Januvia™: A New Treatment Option for Type 2 Diabetes
  Contributed by: Jessica Koerner, Pharm.D.
                        Community Pharmacy Resident

Type 2 diabetes accounts for more than ninety percent of all cases of diabetes and the number of people developing it continues to increase.  Treatment options for type 2 diabetes include both oral and injectable medications, but many patients continue to struggle to maintain a blood glucose or blood sugar at a healthy level.  It is important to achieve that blood glucose goal level in order prevent long-term complications such as blindness, kidney failure, nerve damage, and heart disease.  A new treatment option called Januvia™ is now available!

What is Januvia™?
Januvia™ (sitagliptin phosphate) is the latest FDA approved oral medication indicated for patients with type 2 diabetes.  It can be used alone or in combination with other oral antidiabetic medications such as Glucophage® (metformin) or the thiazolidinediones, Actos® (pioglitazone) and Avandia® (rosiglitazone) to improve blood sugar (glucose) control. 

How does it work?
Januvia™ works differently than any of the currently available medications which treat type 2 diabetes.  It increases and prolongs the action of incretin hormones by inhibiting

the enzyme that breaks them down.  Incretin hormones are released by the intestines and play a big part in the body's normal glucose regulation.  When blood glucose concentrations are elevated, the incretin hormones increase insulin synthesis and release from the pancreas. Insulin helps to move the sugar (glucose) from the blood into the body's cells, where it can be used for energy. The incretin hormones also reduce liver glucose production. The actions of Januvia™ help patients with type 2 diabetes achieve better control of their blood sugar (glucose).

How is Januvia™ taken?
The recommended dose of Januvia™ is 100mg by mouth once daily with or without food.  Available strengths include 100mg, 50mg, and 25mg tablets.

Other important information about Januvia™

• The most common adverse reactions reported included upper respiratory tract infection, nasopharyngitis (inflammation of the nasal or throat membranes), and headache.
  
• The only drug interaction found with Januvia™ is a slight increased level of digoxin, an an

tiarrhythmic heart medication.

• Patients with renal or kidney dysfunction can take Januvia™, but the dose should be decreased depending on the degree of dysfunction.
  
• The use of Januvia™ in combination with medications known to cause hypoglycemia or low blood sugar (glucose) has not been adequately studied.
  
• Januvia™ should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis, a condition associated with very high blood glucose levels.