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Toujeo vs Januvia
Introduction
For patients with Type 2 Diabetes, certain medications that help regulate blood glucose levels can be crucial in managing the disease and preventing complications. Toujeo and Januvia are two such drugs commonly prescribed for this condition. They each have different mechanisms of action but both aim to control high levels of sugar in the blood.
Toujeo is a long-acting form of insulin called insulin glargine, which works by replacing the insulin that is normally produced by the body and helping move sugar from the bloodstream into other body cells where it can be used for energy. This medication usually has an effect on your blood sugar levels for about 24 hours.
On the other hand, Januvia falls under a class of medicines known as DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors). It works by increasing levels of natural substances called incretins. Incretins help to control blood sugar by increasing insulin release, especially after a meal; they also decrease the amount of sugar your liver makes. Unlike Toujeo, Januvia does not replace missing insulin but rather encourages your body to make more when needed.
Toujeo vs Januvia Side By Side
| Attribute | Toujeo | Januvia |
|---|---|---|
| Brand Name | Toujeo | Januvia |
| Contraindications | Should not be taken with drugs known as DDP-4 inhibitors or GLP-1 receptor agonists. Caution in patients with kidney disease. | Should not be taken with drugs known as DDP-4 inhibitors or GLP-1 receptor agonists. Requires caution in patients with kidney disease. |
| Cost | Around $400 for a 300-unit pre-filled pen | Around $470 for a pack of 30 tablets (100 mg) |
| Generic Name | Insulin glargine | Sitagliptin |
| Most Serious Side Effect | Signs of allergic reactions, hypoglycemia, changes at the injection site, potassium levels changing causing muscle cramps or weakness. | Signs of pancreatitis, severe allergic reactions, severe skin reactions, symptoms indicating heart failure. |
| Severe Drug Interactions | Not specified, but interactions with other antidiabetic agents known for causing low blood sugar episodes require monitoring. | Not specified, but caution is advised when used with other medications that can affect kidney function or lower blood sugar. |
| Typical Dose | 0.2 units/kg daily for type 1 diabetes and 10 units (or up to one-third of the total daily dosage) for type 2 diabetes. | 100 mg/day, adjusted based on kidney function. |
What is Toujeo?
Insulin glargine (the generic name for Toujeo) was a significant advancement in the management of diabetes, akin to the introduction of SSRIs in treating depression. It's a long-acting insulin analog that helps control blood sugar levels in individuals with type 1 or type 2 diabetes. Approved by the FDA in 2015, Toujeo works by mimicking your body's natural insulin production, helping glucose enter cells effectively and reducing high blood sugar levels over an extended period.
On the other hand, Sitagliptin (Januvia) is a dipeptidyl peptidase-4 inhibitor approved by the FDA in 2006 for managing type 2 diabetes but not recommended for those with type 1. Januvia enhances pancreatic function resulting in increased insulin release when there is high blood sugar while simultaneously reducing glucagon secretion to prevent further elevation of glucose levels.
While both drugs aim at controlling blood glucose levels, they operate differently - one directly substitutes insulin while another improves its production and reduces excess glucose creation - which may result in varying side effects between patients.
What conditions is Toujeo approved to treat?
Toujeo is approved for the treatment of different variations of diabetes:
- Type 1 diabetes, where the body does not produce insulin
- Type 2 diabetes, where the body does not use insulin properly Januvia on the other hand is only approved for type 2 diabetes to help control blood sugar levels. It works by regulating the levels of insulin your body produces after eating.
How does Toujeo help with these illnesses?
Toujeo aids in the management of type 2 diabetes by mimicking the function of insulin, a hormone that regulates glucose levels in the blood. It accomplishes this through its active ingredient, insulin glargine, which is absorbed slowly and steadily into the bloodstream over 24 hours after injection. This prolonged action helps to maintain more even blood sugar levels throughout the day and night. Glucose is a sugar molecule that acts as fuel for our cells; however, when there's too much glucose (as with untreated diabetes), it can lead to numerous health complications. Therefore, by administering Toujeo and regulating glucose levels, patients can manage their diabetes effectively.
