<p><strong>Pediatric Use</strong>: Safety and effectiveness of sitagliptin in pediatric patients under 18 years of age have not been established.<br />
<br />
<strong>Geriatric Use</strong>: This drug is known to be substantially excreted by the kidney. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in the elderly, and it may be useful to assess renal function in these patients prior to initiating dosing and periodically thereafter.<br />
<br />
<strong>For patients with mild renal insufciency</strong>: (CrCl &lt;50 ml/min or serum creatinine levels of &lt;1.7 mg/DL in men and &lt;1.5 mg/DL in women), no dosage adjustment for sitagliptin is required.<br />
<br />
<strong>For patients with moderate renal insufciency</strong>: (CrCl &lt;30 to &lt;50 mL/min, or serum creatinine levels of &gt;1.7 to &lt;3.0 mg/dL in men and &gt;1.5 to &lt;2.5 mg/dL in women), the dose of sitagliptin is 50 mg once daily.<br />
<br />
<strong>For patients with severe renal insufficiency</strong>: (CrCl &lt;30 mL/min or serum creatinine levels of &gt;3.0 mg/dL in men and 2.5 mg/dL in women) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of sitagliptin is 25 mg once daily. Sitagliptin may be administered without regard to the limiting of hemodialysis.</p>