function falls, so your doctor will check eGFR before and during treatment.
• Tell your doctor if you have had pancreatitis, recurrent genital or urinary infections, low blood pressure, heart failure or kidney problems, or if you take diuretics.
• Pregnancy and breastfeeding: generally not recommended. Speak with your doctor.
• Stop the medicine and consult your doctor before major surgery, during prolonged fasting, or during illness with vomiting or diarrhoea.
• If you also take insulin or a sulfonylurea, those doses may need reducing to prevent hypoglycaemia.
• Limit alcohol.

Storage

Store below 30°C in a cool, dry place, away from light and out of the reach of children. Follow the manufacturer’s instructions on the pack.

Frequently Asked Questions

1. What is ST-GLIPTIN DAPA tablet used for?
It is used to control blood sugar in adults with type 2 diabetes. It contains sitagliptin and dapagliflozin in one tablet.

2. What is the difference between ST-GLIPTIN DAPA 100/10 and 50/5?
The 100/10 has sitagliptin 100mg with dapagliflozin 10mg. The 50/5 has sitagliptin 50mg with dapagliflozin 5mg. Your doctor selects the strength.

3. What are sitagliptin and dapagliflozin tablet uses?
The combination improves blood sugar control in adults with type 2 diabetes when one medicine alone, or metformin with one of them, is not enough.

4. What is sitagliptin and how does it work?
Sitagliptin is a DPP-4 inhibitor. It raises incretin hormone levels, which helps the body release more insulin when sugar is high and less glucagon.

5. What are sitagliptin 100 mg uses?
Sitagliptin 100 mg once daily is the standard dose for lowering blood sugar in type 2 diabetes, alone or with other antidiabetic medicines.

6. What are sitagliptin 50 mg uses?
Sitagliptin 50 mg is generally used in people with moderately reduced kidney function, as decided by the doctor, to improve blood sugar control.

7. What is the sitagliptin 50 mg price and sitagliptin 100 mg price in India?
Prices vary by brand, pack size and pharmacy. Check the MRP on the pack or ask your pharmacist for the current price.

8. What does dapagliflozin do in the body?
It blocks SGLT2 in the kidneys so that excess glucose leaves the body in the urine, which lowers blood sugar.

9. What are dapagliflozin 10 mg uses?
Mainly type 2 diabetes. The standalone drug is also used in selected patients with heart failure or chronic kidney disease, as decided by a doctor.

10. What is dapagliflozin 5 mg used for?
It is a lower strength used in some patients to improve blood sugar control, often when a gentler starting dose is preferred.

11. Is the sitagliptin and dapagliflozin combination safe?
It is generally well tolerated when prescribed appropriately, but it needs monitoring for dehydration, infections and kidney function.

12. Can this tablet cause low blood sugar?
The risk is low on its own, but it can rise if it is combined with insulin or a sulfonylurea such as glimepiride.

13. Can ST-GLIPTIN DAPA cause weight loss?
Dapagliflozin may cause modest weight loss, but this tablet is not a weight-loss medicine and should not be used for that purpose.

14. When should I take this tablet?
Usually once daily in the morning, with or without food, as your doctor directs.

15. What are the common side effects of sitagliptin and dapagliflozin?
Increased urination, genital or urinary infections, cold-like symptoms, headache and nausea are among the common ones.

Conclusion

ST-GLIPTIN DAPA 100/10 and ST-GLIPTIN DAPA 50/5 bring together sitagliptin and dapagliflozin in one convenient tablet for adults with type 2 diabetes who need more than one medicine. The combination targets two different pathways, has a low risk of hypoglycaemia, may support modest weight and blood pressure benefits, and reduces pill burden. Sitagliptin has cardiovascular safety data from TECOS, and dapagliflozin has a large evidence base in heart and kidney outcomes when used as a single ingredient. Still, the combination needs proper patient selection, regular monitoring of HbA1c and kidney function, and awareness of dehydration, genital infection, pancreatitis and ketoacidosis risks. This is a prescription-only medicine, and the strength must be chosen by your doctor. This article is for information only and is not a substitute for medical advice.

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