Table 1

Overview of the registered GLP-1 receptor agonists and DPP-4 inhibitors

Agent	Brand name	Dose	Half-life (h)	Elimination	Renal insufficiency*
GLP-1 receptor agonists
Short-acting
Exenatide twice daily	Byetta	Subcutaneous 5–10 μg BID	2.4	Renal, proteolytic degradation	Moderate: caution Severe: NR
Lixisenatide	Lyxumia	Subcutaneous 10 μg once daily	3.0	Renal, metabolic degradation	Moderate: caution Severe: NR
Long-acting
Albiglutide	Eperzan Tanzeum	Subcutaneous 30–50 mg once weekly	86.4–163.2	Proteolytic degradation	NR
Dulaglutide	Trulicity	Subcutaneous 0.75–1.5 mg once weekly	112	Proteolytic degradation	Moderate: caution Severe: NR
Exenatide once weekly	Bydureon	Subcutaneous 2 mg once weekly	2.4†	Renal, proteolytic degradation	NR
Liraglutide	Victoza	Subcutaneous 1.2–1.8 mg once daily	13.0	Generalised proteolysis; Elimination: renal (6%); faecal (5%)	Moderate: caution Severe: NR
DPP-4 inhibitors
Alogliptin	Nesina Vipidia	Oral 25 mg once daily	12.5–21.1	Renal (>70% unchanged)	Dose reduction
Linagliptin	Trajenta	Oral 5 mg once daily	10.0–40.0	Renal (5%); faecal (95%)	No adjustment
Saxagliptin	Onglyza	Oral 5 mg once daily	2.2–3.8	Metabolised to active metabolite, renal elimination (12–29% unchanged, 21–52% metabolite)	Dose reduction
Sitagliptin	Januvia	Oral 100 mg once daily	8.0–24.0	Renal (80% unchanged)	Dose reduction
Vildagliptin	Galvus Zomelis Jalra	Oral 50 mg twice daily (or 50 mg once daily plus sulfonylurea)	1.5–4.5	Metabolised to inactive metabolite, renal excretion (22% unchanged)	Dose reduction

All data is based on the products’ summary of product characteristics.
*Moderate and severe renal insufficiency are defined as an estimated glomerular filtration rate of 30–59 mL/min/1.73 m² and <30 mL/min/1.73 m², respectively.
†Exenatide once weekly is similar to exenatide twice daily, except for a slower absorption from the subcutaneous space with the once weekly formulation.
DPP-4, dipeptidyl peptidase 4; GLP-1, glucagon-like peptide 1; NR, not recommended.