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Can You Take Actos And Januvia Together

Stopping Diabetes Medicines

Stopping Diabetes Medicines

“I want to get off some of these drugs,” Ellen told me. “But my doctor says I need them. I’m on three for glucose, two for blood pressure, and one for depression. They’re costing me hundreds every month. What can I do?” Ellen is a health-coaching client of mine, age 62 with Type 2 diabetes. She works as an executive secretary in an insurance company. It’s stressful. She’s usually there from 8 AM until 6 PM or later and comes home “too tired to exercise.” She mentioned that just “putting herself together” for work every day requires an hour of prep time. “You have to look good for these executives,” she says. I asked about her drugs. She said she takes metformin (Glucophage and others), sitagliptin ( brand name Januvia), and pioglitazone (Actos) for diabetes, lisinopril (Privinil, Zestril) for blood pressure, simvastatin (Zocor) for cholesterol, and paroxetine (Paxil) for depression. Her A1C is now at 7.3%, down from a high of 9.9% a year ago, when she was on only two medicines. “I think the drugs are depressing me,” she said. “The cost, the side effects… I have nausea most days, I have cough from the lisinopril. That doesn’t help at work. I don’t know what’s worse, the drugs or diabetes.” What would you have said to Ellen? Although I strongly believe in reducing drug use, I told her what most experts say, that she can get off some, possibly all diabetes drugs, but it will take a lot of work. Asqual Getaneh, MD, a diabetes expert who writes for Everyday Health, says that doctors want to be “assured that an A1C will stay down” if a person goes off medicines. She says doctors usually won’t reduce medicines until A1C drops below 7.0%. In the ADA publication Diabetes Forecast, pharmacist Craig Williams, PharmD, writes, “Unf Continue reading >>

American Diabetes Association

American Diabetes Association

Author information Copyright and License information Disclaimer The 70th Scientific Sessions of the American Diabetes Association was attended by 13,500 health care professionals and 17,000 individuals from June 25 to 29, 2010, in Orlando, Florida. This article reviews two sessions showing improved glycemic control with sitagliptin (Januvia and Janumet), a subset analysis of the TRINITY trial looking into hypertension in diabetes, and research on an investigational agent (GFT505) used to treat prediabetic patients with metabolic disorders. A Focus on Glycemic Control, Hypertension, and Metabolic Disorders Initial Sitagliptin/Metformin (Janumet) Yields Better Glycemic Control Than Pioglitazone (Actos) Leonid Katz, MD, Endocrinology, Diabetes & Metabolism, Internal Medicine, Merck Research Laboratories, Rahway, N.J. Initial treatment combining sitagliptin and metformin (Janumet, Merck) produced significantly greater improvement in glycemic control and weight loss when compared with initial pioglitazone (Actos, Takeda/Lilly) in patients with type-2 diabetes mellitus. The finding comes from a study of 517 patients who were randomly assigned to receive sitagliptin/metformin, with the dose titrated upward over four weeks to 50/1,000 mg twice daily (n = 261), or pioglitazone, with the dose titrated upward over four weeks to 45 mg once daily (n = 256). At baseline, subjects glycosylated hemoglobin (HbA1c) levels were between 7.5% and 12% (mean 9% for sitagliptin/metformin and 8.9% for pioglitazone); mean fasting plasma glucose (FPG) was 190.6 mg/dL for the sitagliptin/metformin group and 188.9 mg/dL for those receiving pioglitazone. At week 32, the decrease in HbA1c was 1.9% with sitagliptin/metformin and 1.4% with pioglitazone (P < 0.001). In addition, a significantly greater Continue reading >>

