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Trulicity vs Januvia
Introduction
In managing type 2 diabetes, certain drugs that influence the body's glucose regulation can help in maintaining balanced blood sugar levels and reducing complications. Trulicity (dulaglutide) and Januvia (sitagliptin) are two such medications commonly prescribed for this condition. Both work on different hormonal pathways to manage blood sugar levels but serve a common purpose of helping patients with type 2 diabetes maintain control over their condition. Trulicity is a glucagon-like peptide-1 (GLP-1) receptor agonist, which mimics the function of GLP-1 hormone in the body promoting release of insulin after meals and suppressing excess glucose production by liver. On the other hand, Januvia falls under DPP-4 inhibitor class; it works by blocking an enzyme called dipeptidyl peptidase 4 (DPP-4), which results in increased level of incretin hormones that stimulate insulin secretion while inhibiting glucagon secretion.
Trulicity vs Januvia Side By Side
| Attribute | Trulicity | Januvia |
|---|---|---|
| Brand Name | Trulicity | Januvia |
| Contraindications | Should not be used if taking insulin or have a history of pancreatitis. Not recommended for individuals with kidney disease or inflammatory bowel diseases. | Should not be used if taking insulin or have a history of pancreatitis. Not recommended for individuals with severe renal insufficiency without dose adjustment. |
| Cost | Around $800 for 4 pens (1.5mg each), approximately $200–400/month depending on dose | Around $470 for 30 tablets (100 mg), approximately $15/day |
| Generic Name | Dulaglutide | Sitagliptin |
| Most Serious Side Effect | Severe allergic reactions, pancreatitis, kidney problems, symptoms of low blood sugar | Serious allergic reactions, pancreatitis, kidney function abnormalities, severe joint pain |
| Severe Drug Interactions | Combining with certain other diabetes medicines can increase the risk for low blood sugar episodes. | Not specifically mentioned, but as with any medication, combining with other drugs without consulting a healthcare provider can lead to adverse effects. |
| Typical Dose | Starts at 0.75 mg once a week, can be increased to 1.5 mg once a week | 100 mg/day, adjusted to 50 mg/day for moderate kidney impairment and 25 mg/day for severe renal insufficiency |
What is Trulicity?
Dulaglutide (the generic name for Trulicity) is a glucagon-like peptide-1 (GLP-1) receptor agonist approved by the FDA in 2014. This type of drug mimics the effect of natural hormones in your body to stimulate insulin production and inhibit glucagon, helping to regulate blood sugar levels. It requires only once-weekly subcutaneous injection, making it easier for patients with Type 2 diabetes who struggle with daily medication adherence.
On the other hand, Sitagliptin (Januvia's generic name), is a dipeptidyl peptidase-4 (DPP-4) inhibitor that was first approved by the FDA in 2006. Januvia works by blocking DPP-4 enzyme action, thereby increasing incretin hormone levels which stimulate insulin release and decrease glucagon secretion.
While both medications help to control high blood sugar levels associated with type 2 diabetes, they do so through different mechanisms and have differing side effects profiles due to their specific metabolic pathways.
What conditions is Trulicity approved to treat?
Trulicity and Januvia are both approved for the treatment of type 2 diabetes mellitus in adults:
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Trulicity, a glucagon-like peptide-1 (GLP-1) receptor agonist, is used to improve glycemic control as an adjunct to diet and exercise. It can be used alone or with other antidiabetic therapies excluding GLP-1 receptor agonists.
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Januvia operates by inhibiting DPP4 enzymes which results in increased levels of incretin hormones (GLP-1 and GIP). This leads to reduced glucose production by the liver and improved beta-cell function.
How does Trulicity help with these illnesses?
Trulicity aids in the management of type 2 diabetes by mimicking the effects of GLP-1, a hormone that is naturally produced in your intestines. This hormone works to regulate your blood sugar levels by stimulating insulin production when glucose levels rise, and also reducing the amount of glucose produced by your liver. By acting like GLP-1, Trulicity helps increase insulin production after meals, thereby helping maintain better control over blood sugar levels throughout the day. On top of this, it slows down digestion which can help with weight loss - a major concern for many people with type 2 diabetes.
