Max daily dose of sitagliptin and dapagliflozin
Sitagliptin: max daily dose is 100 mg once daily (reduced to 50 mg/day if eGFR 30-45, and 25 mg/day if eGFR <30).
Dapagliflozin: max daily dose is 10 mg once daily (standard dose; 5 mg used in some initiation scenarios or heart failure with reduced ejection fraction starting dose, but 10 mg is the ceiling).
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Here is the confirmed information from authoritative pharmacology textbooks:
Sitagliptin (DPP-4 inhibitor)
| Condition | Dose |
|---|---|
| Normal renal function | 100 mg once daily (max) |
| eGFR 30-45 mL/min/1.73 m² | 50 mg once daily |
| eGFR <30 mL/min/1.73 m² | 25 mg once daily |
- Relies on renal excretion; dose reduction required in CKD.
- Can be continued perioperatively (unlike GLP-1 RAs).
Source: Goodman & Gilman's Pharmacological Basis of Therapeutics, confirmed in multiple textbooks.
Dapagliflozin (SGLT-2 inhibitor)
| Indication | Dose |
|---|---|
| Type 2 diabetes / heart failure / CKD | 10 mg once daily (max and standard dose) |
| Hepatic impairment (initiation) | 5 mg once daily (starting dose) |
| eGFR <45 mL/min/1.73 m² (T2DM) | Not indicated for glycemic control |
- The starting and target dose are the same: 10 mg once daily - there is no higher dose.
- 5 mg is only used as an initial dose in hepatic failure, not as a lower therapeutic ceiling.
- Not indicated for glycemic control when eGFR <45, but can still be used for heart failure/CKD benefit at lower eGFR levels (down to eGFR ~25 per some guidelines).
Source: Katzung's Basic and Clinical Pharmacology (16th ed.) and Goldman-Cecil Medicine.
Summary: Max daily doses
- Sitagliptin: 100 mg/day
- Dapagliflozin: 10 mg/day
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