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Alogliptin vs Januvia
Introduction
For patients with type 2 diabetes, certain drugs that manage the regulation of blood sugar levels by influencing the action of an enzyme called DPP-4 can help in stabilizing glucose highs and lows. Alogliptin and Januvia are two such medications often prescribed for this condition. They each act on the same enzymes but have slightly different pharmacological properties that may influence patient preference and physician prescription. Alogliptin is a selective inhibitor of dipeptidyl peptidase-4 (DPP-4) which delays degradation of incretin hormones resulting in increased insulin release and decreased glucagon levels. On the other hand, Januvia, also known as Sitagliptin, inhibits DPP-4 to increase insulin synthesis/release and decrease glucagon secretion.
Alogliptin vs Januvia Side By Side
| Attribute | Nesina | Januvia |
|---|---|---|
| Brand Name | Nesina | Januvia |
| Contraindications | Should not be taken with strong CYP3A4/5 inhibitors | Should not be taken with strong CYP3A4/5 inhibitors |
| Cost | $470 for a 30-tablet supply of 25 mg | $480 for a 30-tablet supply of 100 mg |
| Generic Name | Alogliptin | Sitagliptin |
| Most Serious Side Effect | Signs of allergic reaction, symptoms indicating pancreatitis, indicators for heart failure | Severe skin reactions, symptoms of pancreatitis, kidney problems |
| Severe Drug Interactions | Strong CYP3A4/5 inhibitors | Strong CYP3A4/5 inhibitors |
| Typical Dose | 6.25-25 mg/day, with 12.5 mg/day being sufficient for most | 100 mg/day, adjusted based on renal function |
What is Alogliptin?
Alogliptin (also known by the brand name Nesina) was a significant advancement in the class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors, which were designed to control blood sugar levels in Type 2 Diabetes patients. Alogliptin got its FDA approval in 2013. It works by increasing the levels of incretins – hormones that raise insulin levels when blood sugar is high and decrease the amount of glucose produced by liver - thereby making them stay longer within your system. Alogliptin is typically prescribed for adults with type 2 diabetes mellitus.
Comparatively, Sitagliptin phosphate (Januvia's generic name), another drug from DPP-4 inhibitors' family, has a broader influence on both GLP-1 and GIP hormones while having minor effects on other enzymes like DPP8 or DPP9. This results in Januvia presenting fewer side effects than other antidiabetic medications that have stronger influences on these two other enzymes.
What conditions is Alogliptin approved to treat?
Alogliptin is sanctioned for the management of diverse aspects of type 2 diabetes:
- It can be used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
- For use in combination with other anti-diabetic medicines, like metformin or a thiazolidinedione, when these drugs are not providing adequate blood sugar control.
- In certain cases, it may also be utilized in conjunction with insulin therapy.
How does Alogliptin help with these illnesses?
Alogliptin works to manage blood sugar levels in individuals with type 2 diabetes by increasing the amount of incretins available in the body. Incretins are a type of hormone that help regulate insulin - a crucial hormone for controlling blood sugar levels. They do this by stimulating the pancreas to produce more insulin after meals, and also slow down gastric emptying thus reducing glucose absorption into the bloodstream. It is thought that individuals with type 2 diabetes have relatively lower levels of incretins. Therefore, by increasing incretin levels, Alogliptin can limit high blood sugar episodes and help patients manage their condition effectively.
What is Januvia?
Januvia is a brand name for sitagliptin, an oral anti-diabetic drug that belongs to the dipeptidyl peptidase-4 (DPP-4) inhibitors class. It works by increasing levels of GLP-1 and GIP hormones, which in turn helps to regulate blood sugar levels by boosting insulin production and reducing glucagon secretion. Januvia was first approved by the FDA in 2006 and has been widely used as a treatment option for Type 2 diabetes since then. Unlike Alogliptin, Januvia does not inhibit DPP-8 or DPP-9 enzymes, resulting in fewer gastrointestinal side effects such as nausea or diarrhea which are common with other DDP-4 inhibitors like Alogliptin. Moreover, its positive impact on glucose control makes it favorable for patients who do not respond well to other typical antidiabetic medications.
What conditions is Januvia approved to treat?
Januvia, an oral diabetes medicine, is approved by the FDA for the treatment of:
- Type 2 Diabetes Mellitus
- It helps regulate blood sugar levels by increasing insulin production based on your body's food intake and needs.
How does Januvia help with these illnesses?
Januvia, like Alogliptin, is a medication used to manage Type 2 diabetes. It works by regulating the levels of insulin your body produces after eating. Januvia does this by inhibiting an enzyme called DPP-4 which results in an increased level of incretin hormones in the body. These hormones are released throughout the day and levels are increased during meals; they help to regulate blood glucose by increasing insulin production especially after meals and reducing the amount of glucose being produced and released by the liver. Unlike Alogliptin, Januvia has been around for a longer period of time and has more robust clinical trial data supporting its use in managing blood sugar levels in type 2 diabetics. This makes it a preferred choice among many physicians when choosing between these two medications.
How effective are both Alogliptin and Januvia?
