Which DPP-4 inhibitor requires no dose adjustment in any degree of renal impairment because it is eliminated almost entirely by biliary excretion?

• A Sitagliptin
• B Vildagliptin
• C Saxagliptin
• D Linagliptin ✓

Explanation

Linagliptin is unique among gliptins: it is predominantly excreted unchanged in bile and feces, with less than 5 percent renal clearance, so no dose adjustment is needed even in end-stage renal disease. Sitagliptin, saxagliptin and vildagliptin are largely renally cleared and require dose reduction as eGFR falls, making them unsuitable at full dose in severe CKD.

Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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