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Fact Table
| Fact Table | |
|---|---|
| Formula | C16H15F6N5O |
| License | FDA and EMA approved (2006) for type 2 diabetes |
| Bioavailability | ~87% (oral) |
| Legal status | Prescription only (Rx) |
| Chemical Name | (R)-4-oxo-4-[3-(trifluoromethyl)-5,6-dihydro[1,2,4]triazolo[4,3-a]pyrazin-7(8H)-yl]-1-(2,4,5-trifluorophenyl)butan-2-amine |
| Elimination half-life | ~12.4 hours |
| Dosage (Strength) | 25 mg, 50 mg, and 100 mg oral tablets (once daily) |
| Pregnancy | Category B – Use if clearly needed (limited human data) |
| Brands | Januvia; Janumet (sitagliptin/metformin); generics available |
| Protein binding | 38% |
| PubChem CID | 4369359 |
| MedlinePlus | a607029 |
| ChEBI | 85083 |
| ATC code | A10BH01 |
| DrugBank | DB01261 |
| KEGG | D02550 |
| Routes of administration | By mouth (oral tablets) |
Januvia (sitagliptin) is a dipeptidyl peptidase-4 (DPP-4) inhibitor used to treat type 2 diabetes in adults. Sitagliptin works by increasing substances in the body that help the pancreas release more insulin after eating, which helps control blood sugar levels. Januvia is taken as a tablet once daily and works best when combined with a healthy diet and regular exercise.
Directions
Januvia is taken by mouth with or without food. The standard dosage for most adults is 100 mg once daily. Patients with kidney problems may need a lower dose, with 50 mg once daily recommended for moderate kidney impairment and 25 mg once daily for severe kidney problems or end-stage renal disease.
Take Januvia at roughly the same time each day. If a dose is missed, take it as soon as it's remembered unless it's almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular schedule. Don't take two doses at once to make up for a missed one.
Ingredients
The active ingredient in this drug is sitagliptin.
Cautions
- Before using this medication, you may want to consult a healthcare provider about the following:
- Any existing health conditions
- Any allergies
- A list of all medications currently being taken
- Januvia has been linked to rare cases of pancreatitis, which is inflammation of the pancreas. Seek medical help right away if you develop severe stomach pain, nausea, vomiting, or back pain.
- Some people taking DPP-4 inhibitors have developed heart failure. If you have kidney problems or a history of heart failure, your doctor may monitor you more closely. Report symptoms like swelling, shortness of breath, or sudden weight gain.
- Kidney function can worsen in rare cases, sometimes requiring hospitalization. Because of this, your doctor will check your kidney function before starting Januvia and from time to time afterward.
- Januvia can increase the risk of low blood sugar when taken with insulin or sulfonylureas. Your healthcare provider may reduce the dose of these other medications to help prevent dizziness, sweating, shakiness, or confusion.
- Serious allergic reactions have been reported, including swelling, rash, and severe skin reactions like Stevens-Johnson syndrome. These can occur soon after starting the medication, even after the first dose.
- Some patients taking DPP-4 inhibitors have experienced severe joint pain that may appear suddenly or after months of treatment. Symptoms usually improve once the medication is stopped.
- A rare skin condition called bullous pemphigoid has occurred in people taking drugs in this class, causing blisters or open sores. If you notice unusual blisters, stop Januvia and contact your doctor.
Contraindications
Avoid taking or using this medication if there's a known hypersensitivity or allergy to any ingredient in Januvia tablets.
Side Effects
Common side effects of Januvia include:
- Upper respiratory infections
- Stuffy or runny nose
- Sore throat
- Headache
- Stomach upset or diarrhea (less common)
These effects are usually mild and tend to improve as your body adjusts. Some people may also notice swelling in the hands or legs when Januvia is combined with other diabetes medications such as metformin and rosiglitazone. Tell your healthcare provider if symptoms persist or become bothersome.
Januvia can also cause more serious reactions. Low blood sugar may occur, especially if Januvia is taken with insulin or sulfonylureas, and can lead to dizziness, sweating, confusion, weakness, or a fast heartbeat. Rare but serious risks include kidney problems, severe joint pain, allergic reactions, and bullous pemphigoid. Seek medical care right away for blisters, severe abdominal pain, difficulty breathing, swelling of the face, or signs of low blood sugar.
Frequently Asked Questions about Januvia (Sitagliptin)
What is Januvia used for?
Januvia (sitagliptin) is an oral prescription medication used to improve blood sugar control in adults with type 2 diabetes. It is typically used in combination with diet and exercise and may be prescribed alone or with other diabetes medications such as metformin or insulin.
How does Januvia work?
Januvia is a DPP-4 inhibitor, which means it increases levels of incretin hormones. These hormones help the body release more insulin after meals and decrease the amount of sugar produced by the liver, which helps lower blood glucose levels in people with type 2 diabetes.
How should Januvia be taken?
Januvia is taken once daily by mouth, with or without food. It is important to take it at the same time each day. Dosage is usually based on kidney function, so regular monitoring may be necessary to ensure proper dosing.
What are the common side effects of Januvia?
Common side effects of Januvia include upper respiratory tract infections, stuffy or runny nose, sore throat, and headache. Some people may also experience stomach discomfort. Most side effects are mild and tend to go away over time.
Can Januvia cause low blood sugar (hypoglycemia)?
Januvia alone usually does not cause low blood sugar. However, the risk increases when it is taken with other diabetes medications such as sulfonylureas or insulin. Signs of hypoglycemia include shakiness, dizziness, sweating, and confusion.
Is Januvia safe for people with kidney problems?
Januvia can be used in people with kidney impairment, but the dosage must be adjusted based on kidney function. Patients with reduced kidney function should have their creatinine clearance or estimated glomerular filtration rate (eGFR) monitored regularly.
Can Januvia be taken with other diabetes medications?
Yes, Januvia is often prescribed in combination with other antidiabetic drugs such as metformin, sulfonylureas, or insulin. When used together, these combinations may offer better blood sugar control, but they may also increase the risk of side effects.
Are there serious side effects to watch for?
Though rare, serious side effects of Januvia may include pancreatitis, severe joint pain, allergic reactions, or kidney problems. Any sudden or severe abdominal pain, difficulty breathing, or signs of allergic reaction should be reported to a doctor immediately.
Can Januvia cause weight gain?
Januvia is generally considered weight-neutral, meaning it typically does not cause weight gain or loss. This makes it a favorable option for people who are concerned about weight changes as a side effect of diabetes treatment.
Who should not take Januvia?
Januvia is not approved for use in people with type 1 diabetes or for the treatment of diabetic ketoacidosis. It should also be avoided in those with a known hypersensitivity to sitagliptin or any of its ingredients. A healthcare provider should assess its suitability in people with a history of pancreatitis or kidney disease.
