Januvia vs Zituvio: What's the difference?
Januvia and ZITUVIO are medications designed to manage blood sugar levels in people with type 2 diabetes. Both contain an active ingredient called Sitagliptin. Januvia gained approval from the Food and Drug Administration (FDA) on October 16, 2006, while ZITUVIO received its approval more recently on Oct 20, 2023.
The approval of ZITUVIO is particularly noteworthy due to recent concerns raised by the FDA in 2022. The agency found nitrosamine impurities, specifically Nitroso-STG-19 (known as NTTP), in certain samples of sitagliptin. Nitrosamines are a class of compounds that have been classified as probable or possible human carcinogens, meaning they can potentially cause cancer. Merck, the manufacturer of Januvia, is actively investigating this contamination issue.
Before receiving approval, ZITUVIO underwent thorough quality testing to ensure it was free from these potential carcinogens.
The approval of ZITUVIO provides an alternative treatment option for individuals with type 2 diabetes, addressing concerns about potential carcinogenic impurities found in some sitagliptin-based medications.
DPP-4 Inhibitors: How They Work
Januvia and ZITUVIO fall into a class of medications known as dipeptidyl peptidase-4 inhibitors, often abbreviated as DPP-4 inhibitors or referred to as “gliptins.”
These drugs function by inhibiting the activity of an enzyme called DPP-4. This enzyme is responsible for breaking down incretin hormones, such as GLP-1 (glucagon-like peptide-1). By inhibiting DPP-4, Januvia and ZITUVIO extend the action of GLP-1, a hormone that triggers insulin secretion from the pancreas in response to high blood sugar levels.
Moreover, DPP-4 inhibitors also decrease the secretion of glucagon, a hormone that typically elevates blood sugar levels. This dual action helps to regulate blood sugar levels in individuals with diabetes.
Administration and Dosing
Both Januvia and ZITUVIO are available in tablet form in 25, 50, and 100 mg, with the typical dose being 100 mg. They are taken by mouth, once daily, with or without food.
Side Effects
Common side effects shared by Januvia and ZITUVIO may include:
- Headache
- Nausea
- Diarrhea
- Upper respiratory tract infections (a common cold)
- Sore throat
- Stuffy or runny nose
- Muscle or joint pain
- Back pain
These side effects are generally mild and may not occur in every individual taking the medication.
Serious Side Effects
Shared serious side effects:
- Severe autoimmune reactions, such as itching and blisters
- Severe or ongoing joint pain
- Symptoms of heart failure, including shortness of breath, swelling in the legs or feet, and rapid weight gain
- Symptoms of severe skin reactions, such as fever, sore throat, burning sensation in the eyes, skin pain, or a red or purple rash that spreads and leads to blistering and peeling
Januvia Specific Side Effects:
- Hypoglycemia (low blood sugar), with symptoms like confusion, dizziness, fatigue, increased heartbeat, headache, hunger, irritability, sweating, and weakness
- Pancreatitis or inflammation of the pancreas, characterized by persistent and severe stomach pain.
ZITUVIO Specific Side Effects:
- Stomach pain, diarrhea, nausea, and/or vomiting
- Fever
- Little or no urination
- Symptoms of pancreatitis, such as severe upper stomach pain spreading to the back, with or without vomiting
If you experience any of these serious side effects, immediately call your doctor and stop taking the medication. Additionally, if you experience any common side effects, discuss them with your healthcare provider to determine if a dose adjustment or switching to a different medication is necessary.
Who Should Not Use DPP-4 Inhibitors
Individuals with type 1 diabetes should avoid the use of DPP-4 inhibitors, including Januvia and ZITUVIO.
Avoid using DPP-4 inhibitors if you have a history of pancreatitis.
Minimize alcohol consumption while taking a DPP-4 inhibitor. Combining alcohol with a DPP-4 inhibitor can result in dangerously low blood sugar levels and potentially increase the risk of pancreatitis. If you consume alcohol regularly and find it challenging to abstain completely, it is advisable to consult with your doctor for guidance.
Interactions
Avoiding the use of Januvia with medications that could heighten the risk of specific side effects is recommended. For instance, beta-blockers like Metoprolol and Propranolol, as well as eye drops used for glaucoma containing Timolol, are among the medications that may interact with Januvia and increase the risk of adverse effects.
Similarly, ZITUVIO, another DPP-4 inhibitor, may also interact with certain medications or supplements, potentially affecting blood sugar control. It is essential to discuss all medications and supplements with your healthcare provider before starting ZITUVIO treatment.
Cost
Januvia: The price of Januvia can fluctuate based on various factors, including dosage, pharmacy location, and insurance coverage. Generally, without insurance or discounts, Januvia typically falls within the range of $500 to $700 for a one-month supply. However, actual prices may vary.
ZITUVIO: ZITUVIO, available exclusively through Marley Drug, offers a more affordable option for individuals seeking DPP-4 inhibitor medication. Through a partnership between Marley Drug and Zydus Lifesciences, ZITUVIO is priced at a cash rate of $80 per month. This exclusive pricing arrangement reflects the commitment of both companies to ensure that essential medications are accessible and affordable for all Americans
Speak With Your Doctor
Speaking with your doctor about using either Januvia or ZITUVIO for your type 2 diabetes is important due to individual variability in treatment response, potential side effects, and medical history considerations.
Your doctor can assess factors such as your health, medication regimen, and any existing conditions to determine which medication may be most appropriate for you.
Identifying the most appropriate medication is important in optimizing diabetes management, minimizing risks, and improving overall health outcomes tailored to your specific needs and circumstances.