On the other hand, Januvia works differently - it inhibits an enzyme known as DPP-4 which results in increased production of insulin while also reducing the amount of glucose produced by your liver when your blood sugar level is high. This facilitates better regulation of blood sugar levels following meals.
Both medications are used with diet and exercise to improve control over high blood sugar in adults with type 2 diabetes but they operate through different mechanisms within our body's intricate system for managing energy from food intake.
What is Januvia?
Januvia, a brand name for sitagliptin, is an oral diabetes medicine that helps control blood sugar levels. It works by regulating the levels of insulin your body produces after eating and is used in people with type 2 diabetes. Januvia was first approved by the FDA in 2006 and it operates as a DPP-4 inhibitor, controlling high blood sugar which helps prevent kidney damage, blindness, nerve problems, loss of limbs and sexual function issues (common side effects of uncontrolled diabetes).
Its lack of action on insulin production means its side-effect profile is different than that of other anti-diabetic medications such as Toujeo (insulin glargine), particularly in not causing low blood sugar when used alone. The actions on incretins can be beneficial for managing type 2 diabetes especially in patients who do not respond well to other methods like diet and exercise or other medication.
What conditions is Januvia approved to treat?
Januvia is a medication that has been approved for the management of:
- Type 2 diabetes, as it works to regulate blood sugar levels by increasing the amounts of certain natural substances that lower blood sugar.
- It can be used along with diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
How does Januvia help with these illnesses?
Januvia, known generically as sitagliptin, is an oral medication used to treat type 2 diabetes. It works by regulating the levels of insulin your body produces after eating. Januvia belongs to a class of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors that work by increasing the production of two incretin hormones found in the body: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones can help lower blood sugar levels but have a short lifespan due to DPP-4 enzyme breakdown. Sitagliptin works by blocking this enzyme action, thus raising their levels and maintaining their beneficial action for longer periods.
On the other hand, Toujeo is an injectable long-lasting insulin used for controlling high blood sugar in both type 1 and type 2 diabetes patients. It's typically prescribed when oral medications like Januvia do not provide sufficient control over glycemic levels or are contraindicated due to patient-specific factors.
How effective are both Toujeo and Januvia?
Both insulin glargine (Toujeo) and sitagliptin (Januvia) have established histories of success in managing type 2 diabetes, although they were approved by the FDA several years apart, with Januvia being approved first. Since they work differently to control blood sugar levels, they may be prescribed under different circumstances. The effectiveness of Toujeo and Januvia was studied in a head-to-head trial; both drugs showed similar efficacy in controlling HbA1c levels over 26 weeks. In this study, no significant difference was observed between patients receiving Toujeo and those receiving Januvia.
A review on insulin glargine demonstrated that it is effective in reducing fasting plasma glucose from the first week of treatment onwards and has a lower risk for nocturnal hypoglycemia compared to other basal insulins like NPH insulin. Further research indicates that its side effect profile is comparable to or better than many other types of long-acting insulin. As one of the newer generation long-acting insulins developed, there is significant clinical evidence supporting its use in diabetes management.
On the other hand, a meta-analysis indicated that sitagliptin seems more effective than placebo at improving glycemic control without causing weight gain – a common concern with some antidiabetic medications. Nonetheless, while generally well-tolerated as monotherapy or combination therapy with metformin or thiazolidinediones for treating type 2 diabetes mellitus (T2DM), data confirming its efficacy as stand-alone treatment versus combination therapies vary depending on patient characteristics such as baseline HbA1c levels.
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At what dose is Toujeo typically prescribed?
Dosages of Toujeo, an injectable long-acting insulin, can vary significantly based on individual needs. However, it's commonly started at 0.2 units/kg daily for people with type 1 diabetes and 10 units (or up to one-third of the total daily dosage) for those with type 2 diabetes. It should be adjusted according to blood sugar levels and needs.
On the other hand, Januvia is a once-daily oral medication used to control high blood sugar in adults with type 2 diabetes. Its typical starting dose is 100 mg per day taken orally once a day, but this may be reduced depending on kidney function or as directed by your healthcare provider.
In any case of either drug usage, regular monitoring of glucose levels is essential and adjustments should only be made under medical supervision.
At what dose is Januvia typically prescribed?