Yet Another Problem With Januvia

Yet Another Problem With Januvia

UPDATE (April 2, 2013): Before you take Byetta, Victoza, Onglyza, or Januvia please read about the new research that shows that they, and probably all incretin drugs, cause severely abnormal cell growth in the pancreas and precancerous tumors. You'll find that information HERE. Update (January, 2009) : A much more important problem with Januvia--that it promotes cancer by inhibiting a tumor suppressor gene researchers have called "the trigger for prostate cancer"--is discussed in this more recent blog post: More Research Shows Januvia and Glinides Inhibit Tumor Suppressor Gene DPP-4. Posted Dec 8, 2008. Original Post: If you have had or might get melanoma, ovarian cancer, lung cancer or prostate cancer, please read the above post before making your decision about whether Januvia is for you. Here is the original post that was posted 9/12/08: I have been hearing from people about a new, and, to me, very troubling problem with Januvia. The problem is this: now that doctors have decided that all people recently diagnosed with Type 2 Diabetes should be put on Januvia, prescriptions for the combination drug Janumet, which is made up of both Januvia and Metformin, are becoming much more frequent as a first prescription for diabetes. Metformin is a very safe drug that has been used safely for decades. The most recent follow up to the UKPDS study, the 20 year follow-up, which was just presented at the annual EASD conference found that at 20 years after the start of the study, "Patients treated with metformin had a 21% reduction in risk of any diabetes endpoint (P=0.01), a 30% reduction in risk of diabetes-related death (P=0.01), a 33% reduction in risk of MI (P=0.005), and a 27% reduction in risk of all cause mortality (P=0.002)." Metformin is a very good drug for people with Ty Continue reading >>

Combination Therapy With Dpp-4 Inhibitors And Pioglitazone In Type 2 Diabetes: Theoretical Consideration And Therapeutic Potential

Combination Therapy With Dpp-4 Inhibitors And Pioglitazone In Type 2 Diabetes: Theoretical Consideration And Therapeutic Potential

Combination therapy with DPP-4 inhibitors and pioglitazone in type 2 diabetes: theoretical consideration and therapeutic potential We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Combination therapy with DPP-4 inhibitors and pioglitazone in type 2 diabetes: theoretical consideration and therapeutic potential Sitagliptin and vildagliptin represent a new class of anti-diabetic agents that enhance the action of incretin hormones through inhibition of dipeptidyl peptidase-4 (DPP-4), the enzyme that normally inactivates incretin hormones. Because of their distinct mechanism of action, DPP-4 inhibitors can be used as add-on therapy to other classes of drugs for treatment of type 2 diabetes. The objective of this review is to critically evaluate clinical trials of sitagliptin and vildagliptin in combination with pioglitazone. The addition of either sitagliptin or vildagliptin to ongoing pioglitazone therapy is associated with reduction in average hemoglobin A1c (HbA1c) levels of approximately 0.7% compared with placebo and 1% compared with baseline after 24 weeks. When started concomitantly in drug-nave patients, the combination of pioglitazone 30 mg and vildagliptin 100 mg qd reduces HbA1c by 1.9% after 24 weeks, compared with 1.1% with pioglitazone monotherapy. In general, the addition of DPP-4 inhibitors to pioglitazone was well tolerated, did not increase the incidence of hypoglycemia, and did not substantially worsen the weight-ga Continue reading >>

Januvia

Januvia

JANUVIA® (sitagliptin) Tablets DESCRIPTION JANUVIA Tablets contain sitagliptin phosphate, an orally-active inhibitor of the dipeptidyl peptidase4 (DPP-4) enzyme. Sitagliptin phosphate monohydrate is described chemically as 7-[(3R)-3-amino-1-oxo-4-(2,4,5trifluorophenyl)butyl]-5,6,7,8-tetrahydro-3-(trifluoromethyl)-1,2,4-triazolo[4,3-a]pyrazine phosphate (1:1) monohydrate. The empirical formula is C16H15F6N5O•H3PO4•H2O and the molecular weight is 523.32. The structural formula is: Sitagliptin phosphate monohydrate is a white to off-white, crystalline, non-hygroscopic powder. It is soluble in water and N,N-dimethyl formamide; slightly soluble in methanol; very slightly soluble in ethanol, acetone, and acetonitrile; and insoluble in isopropanol and isopropyl acetate. Each film-coated tablet of JANUVIA contains 32.13, 64.25, or 128.5 mg of sitagliptin phosphate monohydrate, which is equivalent to 25, 50, or 100 mg, respectively, of free base and the following inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, and sodium stearyl fumarate. In addition, the film coating contains the following inactive ingredients: polyvinyl alcohol, polyethylene glycol, talc, titanium dioxide, red iron oxide, and yellow iron oxide. For Consumers What are the possible side effects of sitagliptin (Januvia)? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking sitagliptin and call your doctor at once if you have a serious side effect such as: pancreatitis - severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, fast heart rate; or urinating less than usual Continue reading >>

Actos (pioglitazone)

