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4RX Store > Medication List > Diabetes drugs > Order Januvia online

Diabetes Medication (Januvia)

Generic name:
Brand name:
Januvia is a brand of Merck. The active agent of the medication is Sitagliptin. It helps managing blood sugar level in type 2 diabetes when the first-line measures such as diet and physical exercising as well as the use of metformin do not provide the expected effect. The medication can be used alone or with other antidiabetic medications if their effect is insufficient. However, some medications require dosage adjustments as a part of combination therapy. Find out how and when to use the medication from the whole guide below.
Diabetes type 2 monotherapy, Diabetes type 2 complex therapy
The medication lowers blood sugar level through other mechanisms than the other antidiabetic drugs which makes it safe and effective addition to the first-line therapy
MSD Pharmaceuticals - Be well
MSD Pharmaceuticals - Be well
Sitagliptan, Xelevia
Januvia (Generic Sitagliptin)
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  Generic Medication guide:

What is Januvia and when is it appointed?

Januvia is a brand owned by the American drug maker Merck. The basis for this product is Sitagliptin, an oral hypoglycemic agent. It is also sold under other names when made by different companies. You can buy Januvia cheaper if you opt for another manufacturer.

Short drug info
Trade names Januvia, Tesavel, Xelevia, others
Pregnancy category
AU: B3

US: B (No risk in non-human studies)
Routes of administration by mouth (tablets)
Legal status
AU: S4 (Prescription only)

UK: POM (prescription-only)

US: Rx-only
Bioavailability 87%
Protein binding 38%
Metabolism Liver (CYP3A4- and CYP2C8-mediated)
Elimination half-life 8 to 14 hours
Excretion Kidney (80%)

Sitagliptin is a selective suppressor of the enzyme dipeptidyl peptidase-4 (DPP-4), designed for the management of type 2 diabetes. Sitagliptin differs in structure and action from other antidiabetic medications. By suppressing DPP-4, it raises the level of the incretin family hormones: GLP-1 and glucose-dependent peptide (HIP). These hormones family are produced in the bowel during the day, their level increases as a reaction to food intake.

GLP-1 also helps suppress the increased production of glucagon by the pancreas. A drop in glucagon concentration with an elevation in insulin levels contributes to a diminished glucose formation in the liver, which leads to a diminishing of the blood sugar.

Property Name
Property Value
Molecular Weight 407.31 g/mol
Hydrogen Bond Donor Count 1
Hydrogen Bond Acceptor Count 10
Rotatable Bond Count 4
Heavy Atom Count 28
Complexity 566
Defined Bond Stereocenter Count 1
Undefined Bond Stereocenter Count 0
Compound Is Canonicalized yes

At a low level of blood sugar, the indicated effects of incretins on insulin and glucagon production are not observed. GLP-1 and HIP do not affect glucagon release in response to hypoglycemia. The principle of Sitagliptin effect is different from the mechanism of sulfonylurea, which promotes an elevated production of insulin, even when sugar levels are low, and can lead to the lowering of sugar below the norm.

Indications for use of Januvia

The medication is indicated to improve blood sugar control:

- As single-drug therapy: when an individual’s condition is not properly controlled using only diet and physical activity and when metformin cannot be used through intolerances;

- As a part of two-drug therapy in combination with:

a) Metformin, when diet and physical activity with metformin alone do not render sufficient glycemic control;

b) Sulfonylureas, when diet and physical activity with the maximum tolerated dose of sulfonylureas do not render sufficient glycemic control and when metformin cannot be appointed because of intolerance;

c) PPAR agonist (i.e., thiazolidinediones) when the use of the first-line medications is unsuitable and when diet and exercise with a PPAR agonist alone render sufficient glycemic control;

- As a part of triple therapy with:

a) Sulfonylurea and metformin;

b) PPAR agonist and metformin.

Prohibitions for Sitagliptin use:

- Hypersensitivity,

- Type 1 diabetes,

- Diabetic ketoacidosis,

- Pregnancy, lactation,

- Childhood and adolescence (up to 18 years).

You can buy Sitagliptin and use it with care if your doctor approves in chronic renal failure.

Management with diabetes with Sitagliptin

You should know that diabetes cannot be successfully managed only with the use of pills. The first-line measures to normalize blood sugar are low-carb diet and exercising. In case you are overweight, it is necessary to lose weight. If you fail to follow your physician’s recommendations, single or even combined medications cannot guarantee that you won’t develop compilations and will have to go to a hospital for intensive care treatment.

It is advised to take the formulation in a dosage of 100 mg once per day as a single-medication therapy or with metformin and/or a PPAR agonist (for instance, thiazolidinediones).

During the course with sulfonylurea or insulin, lower dosages of these medicines are appointed.

If you missed an intake, the dose should be taken as soon as possible once remembered. But note that double dosage must not be taken in a single day so if it’s almost time for the new intake, skip the missed dosage.

The pills can be used at any time with or without food.

Patients with impaired kidney function

Since the dose is based on the kidneys function, it is advised to assess their function prior to starting the course and periodically during treatment. - Individuals with mild kidney failure do not need dosage lowering. For individuals with moderate kidney failure, the dosage dose is 50 mg once a day.

- For individuals with severe kidney failure, including those who need hemodialysis, the dosage is 25 mg once daily.

Patients with liver failure

No dosage lowering is required for individuals with mild to moderate kidney function impairment. The therapy of individuals with severe kidney failure has not been studied, therefore caution is necessary.


Even a single dose of 800 mg of the medication is generally well tolerated. Although it can cause insignificant changes in the QT interval, no danger for the health is observed. In case of excessive dosage intake, standard supportive measures are necessary: removal of the unabsorbed medication from the digestive tract, control over the vital signs, including ECG, as well as maintenance therapy, if necessary.

Januvia adverse effects

When you buy generic Sitagliptin, you should know that like any other medication it can cause certain adverse reactions:

- Abdominal pain, nausea, vomiting, diarrhea, acute pancreatitis;

- Hyperuricemia, leukocytosis due to an elevation in the number of neutrophils.

Januvia interactions

The formulation can be used with other antidiabetic and other medications. In general, it interacts positively with any medications but sometimes dosage adjustments are required to avoid developing hypoglycemia (a drop of blood sugar below the norm).

Consult your physician if you plan to buy generic Sitagliptin and combine its use with other substances.

Peculiarities of use

- Acute pancreatitis: the use of the formulations from this class is associated with a risk of acute pancreas inflammation. In case of occurrence of persistent, severe abdominal pain you must immediately inform your physician. Usually, after the discontinuation of the medication use, the symptoms disappear.

- Allergy: In case of suspicion of an allergic reaction, the use of medication must be discontinued, other potential causes of the particular phenomenon should be assessed, and alternative therapy for diabetes should be determined.

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