Januvia sitagliptin phosphate for blood sugar
November 15 2016

Januvia is a pharmaceutical drug to lower blood sugar in patients with type 2 diabetes mellitus. Januvia medication may be taken alone or along with certain other medicines to control blood sugar. Januvia Sitagliptin Phosphate is first in new class of oral treatments known as DPP-4 Inhibitors. This brand name is a registered trademark of Merck & Co., Inc.

Januvia and incretins, blood sugar
Januvia drug is an oral, once-daily, selective DPP-4 inhibitor. DPP-4 inhibitors work by enhancing a natural body process that lowers blood sugar, the incretin system. When blood sugar is elevated, incretins work in two ways to help the body regulate high blood sugar levels: they trigger the pancreas to increase the release of insulin and signal the liver to reduce its production of glucose. DPP-4 inhibitors enhance the body’s own ability to control blood sugar levels by increasing the active levels of these incretin hormones in the body, helping to decrease blood sugar levels in patients with type 2 diabetes.

Januvia benefit
Lowers blood sugar when blood sugar is high, especially after a meal.
Helps to improve the levels of insulin produced by your own body after a meal.
Januvia decreases the amount of sugar made by the body.
Has not been studied with medicines known to cause low blood sugar, such as sulfonylureas or insulin.
See how to lower high blood sugar with diet and nutrition.

Januvia for Type 2 Diabetes Treatment
Januvia or sitagliptin phosphate, Merck & Co., Inc.’s treatment for patients with type 2 diabetes, is the first prescription medication in a new class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors, which enhance the body’s own ability to lower blood sugar (glucose) when it is elevated.

FDA approval
In October 2006, the U.S. Food and Drug Administration (FDA) approved Januvia medication as monotherapy and as add-on therapy to either of two other types of oral diabetes medications, metformin or thiazolidinediones (TZDs), to improve blood sugar (glucose) control in patients with type 2 diabetes when diet and exercise are not enough.

Januvia dosage, how much to take
The recommended dose of Januvia drug is 100 mg once daily with or without food. Januvia should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis, as it would not be effective in these settings. According to Merck, no Januvia dosage adjustment is needed for patients with mild to moderate hepatic insufficiency or in patients with mild renal insufficiency. To achieve plasma concentrations of Januvia similar to those in patients with normal renal function, lower dosages are recommended in patients with moderate and severe renal insufficiency as well as in ESRD patients requiring hemodialysis. Because there is a need for dosage adjustment based upon renal function, assessment of renal function is recommended prior to initiation of Januvia and periodically thereafter. Because elderly patients are more likely to have decreased renal function, care should be taken in Januvia dose selection in the elderly and it may be useful to assess renal function in these patients prior to initiating dosing and periodically thereafter.

Januvia and metformin
Januvia has been investigated in patients with type 2 diabetes to improve glycemic control in combination with metformin when diet and exercise, plus metformin, do not provide adequate glycemic control.
Sitagliptin phosphate is also being investigated as part of Merck’s single tablet combination with metformin. Janumet is the proposed trademark for the combination tablet. The mechanism of action of DPP-4 inhibitors is distinct from that of metformin and other drugs in the currently available classes of glucose-lowering agents.

Januvia and PPAR drug
Januvia medication has also been studied as add-on therapy with PPAR agonists in patients with type 2 diabetes in whom use of a PPAR agonist (e.g. a thiazolidinedione) is appropriate.

Januvia side effects, safety, caution, danger
According to Merck, in clinical trials, Januvia drug demonstrated an overall incidence of side effects comparable to placebo. The most common Januvia side effects  greater than 5 percent and higher than placebo were stuffy or runny nose and sore throat, upper respiratory infection, and headache. The incidence of selected gastrointestinal Januvia side effects  was as follows: abdominal pain (2.3 percent; placebo, 2.1 percent), nausea (1.4 percent; placebo, 0.6 percent) and diarrhea (3.0 percent; placebo, 2.3 percent).

Q. I have been on Januvia medication for aprox. 4 months. To be honest, I have felt lethargic, upset stomach (nauseous, acid reflux) spacey. This is in the a.m. when I take the medication. By p.m. I perk up and feel better in the head BUT I still have to watch what I eat as I get an upset stomach and do not want to set it off. I have taken Pepcid Complete to help the affects. Along with that med. I take glucophage, glyburide, Avandia and humalog injection right before dinner. I did try Byetta but could only take it for three days as the stomach reaction was worse than the Januvia.. The reason I started it was to lose weight as no matter how much I tried It would not come off. At this point I have lost 10lbs. which is not a lot but better than nothing. I see my Dr. tomorrow and I am anxious to see what she has to say about all of this.

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Pregnancy and nursing
Januvia should be used during pregnancy only if clearly needed. Caution should be exercised when Januvia is administered to a nursing woman.