Table 1.

Comparison between currently available DPP-4 inhibitors

	Sitagliptin	Saxagliptin	Vildagliptin	Linagliptin	Alogliptin
Dosage	100 mg once daily	5 mg once daily	50 mg twice daily	5 mg once daily	25 mg once daily
Approximate half-life (h)	12	2	3	>120	21
Elimination	Metabolism is a minor pathway; primarily eliminated unchanged in urine (75%)	Elimination by metabolism (cytochrome P450 3A4/5) and renal clearance (24%)	Elimination by metabolism (not CYP450 enzymes) and renal clearance (23%)	Enterohepatic; eliminated unchanged in feces via biliary excretion (85%)	Metabolism is a minor pathway; primarily eliminated unchanged in urine (63%)
Effect on weight	Weight neutral	Weight neutral	Weight neutral	Weight neutral	Weight neutral
HbA1c reduction (monotherapy)	Clinically important; up to −0.8%	Clinically important; up to −0.8%	Clinically important; up to −0.8%	Clinically important; up to −0.8%	Clinically important; up to −0.8%
Use in CKD	Reduce dose to 50 mg/day for moderate CKD (CrCl ≥30 to ≤50 mL/min); reduce dose to 25 mg/day for severe CKD (CrCl <30 mL/min); assess renal function before use and on a regular basis	Reduce dose to 2.5 mg/day for moderate CKD (CrCl ≥30 to ≤50 mL/min); give reduced dose after dialysis in chronic renal failure	Reduce dose to 50 mg/day for moderate CKD (CrCl ≥30 to ≤50 mL/min) and severe CKD (CrCl <30 mL/min)	No dosage reduction required	Reduce dose to 12.5 mg/day for moderate CKD (CrCl ≥30 to ≤50 mL/min); reduce dose to 6.25 mg/day for severe CKD (CrCl <30 mL/min)
Adverse events	Low	Low	Low	Low	Low