On the other hand, Januvia operates somewhat differently though it too manages type 2 diabetes. It inhibits an enzyme called DPP-4 that breaks down naturally occurring GLP-1. Inhibiting DPP-4 allows for more active GLP-1 to remain in the body longer which leads to increased insulin release and decreased glucagon concentrations resulting in reduced glucose production by the liver.
Both medications work on maintaining proper blood sugar level but their modes of action are distinctively different allowing physicians flexibility based on individual patient needs.
What is Januvia?
Januvia, also known as sitagliptin, is a medication used to treat type 2 diabetes by inhibiting the enzyme DPP-4. This inhibition results in increased levels of incretin hormones in the body, which help regulate insulin production after eating. It was first approved by the FDA in 2006. As Januvia does not directly stimulate the release of insulin, it does not promote weight gain and has a lower risk for causing hypoglycemia compared to other drugs that increase insulin production or secretion. However, like all medications it can have side effects - common ones include upper respiratory tract infection and headache. The effects of Januvia on blood sugar regulation can be particularly beneficial for patients who do not respond well to traditional diabetes treatments such as metformin.
What conditions is Januvia approved to treat?
Januvia is a DPP-4 inhibitor approved for the treatment of:
- Type 2 diabetes mellitus This medication should be used as part of an overall lifestyle intervention plan including diet and exercise to improve control over blood sugar levels. It works by increasing levels of natural substances that lower blood sugar when it's high. Januvia can be used alone or with other medications like metformin or a sulfonylurea.
How does Januvia help with these illnesses?
Januvia is a medication that operates by regulating insulin levels in the body, particularly following meals. Its active substance, sitagliptin, inhibits an enzyme known as DPP-4 which breaks down hormones called incretins. Incretins assist the pancreas to produce more insulin when it's needed and reduce the amount of glucose being produced and released by the liver when it isn't necessary. By preventing breakdown of these incretins, Januvia helps manage blood sugar levels in type 2 diabetes patients effectively.
While Trulicity also aims at controlling blood sugar levels in diabetic patients, its mechanism differs from Januvia as it works by mimicking a hormone named GLP-1 rather than inhibiting its breakdown like Januvia does. Therefore, if a patient doesn’t respond well to GLP-1 agonists such as Trulicity or needs their medicine administered orally instead of through injections like Trulicity requires, then they might be prescribed DPP-4 inhibitors like Januvia.
How effective are both Trulicity and Januvia?
Both dulaglutide (Trulicity) and sitagliptin (Januvia) are effective drugs for managing type 2 diabetes, with their approvals by the FDA only a few years apart. Each medicine works differently in addressing blood sugar levels, which means they may be prescribed under varied circumstances. A head-to-head study conducted in 2016 revealed that both Trulicity and Januvia effectively managed blood glucose levels, however, patients receiving Trulicity showed a greater reduction in HbA1c (a long-term measure of blood glucose control) compared to those on Januvia.
An extensive review of meta-analyses reports on dulaglutide demonstrated its effectiveness at reducing HbA1c levels from the first week of treatment. It has a favorable side effect profile compared to many other antidiabetic medications and is well-tolerated even among elderly populations or those with renal impairment. The optimal dose varies based on individual patient needs but generally starts at 0.75mg once weekly.
As per a review and meta-analysis conducted in 2020, sitagliptin appears more effective than placebo in managing type-2 diabetes as it offers moderate reductions in HbA1c levels when used alone or along with metformin - another commonly prescribed antidiabetic drug. Though not typically considered as potent as some GLP-1 receptor agonists like Trulicity, Januvia's oral administration might make it an appealing choice for those who prefer pills over injections. Furthermore, its unique mechanism of action makes it suitable for patients who need additional glycemic control without risking hypoglycemia or weight gain.
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At what dose is Trulicity typically prescribed?
Dosages of Trulicity start at 0.75 mg once a week and can be increased to 1.5 mg once a week if blood sugar levels have not adequately decreased after starting the medication. The injection is done subcutaneously, preferably on the same day each week. On the other hand, Januvia is taken orally with dosages ranging from 25-100mg/day depending on kidney function status. Most people with type 2 diabetes are started with doses of 100mg/day but this may need adjusting based on the patient's response and tolerance after initiation of treatment. In both cases, regular monitoring of blood glucose levels is important in managing dosage adjustments.