Actos (pioglitazone)

On April 8, 2014, Takeda were fined $6bn for destroying thousands of documents relating to health data about Actos . Takeda's partner, the pharmaceutical company Eli Lilly, has been fined $3 billion for its part in the cover up. Pioglitazone works by making cells more sensitive to insulin, which is used to regulate the level of glucose in the body. Improving insulin sensitivity (or reducing insulin resistance) makes it easier for sugar (glucose) in the blood to get into the cells. Actos is intended for adults with type 2 diabetes - particularly overweight diabetic patients - who are unable to control their blood sugar levels through diet and exercise alone or the use of metformin and/or a sulphonylurea. It is designed to be used alongside a healthy, balanced diet and regular physical activity. In the UK it is available as a standalone treatment (monotherapy), a dual-oral therapy in combination with metformin, or a triple-oral therapy in combination with metformin and a sulphonylurea. Actos may also be used in combination with insulin for type 2 diabetics who are unable to control their blood sugars on insulin alone or cannot tolerate meformin. Actos should never be used by diabetic patients who: are allergic or sensitive to any of the ingredients in the medicine or other thiazolidinediones have a heart condition, such as heart attack, or a history of heart problems have bladder cancer or history of bladder cancer It is also important to note that Actos is ineffective and possibly harmful in type 1 diabetes . Actos is administered orally with or without food. The drug is available in 15 mg, 30mg and 45mg tablet doses. The correct dosage set by your prescriber is printed on the pharmacy label, along with instructions on how often take your medicine. You should not change Continue reading >>

Two-in-one: Combination Pills

Two-in-one: Combination Pills

Combination Meds What do a Swiss Army knife, Pantene Pro-V Full & Thick 2-in-1 Shampoo+Conditioner, and Glucovance have in common? They're all combination products, designed to save you time, money, or both. Drug companies are introducing more combo medications -- two drugs in one pill -- to take advantage of patent expirations and competition from generics. Glucovance is a combination of glyburide and metformin, two medications that help people with type 2 control blood glucose. Most combination pills deliver just two different types of medicine. Usually the two meds work together to treat one disease in different ways. Some pills contain two drugs to treat conditions that commonly occur together, such as high blood pressure and high cholesterol. Diabetes Combo Pills Actoplus Met: Combines Actos and metformin Avandamet: Combines Avandia and metformin Avandaryl: Combines Avandia and glimepiride Duetact: Combines Actos and glimepiride Glucovance: Combines glyburide and metformin Janumet: Combines Januvia and metformin Metaglip: Combines glipizide and metformin The Upside of Combo Pills Combination diabetes drugs can encourage people to take medications as prescribed -- and can save them money, says Shannon Miller, a professor of pharmacy practice at Albany College of Pharmacy in New York. Typically, insurance companies charge a copay for each prescription received. Combination pills require just one copay, even though you're getting two medications, she says. For Jack (last name withheld to protect privacy), who has type 2 diabetes, switching to combination drugs to control blood glucose, high blood pressure, and high cholesterol cut his number of daily pills from 11 to seven. He saves $40 a month on copays, for an annual savings of $480. Although costs vary based on spe Continue reading >>

A New Combination Diabetes Treatment Could Become The Standard Instead Of Insulin

A New Combination Diabetes Treatment Could Become The Standard Instead Of Insulin

Home / Conditions / Type 2 Diabetes / A New Combination Diabetes Treatment Could Become the Standard Instead of Insulin A New Combination Diabetes Treatment Could Become the Standard Instead of Insulin Study shows significant improvement in diabetes control with a 1 point drop in A1c with less hypoglycemia. With thousands of possible combinations of diabetes drugs, it can be difficult to find the right combination for an individual patient, as no two patients are the same. A study in Diabetes Care showed that patients with poorly controlled type 2 diabetes who received a combination of exenatide and pioglitazone had a threefold lower rate of hypoglycemia, a one-percentage-point greater reduction in A1C and less weight gain than those in the basal-bolus insulin therapy group. Researchers used a cohort of 251 diabetes patients and found that the difference in A1C between the two groups increased from 0.7% at six months to 0.9% at 12 months and 1% at 18 months. The Qatar Study was designed to examine the efficacy of combination therapy with exenatide plus pioglitazone versus basal-bolus insulin in patients with long-standing poorly controlled type 2 diabetes mellitus (T2DM) on metformin plus a sulfonylurea. The study randomized 231 patients with poorly controlled (HbA1c >7.5%, 58 mmol/mol) T2DM on a sulfonylurea plus metformin to receive 1) pioglitazone plus weekly exenatide (combination therapy), or 2) basal plus prandial insulin (insulin therapy) to maintain HbA1c <7.0% (53 mmol/mol). They were randomized to weekly 2-mg/week extended-release exenatide injection plus 15 mg/day of oral pioglitazone titrated up to 30 mg/day or to insulin glargine given at breakfast plus 4 to 6 units of insulin aspart before each meal. The primary end point, difference in HbA1c at 6 months, Continue reading >>

