Differences Between Januvia and Ozempic
When considering medications for the treatment of type 2 diabetes, two commonly used options are Ozempic and Januvia. Since both Ozempic and Januvia act on the same pathway involving GLP-1, it is not recommended to use them simultaneously. However, determining the better choice between the two depends on several factors, including individual patient characteristics and preferences.
Overview of Type 2 Diabetes Mellitus
Type 2 diabetes is a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia) resulting from the body's inability to effectively use insulin or produce enough of it. Insulin is a hormone produced by the pancreas that regulates the uptake and utilization of glucose (sugar) in the body's cells for energy.
In type 2 diabetes, the body becomes resistant to insulin, or the pancreas doesn't produce enough insulin to maintain normal blood sugar levels. This leads to an accumulation of glucose in the bloodstream, causing various health complications over time.
Symptoms of type 2 diabetes may include increased thirst and hunger, frequent urination, fatigue, blurred vision, slow healing of wounds, and recurring infections.
Monitoring parameters for type 2 diabetes include blood sugar (a current view of how much sugar is in your blood) and A1C (a parameter that measures how well controlled your blood sugar has been for the past 3 months).
Read more about Medication for Type 2 Diabetes
How They Work
Januvia (Sitagliptin)
Januvia is a “dipeptidyl peptidase-4 inhibitor” (DPP-4)”. DPP-4 is an enzyme that breaks down incretin hormones (Incretin hormones stimulate insulin secretion). By inhibiting this breakdown Januvia leads to increased insulin and decreased glucagon production when blood sugar is increased (after a meal). It is effective at lowering both daily blood sugar and long-term A1C.
Unlike GLP-1 receptor agonists such as Ozempic, DPP-4 inhibitors have not been proved to have the same heart and kidney protection. This may make a difference for those who are at greater risk for heart and kidney disease.
Ozempic (Semaglutide)
Ozempic belongs to the class of medications known as “glucagon-like peptide-1” (GLP-1) receptor agonists. These medications directly stimulate GLP-1 receptors, increasing insulin release and decreasing glucagon secretion. This helps to make use of sugar from food as well as store it away for use between meals.
Because of this sugar-reducing effect, Ozempic is effective at lowering your day-to-day blood sugar, as well as your longer-term A1C. As an added bonus, Ozempic has also shown major protective benefits from heart and kidney disease in those who already have heart disease.
7 most questions about Ozempic
Administration
- Januvia is taken orally in the form of a tablet once daily.
- Ozempic is administered as a subcutaneous injection once a week.
Efficacy
- Januvia has been shown to effectively reduce blood sugar levels in people with type 2 diabetes. It is generally used as an adjunct to diet and exercise.
- Ozempic has demonstrated superior glycemic control compared to Januvia in clinical trials. It has also shown benefits in terms of weight loss and reduction in cardiovascular risks.
Cardiovascular Benefits
- Januvia has not shown significant cardiovascular benefits in clinical trials.
- Ozempic has demonstrated cardiovascular benefits, including a reduction in major adverse cardiovascular events in people with type 2 diabetes and a history of cardiovascular disease.
Side Effects
Both medications come with a comparable risk of experiencing side effects, though the exact effects differ slightly.
Januvia
- Nausea
- Diarrhea
- Constipation
- Headache
- Pancreatitis*
*Pancreatitis (inflammation of the pancreas – the organ that makes insulin and glucagon) is a rare side effect that can occur with Januvia. If you experience signs of pancreatitis (upper abdominal pain, fever, nausea, abdominal tenderness) it is important to seek medical attention.
Ozempic
- Nausea
- Diarrhea
- Vomiting
- Abdominal pain
- Decreased appetite
- Injection site pain
- Weight loss
Cost
Januvia
Price is one point in which the medications differ more significantly. A one-month supply of Januvia is typically roughly $650 per month, regardless of the dose.
Ozempic
In contrast, at the typical dose of Ozempic, a one-month supply would cost you closer to $1100. Since Ozempic pens come in set-volumes, if you use an increased dose (greater than 0.5mg per week) you may be paying double this for a monthly supply.
Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of July 14, 2023.
References
- JANUVIA® (sitagliptin) Tablets. Food and Drug Administration. (2006; Revised 04/2011). Retrieved July 14, 2023, from https://www.accessdata.fda.gov
- OZEMPIC (semaglutide) injection, for subcutaneous use. Food and Drug Administration. (12/2017). Retrieved July 14, 2023, from https://www.accessdata.fda.gov
- Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2018;42(Suppl 1): S1-S325. Retrieved July 13, 2023, from https://guidelines.diabetes.ca