Januvia treatment for diabetes is typically initiated at a dosage of 100 mg/day, to be taken orally once daily. Depending on the kidney function and response to therapy, this dose can be reduced to 50 mg or even 25 mg per day. It's not recommended to exceed the initial dosage of 100mg/day since greater efficacy is not usually achieved with higher doses. The adjustment in Januvia dosage may take several weeks, based on individual glycemic control response and tolerability. Always remember that any change in diabetes medication regimen should be done under the guidance of a healthcare provider.
What are the most common side effects for Toujeo?
Common side effects associated with Toujeo include:
- Hypoglycemia (low blood sugar)
- Allergic reactions
- Injection site reactions
- Weight gain
- Swelling of hands and feet
- Rash or itching at the injection site
Januvia, on the other hand, may cause side effects such as:
- Upper respiratory tract infection
- Nasopharyngitis (common cold)
- Headache
- Hypoglycemia when used in combination with certain other diabetes drugs -Stomach upset including nausea.
Remember that every individual reacts differently to medications and these lists are not exhaustive. Always consult your healthcare provider for personalized advice.
Are there any potential serious side effects for Toujeo?
While both Toujeo and Januvia are used to manage blood sugar levels in people with diabetes, they may cause different side effects. For users of Toujeo (a long-acting insulin), you might notice:
- Signs of allergic reactions: rash, itching or swelling especially of the face/tongue/throat, severe dizziness, or trouble breathing.
- Hypoglycemia (low blood sugar): symptoms include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness or tingling hands/feet.
- Changes at the injection site (lipodystrophy).
- Potassium levels changing in your body causing muscle cramps or weakness.
On the other hand for Januvia users (an oral antihyperglycemic medication):
- Little or no urinating; painful and difficult urination; swelling in your feet or ankles due to kidney problems.
- Signs of pancreatitis: severe pain in your upper stomach spreading to your back; nausea and vomiting; loss of appetite.
- Symptoms that indicate heart failure: shortness of breath even on mild exertion such as climbing stairs; feeling weak and tired all day long.
In case any such symptoms occur while taking these medications it is important to consult a healthcare professional immediately.
What are the most common side effects for Januvia?
While comparing diabetes medications, it's crucial to be aware of potential side effects. With Januvia, some common side effects include:
- Upper respiratory tract infection
- Headache
- Nausea
- Diarrhea
- Swelling in the legs or feet (edema)
- Low blood sugar (hypoglycemia) when used with certain other diabetes drugs
In addition, Januvia may cause more serious side effects such as pancreatitis and hypersensitivity reactions. As with any medication decision, it's important to weigh these potential risks against the benefits of controlling your blood sugar levels effectively.
Are there any potential serious side effects for Januvia?
While Januvia is generally considered safe, there are potential side effects that require immediate attention:
- Signs of a severe allergic reaction: hives, itching, difficulty breathing or swallowing, swelling in your face or throat
- Severe skin reactions such as blistering and peeling skin accompanied by fever
- Symptoms of pancreatitis including severe stomach pain that spreads to your back with or without vomiting.
- Changes in urination patterns due to possible kidney problems. This could include painful urination, frequent urges to go, little output when you do go, or a pinkish coloration suggesting blood
- Shortness of breath which may indicate heart failure especially if combined with fatigue and weight gain from fluid retention If any of these symptoms occur while taking Januvia it's important to stop the medication immediately and consult with a health professional.
Contraindications for Toujeo and Januvia?
Both Toujeo and Januvia, like other diabetes medications, may cause changes in your blood glucose levels. If you notice an unexpected increase or decrease in your blood sugar readings, please seek medical attention immediately.
Neither Toujeo nor Januvia should be taken if you are undergoing treatment with drugs known as DDP-4 inhibitors or GLP-1 receptor agonists. Always inform your healthcare professional about any medications you are currently taking; these classes of drugs can have harmful interactions with both Toujeo and Januvia.
Furthermore, those who suffer from kidney disease need to exercise caution when using these medicines – particularly Januvia – because they require renal clearance. In such cases, a dose adjustment might be necessary based on the severity of the kidney impairment.
