Januvia

The hypoglycemic drug Januvia is a drug that inhibits dipeptidyl peptidase-4.

ATC encoding: A10BH01.

Indications Januvia

The medicinal drug Januvia is prescribed in combination with changes in nutrition and therapeutic exercise to stabilize and improve the condition of patients with type II diabetes.

Combined treatment with metformin or thiazolidinedione-type drugs is suggested in cases where dietary changes and monotherapy do not produce the expected result.

Release form

Januvia is produced in tablet form, which contains sitagliptin phosphate hydrate.

Dosage of tablets:

• 50 mg (the drug that has 112 written on one side);
• 100 mg (drug with 277 written on one side).

The beige-colored tablets are packed in aluminum blister plates placed in a cardboard box. The kit includes an annotation to the medicinal product.

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Pharmacodynamics

The hypoglycemic agent Januvia is effective when taken orally. The active ingredient has differences in chemical structure and pharmacological properties from similar insulin preparations, sulfonylurea-based agents, amylin, γ-receptor agonists, etc. By suppressing dipeptidyl peptidase, the active component increases the level of incretin hormones that are produced inside the intestine. Usually, the amount of such hormones increases as a result of food intake. Incretin substances are considered an element of the internal physiological process of regulating glucose homeostasis.

If the blood sugar level is elevated or within the normal range, incretin hormones stimulate active insulin production. In addition, its secretion by β-cells in the pancreas is activated, which is explained by the action of control intracellular processes.

Also, the drug Januvia helps to suppress excessive secretion of glucagon. A decrease in glucagon levels simultaneously with an increase in the amount of insulin leads to a decrease in the production of glucose in the liver. As a result of such processes, glycemia decreases.

At low glucose levels, the above properties do not appear.

The active component of Januvia prevents the hydrolysis of incretin hormones by the enzyme dipeptidyl peptidase. As a result, plasma concentrations of GLP-1 and GIP increase, glucose-dependent insulin production increases, and glucagon secretion decreases.

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Pharmacokinetics

Absorption of the active ingredient can be about 87%, which is not related to food intake.

The average amount of the drug distributed after a single dose of 100 mg is equal to 198 L. The fraction of the active ingredient bound to plasma proteins is small and barely reaches 38%.

Up to 80% of the substance is excreted unchanged in urine. Only up to 15% can be excreted in feces. Only a small amount of the drug is metabolized.

The average half-life of 100 mg of Januvia taken orally can be 12.5 hours. The renal clearance rate is 350 ml per minute.

The presence of mild or moderate renal failure in the patient, as well as the patient's advanced age, are of no clinical significance.

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Dosing and administration

The standard dose of Januvia is 100 mg per day, taken at one time. Taking the medicine is not related to food intake.

If the patient for some reason did not take the dose of the drug on time, then the prescribed amount of the medicine should be taken as soon as possible. Do not take double the amount of Januvia at one time.

Patients with mild to moderate renal impairment do not require any changes in the dosage of the medication. The same applies to elderly patients.

The rules for changing the dosage of Januvia in severe renal failure are unknown, since studies in this area have not been conducted.

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Use Januvia during pregnancy

There have been no reliable studies on the effects of Januvia on pregnancy, lactation, or the health of the fetus and child. For these reasons, treatment with Januvia is not recommended in the above circumstances.

Contraindications

Contraindications for prescribing the hypoglycemic drug Januvia may include:

• increased likelihood of an allergic response in the body;
• the period of bearing and breastfeeding a child;
• Type I diabetes mellitus;
• phenomena of diabetic ketoacidosis.

In addition, doctors do not recommend Januvia treatment for patients under 18 years of age due to the lack of practical research.

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Side effects Januvia

Usually the drug does not cause negative effects, regardless of the presence of any therapeutic combinations with other hypoglycemic agents. In extremely rare cases, the following side effects were observed:

• inflammatory processes in the upper respiratory tract;
• headaches;
• bowel disorder;
• joint pain;
• attacks of nausea or vomiting.

Laboratory tests may show an increase in the level of leukocytes and neutrophils, as well as a decrease in the level of alkaline phosphatase. Both indicators do not play a significant role and cannot be considered clinically important.

Overdose

Trial increases in the single dose of Januvia to 800 mg did not reveal any adverse cardiac reactions. No additional side effects were observed.

Taking more than 800 mg of the drug at one time has not been studied.

If the possibility of an overdose of Januvia is theoretically accepted, the main focus should be on symptomatic and supportive treatment. The effectiveness of dialysis in this case is questionable.

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Interactions with other drugs

No clinically significant drug interactions with Januvia were found during the studies.

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Storage conditions

The medicine is stored at a temperature range of +15° to +30°C. Medicines, including Januvia, must not be stored in places accessible to children.

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Shelf life

Januvia can be stored for up to 2 years, after which the medicine must be disposed of.

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