Merck's Januvia Effective In Combination Studies

Merck's Januvia Effective In Combination Studies

Merck's Januvia effective in combination studies * Januvia plus Actos superior to Actos alone * 60 pct of patients reach blood sugar goal vs 28 pct NEW YORK, June 6 (Reuters) - Merck & Co Incs ( MRK.N ) fast growing diabetes drug Januvia proved effective in helping patients lower blood sugar in combination with Takedas Actos, and when used along with insulin therapy, according to data from a pair of clinical trials. In a 497-patient, 24-week study, treatment with Januvia plus Actos as an initial therapy resulted in a 2.4 percent reduction in A1C level compared with a 1.5 percent reduction for patients taking the Takeda Pharmaceutical Co Ltd ( 4502.T ) drug alone, Merck said. The difference was considered to be statistically significant. A1C is a key measure of a persons average blood glucose level over a two- to three-month period. The American Diabetes Association (ADA) guidelines call for A1C levels of 7 percent or less. Type 2 diabetes patients began the trial with A1C levels of 8 percent to 12 percent. Sixty percent of those who received the combination therapy achieved an A1C of less than 7 percent, compared with 28 percent of patients who only took Actos, known chemically as pioglitazone, according to data presented on Saturday at the annual ADA scientific meeting in New Orleans. Januvia, known chemically as sitagliptin, belongs to a new class of diabetes medicines called DPP-4 inhibitors. Actos belongs to the older, widely used thiazolidinedione, or TZD, class of drugs for the growing type 2 diabetes epidemic. Over time most type 2 diabetes patients require multiple drugs to achieve glycemic control, said John Amatruda, Mercks head of diabetes and obesity and one of the studys authors. Amatruda said these studies should show doctors that getting patients to goal Continue reading >>

Do My Husband's Meds Work Against One Another?

Do My Husband's Meds Work Against One Another?

Do My Husband's Meds Work Against One Another? The article in the December 2009 issue about incretins was very interesting. It is the first piece I've read that explains what Byetta and Januvia are supposed to do, in a way I can actually understand!My husband is on an insulin pump and taking Byetta injections as well as Januvia and Actos tablets. Are these all designed to work together, or is one, or more, working against the others?Judy Morgan, Oklahoma City Judy Morgan, Oklahoma City, Oklahoma Craig Williams, PharmD, responds: Questions about combining diabetes medications are increasingly common because so many options now exist. Chronic medical conditions other than diabetes (like heart failure or kidney disease) often play an important role in deciding what combinations of medications are best for a particular patient. Without knowing more about your husband, we cannot give specific advice, but let's consider the four-drug combination that you asked about. Januvia and Byetta belong to related classes of medications. These drugs work on one or more hormones in the gut that affect insulin secretion, appetite, and glucose production by the liver. Actos works differently and improves the effects of insulin in different areas of the body. All of these effects potentially complement insulin action, and it is reasonable to combine any of them with insulin. However, I wouldn't say the combination of all three agents plus insulin is common, especially since Januvia and Byetta have somewhat overlapping effects. There may not be much benefit to using Januvia and Byetta together. But certain combinations work well for certain patients. In its approvals of Actos, Januvia, and Byetta, the Food and Drug Administration said there was not enough data to routinely recommend that an Continue reading >>

