Januvia (sitagliptin) is an oral medication (tablet) used in combination with diet, exercise, and other medications to help lower blood glucose levels in people with type 2 diabetes . Januvia belongs to a class of medications called DPP-4 inhibitors, which work by blocking the enzyme dipeptidyl peptidase IV, which is responsible for breaking down proteins that stimulate insulin production after a meal. If DPP-4 is inhibited, these proteins can activate insulin release for a longer period of time, reducing blood glucose levels.
Januvia was the first DPP-4 inhibitor approved by the US Food and Drug Administration (FDA) in 2006. It cannot be purchased as a generic drug, but it is available in combination with metformin in a drug called Janumet and with ertugliflozin. . like Steglujan. It is not approved for the treatment of type 1 diabetes or diabetic ketoacidosis.
Januvia is used specifically as a second or third line medicine to treat type 2 diabetes, a chronic condition that affects the way the body metabolizes sugar (glucose). It should be part of a diabetes treatment protocol that includes diet, exercise, and other medications such as metformin or thiazolidinediones .
Your healthcare provider may recommend that you take Januvia if you have not been able to control your blood glucose levels with diet, exercise, and first-line medications such as metformin or sulfonylurea.
Your healthcare provider may prescribe Januvia instead of other less expensive second-line diabetes medications, as they are unlikely to cause hypoglycemia or weight gain. Januvia only works when it is needed, usually with meals, so if there is no glucose in the blood, Januvia does not work. If your glucose levels rise, such as after eating, Januvia will work to lower your glucose levels.
Precautions and contraindications.
If you have or have ever had pancreatitis , tell your doctor before taking Januvia. Some people taking Januvia have developed pancreatitis, although it is currently unknown if the drug is the cause. There have also been rare reports of kidney and heart failure in people taking Januvia or other DPP-4 inhibitors.
Januvia should not be used by people with diabetic ketoacidosis . Pregnant or nursing women should also avoid taking Januvia, as little is known about its effects on pregnancy or breastfeeding.
All indicated doses are indicated by the manufacturer of the drug. Check your prescription and talk to your doctor to make sure you are taking the correct dose. Your healthcare provider will check your kidney function before setting the correct dosage schedule for you and will regularly monitor your kidney health thereafter.
For people without kidney problems, Januvia comes as 100 milligram (mg) tablets to take once a day. For people with moderate kidney function, a 50 mg tablet is available. A 25 mg tablet is available for people with severe kidney disease. In both cases, the dose is maintained once a day.
How to take and store
Januvia does not need to be taken with meals. Store at room temperature.
The most common side effects of Januvia include an upper respiratory infection, sore throat, and headache .
In rare cases, some people experience severe allergic or skin reactions to Januvia, including anaphylaxis. If you develop hives, throat swelling or difficulty breathing, blisters, rashes, or other serious reactions, stop taking Januvia and seek emergency medical attention.
Another serious side effect associated with Januvia to watch out for is an increased risk of pancreatitis. Your healthcare provider will test your pancreatic function shortly after you start using Januvia and then at regular intervals. Stop taking Januvia and call your doctor right away if you have severe abdominal pain that does not go away. The pain may feel like it is from the abdomen to the back and is accompanied by vomiting. These could be symptoms of pancreatitis.
Warnings and interactions
Since Januvia is processed by the kidneys, your healthcare provider will test your kidney (kidney) function before taking Januvia. People with kidney failure may need to take lower doses of Januvia because there have been rare reports of kidney failure with Januvia.
The risk of heart failure has also been reported with DPP-4 inhibitors, which may increase due to liver or kidney failure . If you have any of these conditions, ask your doctor if the benefits of Januvia outweigh the risks for you, and remember to get tested regularly.
While Januvia alone is unlikely to lower blood sugar, if you combine Januvia with medications that lower blood sugar, such as sulfonylurea or insulin, you should also be on the lookout for hypoglycemia .
Januvia and other DPP-4 inhibitors can cause severe joint pain in some people who take them. In 2015, the FDA added a warning about this side effect to the labels of gliptin drugs. Symptoms can start immediately or years after taking gliptin. In cases reported to the FDA, people who stopped taking DPP-4 stopped experiencing joint pain within a month. If you have joint pain, ask your doctor to adjust your medication as needed.