From the Guidelines
Januvia is a DPP-4 inhibitor, a class of oral medications used to treat type 2 diabetes. The generic name for Januvia is sitagliptin. This medication works by blocking the enzyme DPP-4, which normally breaks down incretin hormones in the body. By inhibiting this enzyme, Januvia helps increase the levels of active incretin hormones, which stimulate insulin release when blood sugar is high and reduce the amount of glucose produced by the liver.
Key Characteristics of DPP-4 Inhibitors
- DPP-4 inhibitors have moderate glucose-lowering efficacy 1
- They are well tolerated, have a neutral effect on weight, and have minimal risk of hypoglycemia when used as monotherapy 1
- The use of DPP-4 inhibitors alone does not increase the risk of hypoglycaemia and includes a neutral or mild effect on weight gain 1
- DPP-4 inhibitors, such as sitagliptin, saxagliptin, and alogliptin, do not increase the risk of cardiovascular disease 1
Dosage and Administration
- Januvia is typically prescribed at a dose of 100 mg once daily, though lower doses (25 or 50 mg) may be used in patients with kidney impairment 1
- It can be taken with or without food and is often prescribed alongside other diabetes medications like metformin when a single medication isn't providing adequate blood sugar control
- Dosage adjustments are necessary for some DPP-4 inhibitors, such as sitagliptin, saxagliptin, and alogliptin, in patients with renal dysfunction, but not for linagliptin 1
Safety and Efficacy
- DPP-4 inhibitors have been shown to have a neutral effect on cardiovascular risk and do not increase the risk of major adverse cardiovascular events (MACE) 1
- They also have a neutral effect on heart failure (HF) risk 1
- However, pancreatitis has been reported with the use of DPP-4 inhibitors, although causality has not been established 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Class of Drugs
- Januvia, also known as sitagliptin, belongs to the class of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors 2, 3, 4, 5, 6
Mechanism of Action
- DPP-4 inhibitors work by enhancing the body's own ability to control blood glucose by increasing the active levels of incretin hormones in the body 2
- They control elevated blood glucose by triggering pancreatic insulin secretion, suppressing pancreatic glucagon secretion, and signalling the liver to reduce glucose production 2