Januvia Vs. Ozempic®: Drug Comparison

Januvia^® (sitagliptin) is an oral medication used to manage type 2 diabetes by inhibiting the enzyme DPP-4, which increases the levels of incretin hormones that stimulate insulin release and reduce sugar production in the liver. Its FDA-approved indication is for improving blood sugar control in adults with type 2 diabetes, typically in combination with diet and exercise. Januvia is available in tablet form and is usually taken once daily. Common side effects include upper respiratory infections, headaches, and nausea, while more serious risks include pancreatitis and kidney dysfunction. Caution is advised in patients with kidney impairment or a history of pancreatitis.

Ozempic^® (semaglutide) is an injectable medication used to improve blood sugar control in adults with type 2 diabetes, to reduce the risk of major cardiovascular events in individuals with established heart disease, and to reduce the risk of kdiney problems in certain populations. It works by mimicking the hormone glucagon-like peptide-1 (GLP-1), which increases insulin secretion, decreases glucagon release, and slows gastric emptying. Administered once weekly, Ozempic is often part of a comprehensive treatment plan that includes diet and exercise. Common side effects include nausea, vomiting, diarrhea, and abdominal pain, and it should be used with caution in patients with a history of pancreatitis​.

Dipeptidyl peptidase-4 (DPP-4) inhibitor

Glucagon-like peptide-1 (GLP-1) receptor agonist

Januvia (sitagliptin) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

Ozempic (semaglutide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

• To reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease

• To reduce the risk of sustained eGFR decline, end-stage kidney disease and cardiovascular death in adults with type 2 diabetes mellitus and chronic kidney disease

• Typically taken orally once daily

• Comes in 25 mg, 50 mg, and 100 mg tablets

• Typically taken as an injection once weekly

• Comes in single-patient-use pens that deliver 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection

Adverse reactions reported in ≥5% of patients treated with Januvia and more commonly than in patients treated with placebo are:

• Upper respiratory tract infection

• Inflammation of the nose and throat

• Headache

In the add-on to sulfonylurea and add-on to insulin studies, low blood sugar was also more commonly reported in patients treated with Januvia compared to placebo

The most common adverse reactions, reported in ≥5% of patients are:

• Nausea

• Vomiting

• Diarrhea

• Abdominal pain

• Constipation

• History of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Serious hypersensitivity reaction to semaglutide or any of the excipients in Ozempic

• Drug interactions: Ozempic delays gastric emptying and may impact the absorption of concomitantly administered oral medications

• Pancreatitis

• Heart failure

• Acute renal failure

• Low blood sugar with concomitant use with insulin or insulin secretagogues

• Hypersensitivity reactions

• Severe and disabling joint pain

• Bullous pemphigoid

• Pancreatitis

• Diabetic retinopathy complications

• Never share an Ozempic pen between patients, even if the needle is changed

• Low blood sugar: Concomitant use with an insulin secretagogue or insulin may increase the risk of low blood sugar, including severe low blood sugar

• Acute kidney injury

• Hypersensitivity reactions

• Acute gallbladder disease

• Females and males of reproductive potential: Discontinue Ozempic in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide

WARNING: RISK OF THYROID C-CELL TUMORS

In rodents, semaglutide causes thyroid C-cell tumors. It is unknown whether Ozempic causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.

Ozempic is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

*This information is from the label for brand name Januvia^®. See the Full Prescribing Information for more complete information. Sitagliptin, the active ingredient in Januvia, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sitagliptin.

*This information is from the label for brand name Ozempic^®. See the Full Prescribing Information for more complete information. Semaglutide, the active ingredient in Ozempic, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient semaglutide.