From the Guidelines
Januvia (sitagliptin) is a dipeptidyl peptidase-4 (DPP-4) inhibitor used to treat type 2 diabetes, with a typical starting dose of 100 mg taken orally once daily, and works by increasing levels of incretin hormones to regulate blood sugar.
Key Points
- Januvia is often prescribed alongside diet and exercise, and may be used in combination with other diabetes medications like metformin 1.
- Common side effects include upper respiratory tract infection, headache, and nasopharyngitis.
- Januvia should not be used to treat type 1 diabetes or diabetic ketoacidosis.
- Regular blood sugar monitoring is essential while taking this medication, and patients should inform their healthcare provider of any other medications they're taking to avoid potential interactions.
Mechanism of Action
Januvia works by inhibiting the DPP-4 enzyme, which breaks down incretin hormones, allowing them to stay active in the body for longer periods, stimulating insulin release and reducing glucagon secretion 1.
Dosage and Administration
The typical starting dose of Januvia is 100 mg taken orally once daily, with or without food, and may be adjusted based on individual patient needs and kidney function 1.
Special Considerations
Januvia may be used in patients with chronic kidney disease (CKD), but dose adjustments may be necessary based on kidney function, and it is not recommended for use in patients with severe kidney impairment (GFR < 30 mL/min/1.73 m²) 1.
Cardiovascular Safety
Recent studies have shown that Januvia does not increase the risk of major cardiovascular events, including heart attack, stroke, and death from cardiovascular causes 1.
From the FDA Drug Label
SITAGLIPTIN/METFORMIN 50/850MG
The FDA drug label does not answer the question.
From the Research
What is Januvia (Sitagliptin)?
- Januvia, also known as Sitagliptin, is a medication used to treat type 2 diabetes mellitus 2, 3, 4, 5.
- It belongs to the class of dipeptidyl peptidase-4 (DPP-4) enzyme inhibitors, which work by increasing the amount of circulating incretins, stimulating insulin secretion, and inhibiting glucose production 2, 3, 4.
- Sitagliptin is approved by the US Food and Drug Administration (FDA) for use with diet and exercise to improve glycemic control in adult patients with type 2 diabetes 2.
Mechanism of Action
- Sitagliptin increases post-meal insulin secretion ("incretin effect") by enhancing the postprandial glucagon-like peptide-1 (GLP-1) response ("incretin enhancer"), in a glucose-dependent manner 3.
- It improves glycemic control (HbA1c) in type 2 diabetic patients treated by diet alone, by metformin, by sulfonylurea, by glitazone, or by a metformin-sulfonylurea combined therapy 3, 4, 5.
Dosage and Administration
- The usual adult dose of Sitagliptin is 100 mg once daily 2.
- A dose of 25-50 mg once daily is recommended for patients with moderate-to-severe renal impairment 2.
- Sitagliptin can be used alone or in combination with metformin or a thiazolidinedione (pioglitazone or rosiglitazone) when treatment with either drug alone provides inadequate glucose control 2, 6.
Efficacy and Safety
- Sitagliptin has been shown to be effective in improving glycemic control in patients with type 2 diabetes, with a low risk of hypoglycemia and a neutral effect on body weight 2, 3, 4, 5.
- The most common side effects of Sitagliptin are gastrointestinal complaints, including abdominal pain, nausea, and diarrhea 2.