Available in:Tablet
Dosage:25MG, 50MG, 100MG
Manufacturer:Merck
Available in:Injectable Pen
Dosage:100U/ML, 200U/ML
Manufacturer:Novo Nordisk
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The usual dose of Januvia (Sitagliptin) is 100 mg taken by mouth once daily with or without food.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take Januvia (Sitagliptin) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store Januvia (Sitagliptin) at room temperature and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
The recommended dose of insulin depends on how much natural insulin your pancreas is producing and how well your body is able to use the insulin. Your doctor or diabetes educator will determine the appropriate dose for you according to various lifestyle factors and your blood glucose levels.
Your dose of insulin should be injected subcutaneously (under the skin) exactly as instructed by your doctor or diabetes educator. Do not inject insulin degludec into a vein and do not use insulin degludec in insulin infusion pumps. Insulin degludec is injected under the skin once daily. In addition to insulin degludec, a fast-acting insulin is usually used to control the impact of food intake on blood glucose levels during the day. There are many variations of insulin dosing.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
Insulin degludec should be clear and colourless. Do not use the insulin if you notice anything unusual in the appearance of the solution, such as cloudiness, discoloration, or clumping. It is not necessary to shake or rotate the vial before use. It should not be mixed with any other insulins.
It is important to take Tresiba Flextouch (Insulin-degludec-ultra-long-acting) exactly as prescribed by your doctor. The timing of insulin with respect to your meals is crucial to keeping blood glucose under control and preventing unwanted side effects.
If you miss a dose, inject it as soon as possible as long as there is at least 8 hours until your next dose. If there is less than 8 hours until your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Do not stop using Tresiba Flextouch (Insulin-degludec-ultra-long-acting) without consulting your doctor. When insulin degludec or any other insulin is stopped, blood glucose levels can become dangerously high.
Store unopened Penfill® cartridges and FlexTouch® pre-filled insulin pens in the refrigerator until needed. They may be used until the expiry date on the label. If necessary, they may be stored at room temperature for 8 weeks. Never allow insulin to freeze.
Insulin that is currently in use may be kept at room temperature (below 30°C) for no more than 8 weeks and then discarded. Do not expose insulin to extremely hot temperatures or to sunlight. Keep insulin out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes Januvia (Sitagliptin). If you are concerned about side effects, discuss the risks and benefits of Januvia (Sitagliptin) with your doctor.
The following side effects have been reported by at least 1% of people taking Januvia (Sitagliptin). Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Januvia (Sitagliptin).
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes Tresiba Flextouch (Insulin-degludec-ultra-long-acting). If you are concerned about side effects, discuss the risks and benefits of Tresiba Flextouch (Insulin-degludec-ultra-long-acting) with your doctor.
The following side effects have been reported by at least 1% of people taking Tresiba Flextouch (Insulin-degludec-ultra-long-acting). Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Tresiba Flextouch (Insulin-degludec-ultra-long-acting).
25 mg
Each pink, round, film-coated tablet, with "221" on one side, contains 25 mg of Januvia (Sitagliptin). Nonmedicinal ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate (calcium hydrogen phosphate, anhydrous), croscarmellose sodium, magnesium stearate, and sodium stearyl fumarate; film coating: polyvinyl alcohol, polyethylene glycol (macrogol), talc, titanium dioxide, red iron oxide, and yellow iron oxide.
50 mg
Each light beige, round, film-coated tablet, with "112" on one side, contains 50 mg of Januvia (Sitagliptin). Nonmedicinal ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate (calcium hydrogen phosphate, anhydrous), croscarmellose sodium, magnesium stearate, and sodium stearyl fumarate; film coating: polyvinyl alcohol, polyethylene glycol (macrogol), talc, titanium dioxide, red iron oxide, and yellow iron oxide.
100 mg
Each beige, round, film-coated tablet, with "277" on one side, contains 100 mg of Januvia (Sitagliptin). Nonmedicinal ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate (calcium hydrogen phosphate, anhydrous), croscarmellose sodium, magnesium stearate, and sodium stearyl fumarate; film coating: polyvinyl alcohol, polyethylene glycol (macrogol), talc, titanium dioxide, red iron oxide, and yellow iron oxide.
100 units/mL
Each mL of sterile, aqueous, clear, colourless solution, contains 100 units of insulin degludec. Nonmedicinal ingredients: glycerol, phenol, metacresol, zinc acetate, and water for injection. Hydrochloric acid or sodium hydroxide may be added to adjust pH.