Metformin, Glipizide, Januvia, And Actos Related Questions

Metformin, Glipizide, Januvia, And Actos Related Questions

Metformin, Glipizide, Januvia, and Actos Related Questions Metformin, Glipizide, Januvia, and Actos Related Questions A friend's father (age 70+) is taking all of those drugs, and I wonder if that's a dangerous mix. I read about them today, and it seems Actos is the worst, followed by Glipizide. I also read in an older thread here that it's dangerous to take Actos and Januvia together. Why is that? Is that an unwelcome combination only for causing weight gain? He thinks one of these drugs is raising his cholesterol levels, but I didn't find it mentioned among the side-effects of any of them. I think only Actos could be a potential suspect, although some studies show it may lower cholesterol. What do you think? He is mildly anemic with no apparent reason. I've seen it mentioned many times here that Metformin depletes vitamin B12, but his B12 is within the lab ranges. I don't really trust many of those ranges, so I think he could still be B12 deficient with a result of 432 (211 - 946). Need to ask if he is supplementing with B12. Continue reading >>

Januvia

Januvia

are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or excessive heat exposure Serious urinary tract infections (UTI), some that lead to hospitalization, occu Continue reading >>

Actos And Januvia Drug Interactions - Drugs.com

Actos And Januvia Drug Interactions - Drugs.com

Do not stop taking any medications without consulting your healthcare provider. Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist. Some mixtures of medications can lead to serious and even fatal consequences. Continue reading >>

Best Treatments For Type 2 Diabetes

Best Treatments For Type 2 Diabetes

At-a-glance Six classes of oral medicines (and 12 individual drugs) are now available to help the 25.8 million people in the U.S. with type 2 diabetes control their blood sugar when diet and lifestyle changes are not enough. Our evaluation of these medicines found the following: Newer drugs are no better. Two drugs from a class called the sulfonylureas and a drug named metformin have been around for more than a decade and work just as well as newer medicines. Indeed, several of the newer drugs, such as Januvia and Onglyza, are less effective than the older medications. Newer drugs are no safer. All diabetes pills have the potential to cause adverse effects, both minor and serious. The drugs’ safety and side effect “profiles” may be the most important factor in your choice. The newer drugs are more expensive. The newer diabetes medicines cost many times more than the older drugs. Taking more than one diabetes drug is often necessary. Many people with diabetes do not get enough blood sugar control from one medicine. Two or more may be necessary. However, taking more than one diabetes drug raises the risk of adverse effects and increases costs. Taking effectiveness, safety, adverse effects, dosing, and cost into consideration, we have chosen the following as Consumer Reports Best Buy Drugs if your doctor and you have decided that you need medicine to control your diabetes: Metformin and Metformin Sustained-Release — alone or with glipizide or glimepiride Glipizide and Glipizide Sustained-Release — alone or with metformin Glimepiride — alone or with metformin These medicines are available as low-cost generics, costing from $4 to $35 a month. If you have been diagnosed with diabetes, we recommend that you try metformin first unless it's inappropriate for your hea Continue reading >>

Alternatives For Januvia

Alternatives For Januvia

Januvia is a brand name for an oral anti-hyperglycemic drug that lowers blood sugar or glucose levels. This prescription medication contains the active ingredient sitagliptin and belongs to a class of drugs called dipeptidyl peptidase-4 inhibitors. Januvia is taken once a day and works to regulate blood sugar levels in type 2 diabetics in two ways. Januvia.com notes that it helps increase the levels of insulin produced by the pancreas. Insulin is a hormone that is necessary to carry glucose from the blood into the cells of the body, where it can be used. Januvia also decreases blood glucose levels by decreasing the amount of glucose made by the liver. Like all medications, Januvia can cause side effects and may not be suitable for all patients. There are several alternative medications for treating type 2 diabetes. Video of the Day Metformin is commonly sold under the brand name Glucophage and is in the biguanide class of drugs. It is the most popularly prescribed medication and often the first line of treatment for patients with type 2 diabetes. Drugs.com notes that metformin works by reducing blood glucose levels as well as by heightening the sensitivity of body cells to the hormone insulin. Metformin is sometimes prescribed in combination with other diabetes medications or insulin. In individuals with pre-diabetes or a risk of becoming diabetic, metformin is often prescribed as a preventative measure, along with nutritional and exercise therapies. Glyburide is a medication in a class of diabetes drugs called sulfonylureas. These drugs bind to receptors on the beta cells of the pancreas to stimulate more production of insulin. DiabetesNet.com notes that sulfonylurea medications have been used for the treatment of diabetes for many years and are often prescribed with m Continue reading >>

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