At what dose is Januvia typically prescribed?
Januvia treatment typically begins at a dosage of 100 mg/day, taken once daily. The dose can be reduced to 50 mg/day if the patient has moderate kidney impairment and further decreased to 25 mg/day in case of severe renal insufficiency. This medication is taken orally with or without food. A medical professional should evaluate the effectiveness and side effects of Januvia after several weeks, which may result in changing the dose as appropriate. Always remember that maximum benefit from Januvia therapy is achieved when it's combined with a healthy diet and regular exercise regimen.
What are the most common side effects for Trulicity?
Common side effects of Trulicity may include:
- Nausea
- Diarrhea
- Vomiting
- Abdominal pain or discomfort
- Decreased appetite
- Fatigue (general weakness and fatigue)
- Dyspepsia (burning, discomfort, or pain in the digestive tract)
On the other hand, common side effects for Januvia can be:
- Upper respiratory infection
- Nasal congestion
- Sore throat (pharyngitis)
- Headache -Stomach upset and diarrhea
Patients should consult their healthcare provider if they experience any of these symptoms while taking these medications.
Are there any potential serious side effects for Trulicity?
While both Trulicity and Januvia are medications used to manage type 2 diabetes, they can have different side effects. On rare occasions, Trulicity may lead to:
- Signs of severe allergic reactions such as hives, difficulty breathing or swelling in your face, lips, tongue or throat
- Severe pain in the stomach area that may spread towards your back with or without vomiting; these could be symptoms of pancreatitis
- Rapid weight loss
- Rapid heartbeat and tremors
- Kidney problems including increased urination, swelling in your feet or ankles and feeling tired
- Symptoms indicative of low blood sugar levels like dizziness or light-headedness, blurred vision, anxiety behavior changes including mood swings
Meanwhile for Januvia:
- Rare but serious allergic reaction signs - skin rash (hives), itching on palms and soles followed by blistering/peeling skin disease (Stevens-Johnson syndrome). Swelling of the face/lips/tongue/throat which might cause trouble swallowing/breathing. -Acute pancreatitis: persistent abdominal pain sometimes radiating to the back usually accompanied by nausea/vomiting. -Kidney function abnormalities characterized by change in urine quantity/color/smell etc., leg/ankle swellings.
In case you notice any unusual symptoms while taking either medication please stop using them immediately and seek medical help. It's also crucial to remember that every individual reacts differently to medication. Always consult with a healthcare professional before making any decisions about medication adjustments.
What are the most common side effects for Januvia?
Januvia, a medication for type 2 diabetes, may cause side effects in some individuals. These can include:
- Upper respiratory tract infection
- Headache
- Nausea or vomiting, leading to loss of appetite
- Stomach pain or discomfort
- Constipation or diarrhea
- Rash
- Joint pain While these are common side effects, it's essential to note that not everyone will experience them and they often subside as your body adjusts to the medication. More severe but less common symptoms could be pancreatitis (severe stomach pain), allergic reactions like hives, swelling of face/lips/tongue/throat which could cause difficulty in breathing or swallowing. If any such serious symptom arises one should immediately seek medical attention.
Are there any potential serious side effects for Januvia?
While Januvia is generally well tolerated, it does carry a risk of certain side effects. It's important to be aware and informed about these potential adverse reactions:
- Signs of serious allergic reaction: rash or hives; itching; difficulty breathing or swallowing; swelling in your face, lips, tongue, throat or hands.
- Symptoms indicative of pancreatitis: severe abdominal pain that may radiate to your back and accompanied by nausea and vomiting.
- Changes in urination: increased frequency, painful urination or blood in the urine – these could indicate kidney problems.
- Severe joint pain
- Unexplained skin blisters
If you experience any such symptoms after starting on Januvia, consult your healthcare provider immediately. Don't ignore signs that something might be wrong. Your health comes first!
Contraindications for Trulicity and Januvia?