200 units/mL
Each mL of sterile, aqueous, clear, colourless solution contains 200 units of insulin degludec. Nonmedicinal ingredients: glycerol, phenol, metacresol, zinc acetate, and water for injection. Hydrochloric acid or sodium hydroxide may be added to adjust pH.
The Penfill® 3 mL cartridge is made of glass (type 1), containing a halobutyl rubber closure shaped as a plunger and closed with a halobutyl/polyisoprene rubber closure.
The FlexTouch® Pre-filled pen (multidose disposable pen) comprises a pen-injector with a cartridge (3 mL). The cartridge is made of glass (type 1), containing a halobutyl rubber closure shaped as a plunger and closed with a halobutyl/polyisoprene rubber closure.
Januvia (Sitagliptin) should not be taken by anyone who is allergic to Januvia (Sitagliptin) or to any of the ingredients of the medication.
Do not use Tresiba Flextouch (Insulin-degludec-ultra-long-acting) if you:
There may be an interaction between Januvia (Sitagliptin) and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Januvia (Sitagliptin). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
There may be an interaction between insulin degludec and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Tresiba Flextouch (Insulin-degludec-ultra-long-acting). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Januvia (Sitagliptin).
Hypersensitivity reaction: A Anaphylaxis (severe allergic reaction) called hypersensitivity reaction has occurred for some people with the use of Januvia (Sitagliptin). Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including Fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.
Immune system: Januvia (Sitagliptin) can reduce the number of cells that fight infection in the body (white blood cells). This side effect may be more of a concern for people who already have a weakened immune system. People who have HIV infection, have had an organ transplant and are taking medications to reduce the activity of the immune system, or are taking medication to treat certain types of cancer are more likely to have a weakened immune system. If any of these conditions apply to you, discuss with your doctor how Januvia (Sitagliptin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Januvia (Sitagliptin), and whether any special monitoring is needed.
Kidney function: Januvia (Sitagliptin) has been reported to cause decreased kidney function and may cause kidney failure. Your doctor may recommend regular testing to check your kidney function while you are taking Januvia (Sitagliptin). If you notice signs of kidney problems, such as decreased urine production; swelling in your hands, wrists, feet, or ankles; difficulty breathing, or weakness, contact your doctor as soon as possible.
People with decreased kidney function may require lower doses of Januvia (Sitagliptin). If you have Kidney Disease or decreased kidney function, discuss with your doctor how Januvia (Sitagliptin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Januvia (Sitagliptin), and whether any special monitoring is needed.
Januvia (Sitagliptin) is not recommended for people with moderately to severely reduced kidney function.
Liver function: Januvia (Sitagliptin) is not recommended for people with severely reduced liver function. People with moderately reduced liver function should discuss with their doctor how Januvia (Sitagliptin) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Januvia (Sitagliptin), and whether any special monitoring is needed.
Low blood glucose (sugar): Hypoglycemia (low blood sugar) can occur when Januvia (Sitagliptin) is used in combination with metformin and a sulfonylurea (e.g., glyburide, gliclazide), or insulin. If you experience low blood sugar (e.g., headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, and feeling jittery) while taking Januvia (Sitagliptin), contact your doctor.
Pancreatitis: Januvia (Sitagliptin) may cause pancreatitis (inflammation of the pancreas). People with a history of pancreatitis, gallstones, Alcoholism, or high triglycerides may be more at risk of experiencing this. If you experience prolonged and severe abdominal pain with or without vomiting while taking Januvia (Sitagliptin), contact your doctor immediately.
Type 1 Diabetes and diabetic ketoacidosis: Januvia (Sitagliptin) should not be used by people with type 1 diabetes or to treat diabetic ketoacidosis (increased ketones in the blood or urine).
Pregnancy: Januvia (Sitagliptin) is not recommended for use during pregnancy. If you become pregnant while taking Januvia (Sitagliptin), contact your doctor immediately.
Breast-feeding: It is not known if Januvia (Sitagliptin) passes into breast milk. If you are a breast-feeding mother and are taking Januvia (Sitagliptin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Januvia (Sitagliptin) have not been established for children.
Seniors: Seniors are more likely to have decreased renal function and may require lower doses of Januvia (Sitagliptin).
Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Tresiba Flextouch (Insulin-degludec-ultra-long-acting).
Allergic reactions: If you notice signs of a serious allergic reaction (swelling of face or throat, sudden sweating, vomiting, difficulty breathing, rapid heartbeat, itchy skin rash, and dizziness), stop using the medication and seek immediate medical attention.
