Januvia Vs. Trulicity: 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.

Trulicity^® (dulaglutide) is an injectable medication used to improve blood sugar control in adults and pediatric patients aged 10 years and older with type 2 diabetes, alongside diet and exercise. It acts as a glucagon-like peptide-1 (GLP-1) receptor agonist, enhancing insulin secretion, slowing gastric emptying, and reducing glucagon production. Additionally, Trulicity is indicated to reduce the risk of major adverse cardiovascular events, such as heart attack, stroke, and cardiovascular death in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors. Administered once weekly, Trulicity can be used alone or with other diabetes medications. Common side effects include gastrointestinal issues like nausea, diarrhea, and vomiting. It should be used cautiously in individuals 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

Trulicity (dulaglutide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus.

• To reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple cardiovascular risk factors

• Typically taken orally once daily

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

• Typically taken as an injection once weekly

• Comes in 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg per 0.5 mL single-dose pens

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

Most common adverse reactions (incidence ≥5%) are:

• Nausea

• Diarrhea

• Vomiting

• Abdominal pain

• Decreased appetite

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

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

• Patients with a serious hypersensitivity reaction to dulaglutide or any of the product components

• Drug interactions: Trulicity delays gastric emptying and has the potential to reduce the rate of 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

• Thyroid C-cell tumors

• Pancreatitis

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

• Hypersensitivity reactions

• Acute kidney injury

• Severe gastrointestinal disease

• Diabetic retinopathy complications

• Acute gallbladder disease

• Pregnancy: Should be used during pregnancy only if the potential benefit justifies the potential risk to fetus

WARNING: RISK OF THYROID C-CELL TUMORS

Dulaglutide causes thyroid C-cell tumors in rats. It is unknown whether Trulicity causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of dulaglutide-induced rodent thyroid C-cell tumors has not been determined.

Trulicity is contraindicated in patients with a personal or family history of MTC and 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 Trulicity^®. See the Full Prescribing Information for more complete information.