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Januvia vs Jardiance
Introduction
For patients with type 2 diabetes, certain drugs can help to control blood glucose levels by influencing the way the body metabolizes sugar. Januvia and Jardiance are two such medications that are commonly prescribed for this condition. They each impact different bodily processes, but both aim to stabilize blood glucose in patients with type 2 diabetes. Januvia is a dipeptidyl peptidase-4 (DPP-4) inhibitor which works by increasing the release of insulin from the pancreas and reducing the amount of glucose produced by the liver. On the other hand, Jardiance belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors, which work primarily by preventing kidneys from reabsorbing sugar back into your body and instead facilitating its excretion through urine.
Januvia vs Jardiance Side By Side
| Attribute | Januvia | Jardiance |
|---|---|---|
| Brand Name | Januvia | Jardiance |
| Contraindications | Should not be taken if using insulin or GLP-1 agonists, by patients with severe kidney disease or on dialysis, and those with certain conditions like heart failure or bladder cancer. | Should not be taken by patients with severe kidney disease or on dialysis, and those with certain conditions like heart failure or bladder cancer. |
| Cost | Around $500 for 30 tablets (100 mg) | Ranges from about $550 to $600 for 30 tablets (10 mg or 25 mg) |
| Generic Name | Sitagliptin | Empagliflozin |
| Most Serious Side Effect | Pancreatitis | Ketoacidosis |
| Severe Drug Interactions | Can interact with insulin or GLP-1 agonists leading to hypoglycemia. | Not specifically mentioned, but caution is advised when combined with drugs that may lead to hypoglycemia. |
| Typical Dose | 100 mg/day, adjusted to 25 or 50 mg/day for patients with kidney problems | Starts at 10 mg once daily, can be increased to 25 mg per day |
What is Januvia?
Sitagliptin (the generic name for Januvia) was the first drug of its kind in the class termed DPP-4 inhibitors, which brought forth a new approach to managing type 2 diabetes. Sitagliptin received FDA approval in 2006 and works by inhibiting an enzyme called dipeptidyl peptidase-4. This action helps increase insulin production while also decreasing sugar produced by the liver when blood glucose is high, effectively maintaining balanced blood sugar levels.
On the other hand, Empagliflozin (known as Jardiance), which belongs to another class of medication called SGLT2 inhibitors, was approved later by the FDA in 2014. It functions differently than Januvia; it prevents kidneys from reabsorbing glucose back into your blood thereby allowing more glucose to be removed through urine.
Both these drugs are prescribed for controlling high blood sugar associated with type 2 diabetes. While both medications have similar side effects such as urinary tract infections and upper respiratory tract infections, Jardiance may cause dehydration due to increased urination whereas Januvia might cause joint pain and pancreatitis on rare occasions.
What conditions is Januvia approved to treat?
Januvia and Jardiance are approved for the treatment of different aspects of type 2 diabetes:
- Januvia is a DPP-4 inhibitor that helps to increase levels of insulin when blood sugar is high, particularly after meals, and reduce the amount of glucose produced by the liver.
- Jardiance, an SGLT2 inhibitor, works by helping kidneys get rid of glucose in your bloodstream. It also has proven cardiovascular benefits and can help with weight loss.
These medications work differently but ultimately aim to control high blood sugar levels in patients diagnosed with Type 2 Diabetes.
How does Januvia help with these illnesses?
Januvia aids in managing type 2 diabetes by increasing the levels of incretins available in the body. Incretins are a group of metabolic hormones that stimulate a decrease in blood glucose levels. Januvia works by blocking an enzyme known as DPP-4, which breaks down these incretins. By doing so, it allows for more effective regulation of insulin after meals and decreases the amount of sugar made by the body.
Jardiance, on the other hand, helps manage diabetes by reducing glucose reabsorption in kidneys through inhibiting SGLT2 (sodium-glucose co-transporter 2), leading to excretion of excess glucose via urine. This not only lowers blood sugar levels but also contributes to weight loss due to calorie loss associated with glucose excretion.