Both alogliptin and sitagliptin (Januvia) are effective in treating patients with type 2 diabetes, each acting as a DPP-4 inhibitor to increase the levels of incretin hormones in the body. These drugs were approved by the FDA within five years of each other, with Januvia receiving approval first.
A double-blind clinical trial conducted in 2010 directly compared alogliptin and sitagliptin for their efficacy in managing blood glucose levels over a period of 26 weeks. Both medications showed similar effectiveness at reducing HbA1c levels, which is a key indicator used to track diabetes management. No significant difference was found between these two treatments across various metrics.
In terms of side effects, both drugs have been well-tolerated amongst patient populations, showing minimal risk of hypoglycemia when used alone or combined with certain other antidiabetic agents. A review published in 2013 noted that gastrointestinal issues such as nausea and diarrhea are slightly more common with sitagliptin use than they are with alogliptin.
Research indicates that while both medications effectively reduce blood sugar levels on their own or alongside metformin or thiazolidinediones, some studies suggest that Januvia may be somewhat superior to Alogliptin at lowering fasting plasma glucose concentrations due to its higher potency as an enzyme inhibitor. However, this potential benefit should be weighed against the possibility for greater incidence of minor side effects.
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At what dose is Alogliptin typically prescribed?
Oral dosages of Alogliptin range from 6.25-25 mg/day, but studies have indicated that 12.5 mg/day is sufficient for treating type 2 diabetes in most people. There isn't a recommended dosage for children and adolescents as its safety and effectiveness haven't been established in these age groups yet. In adults, the dosage can be increased after a few weeks if there's no response to the initial amount prescribed by your healthcare provider. The maximum dosage that should not be exceeded in any case is 25 mg/day.
At what dose is Januvia typically prescribed?
Januvia treatment is typically initiated at a dosage of 100 mg/day, taken orally once daily. However, for patients with moderate renal insufficiency (creatinine clearance [CrCl] ≥30 to <50 mL/min), the recommended dose is reduced to 50 mg once daily. For those with severe renal insufficiency (CrCl <30 mL/min) or end-stage renal disease requiring hemodialysis or peritoneal dialysis, the dose should be further reduced to 25 mg once daily. It's important to note that Januvia can be administered regardless of meals but if a dose is missed it should be taken as soon as possible unless it's almost time for your next one; in this case, skip the missed dose and continue your regular schedule. Avoid doubling doses.
What are the most common side effects for Alogliptin?
The most common side effects of Alogliptin are typically mild, and include:
- Headache
- Nasopharyngitis (cold symptoms such as sore throat, runny nose)
- Upper respiratory tract infection
- Urinary tract infection
- Hypoglycemia (low blood sugar levels) in combination with other diabetes medication
- Abdominal pain or discomfort
- Diarrhea
Remember to consult your healthcare provider if you experience any of these side effects persistently. It’s important that the benefits of taking Alogliptin outweigh its potential risks.
Are there any potential serious side effects for Alogliptin?
While Alogliptin and Januvia are both DPP-4 inhibitors used in the management of type 2 diabetes, it's crucial to know their potential side effects for an informed decision.
In rare cases, alogliptin can lead to:
- Signs of allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Symptoms indicating pancreatitis: severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite
- Indicators for heart failure: shortness of breath (even with mild exertion), swelling in your legs or feet, rapid weight gain
On the other hand, Januvia may cause:
- Severe skin reactions: fever; sore throat; swelling in your face or tongue; burning sensation in eyes; skin pain followed by a red or purple rash that spreads (especially on the face or upper body) causing blistering and peeling
- Pancreatitis signs similar to those mentioned above
- Kidney problems – Little or no urination; painful/difficult urination; swelling in feet/ankles.
If you notice any such symptoms while taking either medication immediately contact healthcare professionals. Remember these medications should be taken under proper medical supervision as part of broader lifestyle changes like diet control and regular exercise.
What are the most common side effects for Januvia?
Januvia, another anti-diabetic medication similar to Alogliptin, can cause an array of side effects in certain individuals. These may include:
- Headache or dizziness
- Nausea and occasional vomiting
- Upper respiratory tract infection symptoms such as stuffy nose, sore throat
- Stomach pain and constipation
- Swelling of the hands or legs due to fluid retention
- Skin rash It's also important to note that while weight loss is a common symptom with many diabetes medications, Januvia does not typically result in significant weight changes. Always remember that your reaction could vary based on numerous factors and it's crucial to monitor any discomforting symptoms closely under the guidance of your healthcare provider.
Are there any potential serious side effects for Januvia?
While Januvia is generally well-tolerated, it's important to be aware of any potential side effects. Signs that you might be experiencing a reaction include:
- Symptoms of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat.
- Severe and persistent pain in the stomach which may reach through to your back with or without vomiting. These could be symptoms of pancreatitis.
- Swelling in specific parts of body like hands or feet; feeling short winded.
- Rapid weight gain
- Frequent urination or increased thirst – these can both suggest kidney problems
- Skin reactions including redness, itching, rash and peeling.
