Januvia

What is Januvia (Sitagliptin)?

Januvia is a once-a-day prescription drug that, alongside a healthy diet and regular exercise, helps to lower blood sugar in adults that have type 2 diabetes. Its chemical, or generic name is Sitagliptin. Your doctor may refer to Januvia as Sitagliptin, Januvia’s generic name.

What is it used for?

Januvia is used for the treatment of type 2 diabetes, but not type 1 diabetes. It is prescribed either alone or in combination with other oral antidiabetic drugs in order to help improve blood sugar levels.

How does this medication work?

Januvia is a member of a group of medicines called DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors). It works by blocking enzymes that breakdown important hormones involved in eating, appetite and digestion. These hormones play a large role in regulating blood sugar levels. When the breakdown of these hormones is blocked it allows the pancreas to increase the amount of insulin production, and also decrease the amount of glucagon production, which normally increases your blood sugar levels. As your blood sugar levels begin returning to normal, the effects on of insulin and glucagon slowly diminishes, which prevents an “overshoot” that can lead to low blood sugar (hypoglycemia) which is often seen with other oral antidiabetic drugs.

How to take Januvia (Sitagliptin)

Januvia should be taken once daily, as your doctor tells you. You may take your medicine with or without food. You might also be required by your doctor to do blood tests from time to time to see how your kidneys are working. Your dose may be changed by your doctor based on the results of your blood tests. Your doctor might also ask you to take it along with other diabetes medicines. Hypoglycemia or low blood sugar can occur more often when it is used with certain other diabetes medicines.

If you should happen to miss a dosage, make sure that you take it as soon as you can. If you don’t remember until it is almost time for your next dosage, skip that missed dose and go back to your regular schedule. Never take two doses at the same time to make up for any missed doses.

Januvia Dosage

The recommended dose of is 100 mg once daily, and can be taken with or without food.

For patients with mild kidney insufficiency no dosage adjustment for is required. For patients with moderate kidney insufficiency the dose is lowered to 50 mg once daily. For patients with severe kidney insufficiency or with end-stage renal disease (ESRD) which requires hemodialysis or peritoneal dialysis, the dose lowered to 25 mg once daily. It may be administered without regard to the timing of dialysis.

When it is used in combination with insulin, or an insulin secretagogue (e.g., sulfonylurea), a smaller dose of insulin or the insulin secretagogue might be required to reduce the risk of low blood sugar (hypoglycemia).

Warnings and Precautions

As with most drugs prescribed for the treatment of diabetes, Januvia should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the urine or blood). You should not use it if you are allergic to sitagliptin.

Cases of pancreatitis (inflammation of the pancreas) which may be severe and lead to death have been reported in some patients. Cases of a skin condition called bullous pemphigoid that may require hospital treatment have also been reported in some people. Tell your doctor immediately if you develop blisters or have any breakdown of your skin.

To make sure it is safe for you, tell your doctor if you have:

• pancreatitis
• kidney disease (or if you are on dialysis)
• gallstones
• high triglycerides (a type of fat in the blood)
• a history of alcoholism

Januvia Side Effects

Common negative effects may include:

• stuffy or runny nose
• sore throat

Less common negative effects may include:

• allergic reactions, including hives, rash, and swelling of the tongue, lips, face, and throat which may cause problems with swallowing or breathing
• inflammation of the pancreas
• kidney complications (sometimes requiring dialysis)
• vomiting
• headache
• constipation
• joint pain
• muscle aches
• back pain
• arm or leg pain
• itching
• blisters

Rare negative effects may include:

• Pancreatitis. Symptoms include prolonged severe abdominal pain that may be accompanied by vomiting
• Bullous pemphigoid (blisters or a breakdown of your skin)
• Acute kidney failure. Symptoms may include loss of appetite and weakness, nausea, breathlessness, and passing little or no urine.

Tell your doctor immediately if you develop any unusual side effects, or any of the above side effects that get worse or do not go away.

More information about Januvia

• Product Monograph – Health Canada
• U.S. Food and Drug Administration Medication Guide