Januvia is an oral medication prescribed to treat type 2 diabetes, a disease in which the pancreas either doesn't manufacture enough insulin, or the body is unable to use the insulin that is produced. This results in high levels of blood glucose, because insulin is not moving sugar into the cells. If left untreated, diabetes can cause damage over time to other organs and systems of the body, including the heart, kidneys and nerves. Doctors prescribe oral medications, called antiglycemics, in conjunction with exercise and diet to gain control of this disease.
Classification and Indication
\Januvia is Merck's brand name for sitagliptin; it remains under patent and is not yet available in generic form. Januvia is in a newer classification of drugs called dipeptidyl peptidase-4 inhibitors, or DPP-4 inhibitors. It is approved by the FDA for treatment of type 2 diabetes and should not be prescribed for type 1 diabetes.
Mechanism of Action
When food is ingested and blood sugar levels rise, the body sends chemical signals to the pancreas to increase insulin output and to the liver to reduce its production of sugar. DPP-4 is an enzyme in the body that blocks some of these messages. By impeding the action of DPP-4, Januvia allows more of the signals to get through to both the pancreas and the liver. The end result is more available insulin in the bloodstream to ferry sugar into the cells. Because of its particular mechanism of action, Januvia is less likely than some other diabetes medications to cause hypoglycemia, or dangerously low blood sugar levels.
Dosing
Januvia exists in tablet form in strengths of 25 mg, 50 mg and 100 mg. The typical beginning dose is 100 mg once daily, taken independent from meal consumption. Doctors order an antiglycemic like Januvia when diet and exercise are not enough to effectively manage type 2 diabetes. Doctors often prescribe lower doses for people with renal insufficiency.
Contraindications and Side Effects
People with increased sensitivity to sitagliptin should not take Januvia. As with any medicine taken to reduce blood sugar, hypoglycemia is a possible side effect. Januvia has been reported to cause relatively mild side effects such as nausea, stomach discomfort, headache, diarrhea, and a runny or stuffy nose. More serious side effects can include acute pancreatitis and dangerous skin reactions. Immediate medical intervention is required to treat these conditions.
Combination
For some people, one medication alone is not enough to manage their sugar levels and several drugs from different classifications are necessary to maximize disease control. Janumet is a prescription medication that consists of both Januvia and another antiglycemic, metformin. Because these two drugs work differently, their combination in one pill helps to improve management of type 2 diabetes.
