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There are various types of agents used in the management of diabetes mellitus. They include insulin and others are oral antidiabetic agents. There are various oral agents and sitagliptin is one of them. It is also called Januvia and belongs to the class of drugs, dipeptidyl peptidase- 4 inhibitor class. It has been found effective in its functions and it can be used in combination with other oral antidiabetic drugs. These include thiazolidinediones and metformin and other drugs.


Januvia - instructions, description of the drug


1 tablet Januviya contains 25, 50 or 100 mg of the active substance sitagliptin phosphate hydrate.

Auxiliary components: croscarmellose sodium, magnesium stearate, microcrystalline cellulose, sodium fumarate, calcium hydrophosphate unground.

Shell: titanium dioxide, talc, red and yellow iron oxides, macrogol, polyvinyl alcohol.

Pharmachologic effect

Januia belongs to the group of incretins, is a highly selective inhibitor of DPP-4, the drug found wide use in the treatment of type II diabetes. In therapeutic amounts, the drug does not inhibit the related DPP-8 and DPP-9 enzymes.

Januia blocks the enzyme DPP-4, which is responsible for the hydrolysis of GLP-1 and the HIP - incretins involved in the regulation of glucose homeostasis. The drug promotes the growth of the concentration of active incretin, prolongs and potentiates their action. Through the intracellular mechanisms associated with cAMP, insulin synthesis is increased by beta-islet cells of the pancreas.

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In turn, GLP-1, belonging to the number of incretins, also suppresses the secretion of the contra-insulin hormone glucagon, with a decrease in the concentration of which inhibits hepatic gluconeogenesis. As a result - an additional reduction in blood glucose levels.

The clinical effect of Januvia is manifested by a decrease in HbA 1c, lean glycemia and normalization of body weight.

The pharmacokinetic effects of Januvia in healthy and sick individuals with diabetes are different.

The active component of sitagliptin is absorbed within 1-4 hours after taking the funds. Conjugation of it with plasma proteins is 38%. By radioanalysis, it was determined that 79% of the ingested substance is eliminated unchanged by the renal tubules by active secretion.

Indications for use

Januia is indicated for adult patients suffering from type 2 diabetes in order to control the glycemic level in monotherapy as part of combined treatment regimens.

The drug is prescribed to patients with the ineffectiveness of diet in combination with optimal physical activity, with the impossible use of metformin due to its intolerance.

Januvia is indicated as one of the components of combination therapy with metformin, sulfonylurea drugs or PPAR-γ activator, when there is no proper effect on glycemic control with diet and moderate physical activity.

As part of the ternary therapy regimen, Januvia is used in combination with a sulfonylurea / metformin or metformin / PPAR-γ agonist, when the clinical effect of the double regimen is not enough.

Januia can be used on the background of insulin therapy with a lack of effectiveness thereof.

Mode of application

The daily amount of Januvia - 100 mg is taken once per os, regardless of the meal, in combination with other hypoglycemic agents or in monotherapy.

In case of late receipt of the required amount of the drug, the patient should take the remedy immediately after clarification. Do not take a double daily dose of the drug.

For patients with moderate renal dysfunction, in whom the CC is 30–50 ml / min, the daily dosage of Januvia is 50 mg, for severe CI with CC below 30 ml / min the daily amount of the drug is 25 mg In such patients, the intake of Januvia does not depend on the time of the hemodialysis session.

Side effects

In the area of ​​the respiratory tract in monotherapy with Yanuvia, the most frequent undesirable reactions were infections of its upper sections, nasopharyngitis. The combined treatment of Yanuvia with insulin is often accompanied by the flu.

Allergic reactions were observed with almost the same frequency in patients taking Yanuviya, with monotherapy or as part of a two-three-component scheme.

Hypoglycemic conditions are most prevalent among patients who have taken Yanuvia with sulfonylurea drugs - up to 14%; taking it on the background of insulin therapy led to hypoglycemic conditions with a frequency of 9%.

