Glucose Control with Sitagliptin Phosphate
Sitagliptin generic phosphate (Januvia, Merck), the first diabetes treatment approved in a new class of drugs known as DDP-4 inhibitors, enhances the body’s own ability to lower elevated blood glucose levels.
The FDA approved the tablets for use in addition to diet and exercise to improve blood sugar levels in patients with type-2 diabetes; the drug can be used alone or in combination with two other oral diabetes medications: metformin generic (Glucophage, Bristol-Myers Squibb) or a peroxisome proliferator-activated receptor gamma (PPAR) agonist when either of these drugs alone do not provide adequate blood glucose control.
Januvia decreases the amount of sugar made by the body. It is unlikely to cause hypoglycemia because it does not work when blood glucose levels are low. It prolongs the activity of proteins that increase the release of insulin after blood glucose levels rise, such as after a meal. It blocks an enzyme (dipeptidyl peptidase IV or DPP-IV), which breaks down these proteins, leading to better blood sugar control.
Januvia drug was evaluated in 2,719 patients, but it has not been studied in children under 18 years of age or with medications that cause low blood sugar, such as sulfonylureas and insulin.
It should not be used for patients with type-1 diabetes mellitus or diabetic keto-acidosis.
The usual dose is 100 mg daily. Re-nally impaired patients may need a reduction in dose to either 50 mg or 25 mg.