While hypoglycemia is less likely to occur with these two drugs compared to some other diabetes therapies due to their mechanisms of action, it's still a potential risk that requires monitoring. This is especially true for individuals simultaneously using other antidiabetic agents known for causing low blood sugar episodes.
Also noteworthy is that while both medications effectively manage high blood sugar levels associated with type 2 diabetes, they act quite differently: While Toujeo (a long-lasting insulin) helps regulate glucose metabolism around the clock by mimicking natural basal insulin secretion patterns throughout the day and night, Januvia works by increasing hormones that stimulate the pancreas to produce more insulin after meals and signal the liver to stop producing glucose when it isn't needed.
How much do Toujeo and Januvia cost?
For the brand name versions of these drugs:
- The price of a 300-unit pre-filled pen of Toujeo (insulin glargine) averages around $400, which works out to approximately $13-$26/day, depending on your insulin requirements.
- The price for a pack of 30 tablets of Januvia (100 mg) is about $470, working out to approximately $15.70/day.
Thus if you are in the higher dosage range for Toujeo (i.e., more than 20 units per day), then brand-name Januvia may be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you.
There are currently no generic forms available for either Januvia or Toujeo as they're still under patent protection. It's advised to consider all factors including effectiveness, potential side effects and overall health condition when choosing between these two medications. Your healthcare provider can provide guidance based on your specific needs and circumstances.
Popularity of Toujeo and Januvia
Insulin glargine, available as the brand name Toujeo, was estimated to have been prescribed to about 1.8 million people in the US in 2020. Insulin glargine accounted for just over 20% of long-acting insulin prescriptions in the US. It's a basal insulin analog that provides consistent glucose control with once-daily dosing and has generally been increasing in prevalence since its introduction.
Sitagliptin phosphate monohydrate, marketed under the brand name Januvia, was prescribed to around 6 million people in the USA during 2020. In terms of prescription oral medications for type 2 diabetes mellitus (T2DM), sitagliptin accounts for approximately 30% of DPP-4 inhibitor prescriptions and around 10% of overall T2DM oral medication prescriptions. The prevalence of sitagliptin has remained relatively steady over recent years.
Conclusion
Both Toujeo (insulin glargine) and Januvia (sitagliptin) have established records of usage in patients with diabetes, and are backed by numerous clinical studies indicating their effectiveness in managing blood glucose levels. These drugs can be combined under the careful consideration of a physician as they work through different mechanisms; while Toujeo is an insulin-based treatment that lowers blood sugar directly, Januvia works by inhibiting the enzyme DPP-4 to increase the production of insulin and decrease the amount of glucose made by your body.
Toujeo is often used as a first-line therapy for type 1 diabetes or as part of a combination treatment plan for type 2 diabetes. Conversely, Januvia is typically prescribed when lifestyle changes or metformin alone don't adequately control blood sugar levels in people with type 2 diabetes.
Both medications are only available in brand-name form, which may represent higher costs especially for those paying out-of-pocket. While both require consistent monitoring to fine-tune dosages and ensure optimal results, effects from either medication should be noticeable soon after beginning therapy.
The side effect profile differs between these two drugs due to their distinct modes of action: common side effects with Toujeo include hypoglycemia (low blood sugar), allergic reactions at injection site; whereas Januvia's possible adverse effects include upper respiratory infection, headaches, diarrhea. As always though, any persistent concerns should prompt consultation with healthcare professionals.
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Refrences
- Aschner, P., Chan, J., Owens, D. R., Picard, S., Wang, E., Dain, M.-P., … Fonseca, V. (2012, June). Insulin glargine versus sitagliptin in insulin-naive patients with type 2 diabetes mellitus uncontrolled on metformin (EASIE): a multicentre, randomised open-label trial. The Lancet. Elsevier BV.http://doi.org/10.1016/s0140-6736(12)60439-5
- Dhillon, S. (2010, March). Sitagliptin. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11203790-000000000-00000
- Bardsley, J. K., & Ratner, R. E. (2008, November). Sitagliptin: an oral agent for glucose control. Expert Review of Endocrinology & Metabolism. Informa UK Limited.http://doi.org/10.1586/17446651.3.6.691
- 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
- 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