Anitdiabetic Drug Januvia

by Danita Jones
(Bahamas)

Antidiabetic Drug Januvia


Januvia is a white round tablet that is scored and comes as 25mg, 50mg and 100mg. Januvia can also be used in combination therapy with metformin by the name of Janumet. Janumet can come as a 50/500mg, 50/1000mg and 50/850mg tablet.

Therapeutic Class:
Type 2 diabetes mellitus (Non-insulin dependent diabetes mellitus), which is the most common form of diabetes, is a condition in the body known to have elevated glucose or blood sugar levels.

This is a condition in which the body either fails to make the required amount of insulin, the insulin may not work as well as needed or there is too much glucose made by the body.

Januvia is a highly selective inhibitor of dipeptidyl peptidase 4 (DPP-4) enzymes for the treatment of type 2 diabetes. The DDP-4 inhibitors are a class of agents that act as incretin enhancers.

Incretins are a group of gastrointestinal hormones that cause an increase in the amount of insulin released from the beta cells of the islets of Langerhans (found in the pancreas) after eating, even before blood glucose levels become elevated.

They also suppress the glucagon secretion from pancreatic alpha cells when blood glucose levels are normal of elevated. By inhibiting the DDP-4 enzyme, sitagliptin phosphate increases the levels of the incretin hormones.

Indications:
Januvia helps patients to balance out the blood sugar levels as an adjunct to diet and exercise as monotherapy or in combination therapy with other antidiabetic agents.

Pregnancy Implications:
There are no adequate and well- controlled studies in pregnant women. Insulin is the drug of choice for the control of diabetes mellitus during pregnancy.

Lactation:
Excretion of the drug in breast milk is unknown.

Contraindications:
Januvia is not for patients with type 1 diabetes (Insulin dependent diabetes mellitus) or for patients with diabetic ketoacidosis or for patients who exhibit hypersensitivity to sitagliptin phosphate.

Precautions:
Those who take sitagliptin phosphate should monitor blood glucose levels closely when using in conjunction with sulphonylureas (Amaryl or Glynase), as there is an increased risk of hypoglycemia.

Dosage and Administration:
The recommended dose of Januvia is 100mg daily as monotherapy or as combination therapy with metformin. It can be taken with or without food.

For patients who have mild renal insufficiency no dosage adjustment is required. For those with moderate renal insufficiency the recommended dosage is Januvia 50mg daily. For those who have sever renal insufficiency the recommended dosage is Januvia 25mg daily and can be administered without regard to the timing to hemodialysis.

Side effects:
Januvia was generally well tolerated in controlled clinical studies as both monotherapy and combination therapy.

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