Both medications serve similar purposes but their mechanisms differ significantly; understanding these differences can support informed decision-making when exploring treatment options for type 2 diabetes.
What is Jardiance?
Jardiance, also known by its generic name empagliflozin, is an oral diabetes medicine that helps control blood sugar levels. It works by helping the kidneys get rid of glucose from your bloodstream. Jardiance was approved for use in adults with type 2 diabetes by the FDA in 2014 and has been shown to reduce cardiovascular death and hospitalization due to heart failure when used along with diet and exercise in individuals with type 2 diabetes who have established cardiovascular disease. Unlike Januvia which works by regulating the levels of insulin your body produces after eating, Jardiance acts independently of insulin pathways to lower blood glucose and so may be effective even during later stages of the disease where insulin production is significantly lowered. Its side-effect profile differs as well; common side effects include urinary tract infections, yeast infections, thirst and dehydration but it does not generally cause weight gain or hypoglycemia unless combined with other drugs that do so like sulfonylureas or insulin.
What conditions is Jardiance approved to treat?
Jardiance has been approved by the FDA to treat several conditions:
- Type 2 diabetes as an adjunct to diet and exercise to improve glycemic control
- To reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease.
How does Jardiance help with these illnesses?
Jardiance is an oral medication used in the treatment of type 2 diabetes. It acts by blocking a protein called SGLT2, which normally reabsorbs glucose back into the blood from kidneys. By inhibiting this protein, Jardiance allows more glucose to be excreted through urine, thereby lowering blood sugar levels in the body. Unlike Januvia that works by increasing the level of hormones that stimulate insulin production, Jardiance functions independently of insulin mechanisms to exert its effect on blood sugars. This distinctive action makes it an effective alternative for patients who do not respond well or have contraindications to other common antidiabetic medications such as Januvia. Moreover, studies suggest that Jardiance may also provide additional benefits like reducing cardiovascular-related mortality and hospitalization due to heart failure - making it a potentially preferred choice for certain patient populations.
How effective are both Januvia and Jardiance?
Both sitagliptin (Januvia) and empagliflozin (Jardiance) have proven to be successful in managing type 2 diabetes, and they were approved by the FDA within a few years of each other. As they act on different pathways in glucose metabolism, they may be prescribed under different circumstances. The effectiveness of sitagliptin and empagliflozin in controlling blood sugar levels has been directly studied; both drugs exhibited similar efficacy in this regard as well as promising safety profiles.
A systematic review reported that sitagliptin effectively reduces HbA1c levels from baseline with a favorable side effect profile compared to many other antidiabetic medications, making it an effective choice for long-term glycemic control. Further, as one of the first DPP-4 inhibitors introduced into clinical practice, there is significant history and study behind its use. Its optimal dose is considered to be 100 mg/day.
On the other hand, a meta-analysis indicated that empagliflozin seems more efficient at reducing body weight and systolic blood pressure along with glycemic control when compared to placebo or other common antidiabetic medications. It's typically used when diet and exercise do not provide adequate control on their own or alongside other oral hypoglycemics like metformin if needed. Empagliflozin also demonstrated cardiovascular benefits which are yet not established for sitagliptin. Despite these differences due to their unique pharmacology, both Januvia (sitagliptin) and Jardiance(empagliflozin) can play crucial roles in managing type 2 diabetes depending upon individual patient characteristics including co-existing heart disease.
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At what dose is Januvia typically prescribed?
Oral dosages of Januvia are typically 100 mg/day, but for patients with kidney problems, the dosage might be reduced to 25 or 50 mg/day. It is used in adults to improve blood sugar control in type 2 diabetes. On the other hand, Jardiance is usually prescribed at a starting dose of 10 mg once daily before being increased to a maximum dose of 25 mg per day based on efficacy and tolerability. Like Januvia, it's also used for managing blood sugar levels in adult patients with type 2 diabetes. For either medication, dosage adjustments should always be under the supervision and direction of your healthcare provider.
At what dose is Jardiance typically prescribed?