Appearance of insulin: The contents of the pre-filled pen or insulin cartridge degludec should be clear and colourless. Do not use Tresiba Flextouch (Insulin-degludec-ultra-long-acting) if you notice anything unusual about its appearance, such as cloudiness, discoloration, or clumping.
Blood glucose monitoring: It is important for anyone using insulin to monitor their blood glucose levels regularly, as recommended by their doctor or diabetes educator. It is especially important to test blood glucose more often when your insulin dose or schedule changes, or when you are ill or under stress. If blood tests consistently show high or low blood glucose levels, contact your doctor or diabetes educator.
Changes at injection site: Fatty tissue under the skin at the injection site may shrink or thicken if you inject yourself too often at the same site. To help avoid this effect, change the site with each injection. Talk to your doctor or diabetes educator if you notice your skin pitting or thickening at the injection site.
Changes in insulin requirements: Many things can affect blood glucose levels and insulin requirements. These include:
It is important to tell your doctor about your current health situation and any changes that may affect the amount of insulin you need. Blood glucose should be monitored regularly as recommended by your doctor or diabetes educator.
Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking insulin.
Family and friends: Educate your family and friends about the signs and symptoms of hypoglycemia (low blood glucose). Keep a Glucagon kit available and instruct them on its proper use in case you experience severe low blood glucose or you lose consciousness.
High blood glucose (hyperglycemia): Hyperglycemia may occur if your insulin dose is too low or you miss a dose of insulin. Symptoms of hyperglycemia generally build up over hours or days. Contact your doctor or diabetes educator if you experience symptoms of hyperglycemia, such as increased need to urinate, nausea, vomiting, drowsiness, Dry Mouth, flushed dry skin, loss of appetite, and a fruity odour to your breath.
If hyperglycemia is permitted to continue, a condition known as diabetic ketoacidosis may occur. In this condition, your body starts to use body fat as fuel, eventually leading to a large concentration of acid in the blood stream. This can result in unconsciousness, coma, or death. To prevent this from occurring, you may need to have your insulin dose adjusted.
Kidney function: Kidney Disease or reduced kidney function may change the amount of insulin needed by the body. If you have kidney problems, discuss with your doctor how Tresiba Flextouch (Insulin-degludec-ultra-long-acting) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Tresiba Flextouch (Insulin-degludec-ultra-long-acting), and whether any special monitoring is needed. Your doctor may want to test your kidney function regularly with blood tests while you are taking Tresiba Flextouch (Insulin-degludec-ultra-long-acting).
Liver function: Liver disease or reduced liver function may change the amount of insulin needed by the body. If you have liver problems, discuss with your doctor how Tresiba Flextouch (Insulin-degludec-ultra-long-acting) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Tresiba Flextouch (Insulin-degludec-ultra-long-acting), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Tresiba Flextouch (Insulin-degludec-ultra-long-acting).
Low blood glucose (hypoglycemia): Hypoglycemia may occur if too much insulin is used, if meals are missed, or if you exercise more than usual. Symptoms of mild-to-moderate hypoglycemia may occur suddenly and can include cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling (tongue, lips, or fingers). Mild-to-moderate hypoglycemia may be treated by eating foods or drinks that contain sugar. You should always carry a quick source of sugar, such as hard candies, glucose tablets, juice, or regular soft drinks (not diet soft drinks). If you experience symptoms of hypoglycemia, eat one of these sources of sugar and then rest. If you feel symptoms of hypoglycemia coming on, don't take insulin.
Signs of severe hypoglycemia can include disorientation, loss of consciousness, and seizures. People who are unable to take sugar by mouth or who are unconscious may require an injection of glucagon or treatment with intravenous (into the vein) glucose.
Pregnancy: It is essential to maintain good blood glucose control throughout pregnancy. Insulin requirements usually decrease during the first trimester and increase during the second and third trimesters. Therefore, contact your doctor if you are pregnant or are thinking about pregnancy.
Breast-feeding: It is not known if insulin degludec passes into breast milk. If you are a breast-feeding mother and are using Tresiba Flextouch (Insulin-degludec-ultra-long-acting), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Breast-feeding mothers may require adjustments in their insulin dose or diet.
Children: The safety and effectiveness of using Tresiba Flextouch (Insulin-degludec-ultra-long-acting) have not been established for children who are less than 2 years of age.
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