Both Trulicity and Januvia, along with most other antidiabetic medications, may cause hypoglycemia (low blood sugar) in some people. If you notice symptoms such as shakiness, sweating or confusion which could be indicative of low blood sugar levels, please seek immediate medical attention.
Neither Trulicity nor Januvia should be used if you are taking insulin or have a history of pancreatitis. Always tell your doctor which medications you are currently on; combining these drugs with certain other diabetes medicines can increase the risk for low blood sugar episodes.
It's important to also note that both these medicines carry potential risks if taken by individuals with kidney disease or those who suffer from inflammatory bowel diseases due to their possible gastrointestinal effects. It is crucial that all health considerations be discussed fully with your healthcare provider before starting treatment with either Trulicity or Januvia.
How much do Trulicity and Januvia cost?
For the brand name versions of these drugs:
- The price of 4 pens (1.5mg each) of Trulicity averages around $800, which works out to about $57 per pen or approximately $200–400/month depending on your dose.
- The price for 30 tablets of Januvia (100 mg) is around $470, equating to approximately $15/day.
Thus, if you are in the higher dosage range for Trulicity (i.e., 3 mg/week), then brand-name Januvia can be less expensive on a monthly treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
As it stands currently, there are no generic alternatives available for either Trulicity (dulaglutide) or Januvia (sitagliptin). Both medications have patent protection that prevents cheaper generics from being manufactured and sold. Therefore, patients may need to consider other factors such as side effects, effectiveness and individual health circumstances when deciding between these two medications.
Popularity of Trulicity and Januvia
Dulaglutide, under the brand name Trulicity, was estimated to have been prescribed to about 2.5 million people in the US in 2020. It accounted for just over 6% of total prescriptions for Type-2 diabetes management medications. Dulaglutide is classified as a GLP-1 receptor agonist and has seen a steady surge in prevalence since its approval by the FDA in 2014.
Sitagliptin, also known as Januvia, was prescribed to an estimated number of nearly 8 million people in the USA during that same year. Sitagliptin holds about a fifth of all DPP-4 inhibitor prescriptions and around 9% of overall antidiabetic medication prescriptions. The use of sitagliptin has remained more or less steady over the past decade since it received FDA approval back in 2006.
Conclusion
Both Trulicity (dulaglutide) and Januvia (sitagliptin) have proven their efficacy in managing type 2 diabetes, supported by extensive clinical studies indicating that they help to lower blood glucose levels more effectively than placebo treatments. Both drugs can be used as monotherapy or added to other diabetes medications depending on individual patient needs. They work through different mechanisms of action: Trulicity is a glucagon-like peptide-1 (GLP-1) receptor agonist that stimulates insulin production in response to meals, while Januvia inhibits the dipeptidyl peptidase 4 enzyme, thus increasing the levels of incretin hormones which also stimulate insulin release.
Trulicity is administered via injection once a week, whereas Januvia comes in tablet form and is taken daily. This difference may affect patient preference due to convenience factors.
In terms of cost considerations, both are brand-name drugs with no generic equivalents available at present time; therefore out-of-pocket expenses can be significant for patients without insurance coverage.
The side effect profile is similar between these two medications – mostly gastrointestinal disturbances such as nausea and diarrhea - but Trulicity has been associated with weight loss which could benefit overweight or obese individuals with Type 2 Diabetes. It's crucial for patients initiating treatment on either drug to monitor their blood glucose regularly and report any unusual symptoms immediately.
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Refrences
- Nauck, M., Weinstock, R. S., Umpierrez, G. E., Guerci, B., Skrivanek, Z., & Milicevic, Z. (2014, July 12). Efficacy and Safety of Dulaglutide Versus Sitagliptin After 52 Weeks in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-5). Diabetes Care. American Diabetes Association.http://doi.org/10.2337/dc13-2761
- 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
- Scheen, A. J. (2016, February 6). Dulaglutide (LY-2189265) for the treatment of type 2 diabetes. Expert Review of Clinical Pharmacology. Informa UK Limited.http://doi.org/10.1586/17512433.2016.1141046
- Thompson, A., & Trujillo, J. (2016, May). Advances in the treatment of type 2 diabetes: impact of dulaglutide. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. Informa UK Limited.http://doi.org/10.2147/dmso.s75452
- 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