Jardiance therapy usually starts at a dose of 10 mg once daily, taken in the morning. This can be increased to a maximum dosage of 25 mg per day if necessary and as directed by your healthcare professional. As treatment progresses, the dose may remain consistent or adjusted depending on individual response and tolerance levels. Always remember, even when taking Jardiance for diabetes management, it's crucial to monitor blood glucose regularly and maintain a balanced diet and regular exercise routine.
What are the most common side effects for Januvia?
Common side effects of Januvia and Jardiance can include:
- Upper respiratory tract infection
- Nasopharyngitis (cold symptoms)
- Headache
- Nausea
- Hypoglycemia (low blood sugar) when used with certain other diabetes drugs
- Stomach discomfort and diarrhea
- Pancreatitis (inflammation of the pancreas)
- Weight loss
- Urinary tract infections, including yeast infections in women -Increased urination, thirstiness due to higher than normal blood sugar levels.
For both medications, it is important to monitor your health closely while taking them and report any new or worsening symptoms to your healthcare provider right away.
Are there any potential serious side effects for Januvia?
While both Januvia and Jardiance are medications used to manage type 2 diabetes, they can cause different side effects. For Januvia, potential serious adverse reactions include:
- Pancreatitis: severe abdominal pain that may radiate to your back and accompanied by vomiting
- Hypoglycemia or low blood sugar: symptoms like dizziness, headache, confusion or trouble speaking
- Serious allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Meanwhile for Jardiance the following severe side effects could occur:
- Dehydration leading to low blood pressure: symptoms include lightheadedness, fainting and weakness especially when standing up.
- Ketoacidosis (increased ketones in your blood or urine): this condition might appear as rapid breathing, nausea,vomiting stomach pain etc.
- Sudden kidney injury Serious urinary tract infection which might lead to bloodstream infections -Hypersensitivity reaction including angioedema or serious skin reactions
Regardless of the medication you're taking if any above mentioned symptoms occur seek immediate medical help.
What are the most common side effects for Jardiance?
Jardiance, an oral diabetes medicine that helps control blood sugar levels, has a few potential side effects. These can include:
- Urinary tract infections and increased urination
- Thirst and dry mouth due to dehydration
- Nausea or stomach pain
- Fatigue and weakness
- Yeast infection in both men and women
- Changes in cholesterol levels, potentially leading to weight loss over time.
In rare cases, it may cause serious side effects such as ketoacidosis (excess of acids in the blood) which requires immediate medical attention. It's important to note that everyone responds differently to medication; while these are potential side effects you might experience with Jardiance, not every patient will experience them all. Always consult your healthcare provider for any concerns related to your prescribed medication.
Are there any potential serious side effects for Jardiance?
While Jardiance is generally well tolerated, some patients may experience severe side effects. These could include:
- Signs of a serious allergic reaction such as hives; difficulty breathing or swallowing; swelling of your face, lips, tongue or throat
- Symptoms related to dehydration: extreme thirst, dry mouth, infrequent urination or dark-colored urine
- Urinary tract infections presenting with burning sensation during urination and/or frequent urge to urinate
- Kidney problems indicated by swelling in your feet or ankles; feeling tired or short of breath
- Ketoacidosis (too much acid in the blood) which can cause nausea, vomiting, stomach pain, confusion and unusual drowsiness
- Unusual weight loss
- Signs of heart failure: shortness of breath that worsens when you lie down; waking up from sleep due to trouble breathing
If you observe any of these symptoms while on Jardiance therapy, it's imperative you seek immediate medical attention.
Contraindications for Januvia and Jardiance?
Both Januvia and Jardiance, like most diabetes medications, may cause some side effects. If you notice symptoms such as excessive thirst, frequent urination, fatigue or weight loss worsening after starting these drugs, please seek immediate medical attention.
Neither Januvia nor Jardiance should be taken if you are using insulin or have been taking drugs known as GLP-1 agonists. Always inform your doctor about all the medicines you are currently taking; these types of drugs can interact with Januvia and Jardiance leading to a potentially dangerous condition called hypoglycemia (low blood sugar).