If you experience any of these signs after taking Januvia, contact your healthcare provider immediately for further guidance.
Contraindications for Alogliptin and Januvia?
Both Alogliptin and Januvia, like most antidiabetic medications, may cause side effects such as abdominal pain or stomach upset in some individuals. If you notice your symptoms worsening or experience severe side effects such as persistent nausea/vomiting, loss of appetite, or yellowing eyes/skin (jaundice), please seek immediate medical attention.
Neither Alogliptin nor Januvia should be taken if you are taking strong CYP3A4/5 inhibitors (such as ritonavir) that can increase the level of these drugs in your body. Always inform your physician about all the medications you are currently taking; strong CYP3A4/5 inhibitors might require a period to clear from the system to prevent dangerous interactions with Alogliptin and Januvia.
How much do Alogliptin and Januvia cost?
For the brand name versions of these drugs:
- The cost of a 30-tablet supply of Alogliptin (25 mg) averages around $470, which works out to about $15.67 per day.
- The price for a similar quantity and dosage of Januvia is approximately $480, working out at roughly $16 per day.
Thus, if you are taking the maximum recommended dose for either drug (i.e., 25 mg/day), then brand-name Alogliptin is slightly less expensive on a daily basis than Januvia. However, it's crucial to note that cost should not be the primary factor in determining which drug is best suited for your health needs.
At this time, there are no generic versions available for both Alogliptin and Januvia in U.S markets. Hence their costs remain relatively high compared with medications where generics do exist. As always consult with your healthcare provider to ensure the chosen medication meets your treatment goals and fits within your budget constraints.
Popularity of Alogliptin and Januvia
Alogliptin, marketed under the brand name Nesina, is a medication used to regulate blood sugar levels in people with type 2 diabetes. In 2020, it was estimated that about 500,000 prescriptions were written for Alogliptin. This drug belongs to the DPP-4 inhibitor class of antidiabetic drugs and accounts for roughly 5% of all such medications prescribed.
On the other hand, Sitagliptin, sold under the brand name Januvia among others, was prescribed to nearly 8 million people in the USA in 2020. Januvia holds just over half of all DPP-4 inhibitor prescriptions and around a quarter of overall antidiabetic drugs prescribed. The prevalence of Sitagliptin has been steadily growing since its FDA approval in October 2006 due to its effectiveness and tolerability.
While both these drugs work similarly by inhibiting an enzyme which increases insulin release while decreasing glucose production from liver when blood sugar is high after meals; they have some differences as well – mainly being that Alogliptin may cause less nausea compared to Sitagliptin.
Conclusion
Both Alogliptin and Januvia (sitagliptin) are well-established in the treatment of type 2 diabetes, supported by numerous clinical studies indicating that they effectively lower blood sugar levels compared to placebo. Occasionally, these two drugs may be used together under careful supervision of a healthcare provider as they can enhance each other's glucose-lowering effects.
Alogliptin and Januvia work by inhibiting the enzyme DPP-4, which breaks down hormones called incretins. These hormones help stimulate insulin production after meals and slow down glucose production by the liver. While both drugs employ this same mechanism of action, doctors may prescribe them differently based on individual patient needs and responses.
Alogliptin is often considered when patients need an alternative to metformin or sulfonylureas due to intolerances or contraindications whereas Januvia tends to be more popularly prescribed possibly due to its once-daily dosing schedule versus twice daily for Alogliptin.
Both medications are available in generic form offering cost savings especially for those paying out-of-pocket. It might take some time before noticeable improvements in blood sugar control become apparent with either drug.
In terms of side effects, both drugs have similar profiles with common ones being cold-like symptoms, headache and upset stomach. Serious but rare side effects include pancreatitis and heart failure. As with any medication regimen for diabetes management it's important individuals closely monitor their blood sugars frequently when starting a new therapy like Alogliptin or Januvia - consulting promptly with their healthcare provider if they notice no improvement or worsening control over their blood sugars.
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Refrences
- Scott, L. J. (2017, January 11). Sitagliptin: A Review in Type 2 Diabetes. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-016-0686-9
- B. Ghatak, S., S. Patel, D., Shanker, N., Srivastava, A., S. Deshpand, S., & J. Panchal, S. (2010, November 1). Alogliptin: a Novel Molecule for Improving Glycemic Control in Type II Diabetes Mellitus. Current Diabetes Reviews. Bentham Science Publishers Ltd.http://doi.org/10.2174/157339910793499119
- Neumiller, J. J., & Holland, D. Q. (2015, November 18). Alogliptin + metformin combination for the treatment of type 2 diabetes mellitus. Expert Review of Endocrinology & Metabolism. Informa UK Limited.http://doi.org/10.1586/17446651.2016.1110484
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- Thornberry, N., & Weber, A. (2007, March 1). Discovery of JANUVIA™ (Sitagliptin), a Selective Dipeptidyl Peptidase IV Inhibitor for the Treatment of Type2 Diabetes. Current Topics in Medicinal Chemistry. Bentham Science Publishers Ltd.http://doi.org/10.2174/156802607780091028
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