Moreover, both Januvia and Jardiance should not be used by patients with severe kidney disease or those on dialysis. Also people with certain conditions like heart failure or bladder cancer need to discuss potential risks with their healthcare provider before starting on either of these medications.
How much do Januvia and Jardiance cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Januvia (100 mg) averages around $500, which works out to approximately $16/day, irrespective of your dose as it is typically taken once daily.
- The price for a package of 30 Jardiance tablets (10 mg or 25 mg) ranges from about $550 to $600, working out to approximately $18-$20/day.
Thus, if you are taking standard doses for either drug (i.e., one tablet per day), then brand-name Januvia tends to be less expensive on a per-day treatment basis. However, cost should not be a primary consideration in determining which of these diabetes medications is right for you.
As far as generic versions go:
- Currently there's no generic version available for either Januvia or Jardiance in the United States. Both are relatively new drugs and still under patent protection. Hence their prices remain high compared with older diabetes medicines that now have generic alternatives.
Always consult with your healthcare provider about what medication would best suit your condition based on efficacy and side effects rather than just cost alone.
Popularity of Januvia and Jardiance
Sitagliptin, in generic form as well as brand names such as Januvia, was estimated to have been prescribed to about 8 million people in the US in 2020. It accounted for almost 15% of prescriptions for oral diabetes medications. Sitagliptin belongs to a class of drugs known as DPP-4 inhibitors which work by increasing levels of incretin hormones that help control blood sugar.
Empagliflozin, including brand versions such as Jardiance, was prescribed to around 2 million people in the USA during the same period. In terms of prescriptions for diabetes medications specifically classified under SGLT2 inhibitors, empagliflozin represents nearly half (48%) due its additional cardiovascular protection benefits on top of blood glucose level regulation. The prevalence and usage of both sitagliptin and empagliflozin have generally increased since their introduction owing mainly to an increase in type II diabetes diagnoses over recent years.
Conclusion
Both Januvia (sitagliptin) and Jardiance (empagliflozin) are integral components of diabetes management, particularly for patients with type 2 diabetes. They have been proven effective in numerous clinical studies, often outperforming placebo treatments in their ability to manage blood glucose levels. Both drugs can be used as monotherapy or in combination with other antidiabetic drugs such as metformin. Their mechanisms of action differ significantly: Januvia works by increasing the hormones that stimulate insulin production after meals, while Jardiance reduces blood sugar by causing the kidneys to remove sugar from the body through urine.
Januvia does not cause weight loss which is a common advantage sought by diabetic patients whereas Jardiance has been associated with modest weight loss and also offers cardiovascular benefits that are not seen with Januvia.
Both medications come available in generic form—significant cost savings for those who pay out-of-pocket expenses. It may take some time before you notice any changes because your body needs time to adjust to these new medicines.
Side effects between the two vary but both tend to be well-tolerated overall; however, Jardiance may increase risk for urinary tract infections due its mechanism of action involving increased urination. Patients taking either medication should monitor their health closely and contact a healthcare provider immediately if they experience symptoms like persistent nausea/vomiting or stomach/abdominal pain.
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Refrences
- Scott, L. J. (2014, October). Empagliflozin: A Review of Its Use in Patients with Type 2 Diabetes Mellitus. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-014-0298-1
- 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
- Shafiq, A., Mahboob, E., Samad, M. A., Ur Rehman, M. H., & Tharwani, Z. H. (2022, September). The dual role of empagliflozin: Cardio renal protection in T2DM patients. Annals of Medicine & Surgery. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1016/j.amsu.2022.104555
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- Reynolds, J. K., Neumiller, J. J., & Campbell, R. K. (2008, September 22). Janumet<sup>™</sup>: a combination product suitable for use in patients with Type 2 diabetes. Expert Opinion on Investigational Drugs. Informa Healthcare.http://doi.org/10.1517/13543784.17.10.1559
- Jahagirdar, V., & Barnett, A. H. (2014, October 10). Empagliflozin for the treatment of type 2 diabetes. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.2014.966078