In the area of ​​the central nervous system, the most common adverse reactions were dizziness, cranialyalgia, and excessive drowsiness.

On the part of the gastrointestinal tract, dyspeptic syndrome, flatulence, abnormal stools, and discomfort in the upper abdominal cavity were noted while taking Januvia.

When Januvia was combined with PPAR agonists, patients often had peripheral edema.

The most rare side effects when taking Januvia are arthralgia, myalgia and changes in laboratory parameters (minor hyperuricemia, decreased alkaline phosphatase, leukocytosis).


Januia is not used in case of excessive sensitivity to its components.

The drug is prohibited to use in children and pregnant women during lactation.

Insulin-dependent diabetes mellitus and ketoacidosis are direct contraindications to the use of Januvia.


The lack of clinical data on the use of Januvia in the gestational and lactation periods is a reason for not using it in pregnant and lactating women.

Drug interaction

The interaction of Januvia with other drugs, manifested by unpredictable clinical effects, was not found.

Despite an increase in the AUC of digoxin, cyclosporine, and other P-glycoprotein inhibitors, while using them with Yanuvia, correction of their dosages is not needed.


In a clinical study, the dosage of Januvia 800 mg was tolerated relatively well by volunteers, only some patients had clinically insignificant changes in the QT interval. There is no other data on drug overdose.

Therapy for overdose of Januvia consists of standard detoxification measures, monitoring of the patient’s vital functions, and, if necessary, symptomatic and supportive treatment.

The active substance of Januvia - sitagliptin - is not dialyzed, therefore, any types of dialysis during its overdose are ineffective.

Release form

The Januvia tablets are round-shaped, light pink in color with a beige shade, on one side of which there is an inscription "112" or "227" depending on the dosage of 50 or 100 mg, respectively.

Storage conditions

Store at room temperature.

Active ingredient: sitagliptin

Manufacturer: Merck Sharp & Dohme


In order to achieve the required therapeutic concentration of Januvia in patients with moderate or severe renal dysfunction, dose adjustment is required.

Patients with PN do not need to change the dosage of the drug due to the lack of hepatic metabolism.

The age characteristics of elderly patients also do not require correction of the amount of Januvia.

Early signs of type II diabetes

Type II diabetes mellitus is a widespread disease that can occur in any period of life, but most often develops in people of middle and old age. This pathology is characterized by elevated blood glucose levels. To identify the disease in time, it is important to know the first signs and symptoms of its development.

In persons with type II diabetes, the production or use of insulin, a hormone that regulates the transport of glucose into cells, is impaired. If glucose does not get inside the cells, they cannot use it as an energy source, which is manifested by certain symptoms.

There are many symptoms of type II diabetes, and individuals predisposed to this disease should be closely monitored for the first signs. The sooner the disorder is diagnosed, the faster the patient will be able to receive the necessary treatment.

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Symptoms of type II diabetes include frequent urination and increased thirst. When glucose accumulates in the bloodstream, the fluid exits the tissues into the blood under the force of osmosis. Dehydration of tissues leads to the emergence of thirst, and the use of large amounts of fluid - to increase urination.

Another sign of impaired glucose metabolism is severe hunger. Since in case of diabetes mellitus type II, glucose cannot get inside the cells, muscles and other organs lack energy, which is manifested by increased hunger.

Insufficient insulin production and impaired glucose uptake cause the body to use body fat and muscle components as an energy resource. Thus, another symptom of type 2 diabetes is a decrease in body weight.

When cells receive insufficient glucose, chronic fatigue develops, often accompanying the disease in question. This is one of the most debilitating symptoms of the disorder, as it negatively affects the quality of life.

Blurred vision is another reason to suspect the development of type II diabetes. With an increased level of glucose, the water balance of the optical structures of the eye is disturbed, which can adversely affect the clarity of vision.

In the event of an impaired glucose metabolism, the recovery time after infections and open skin lesions as a result of circulatory disorders and a deficiency in certain nutrients is slowed down.

The earliest sign of type II diabetes is considered darkening of the skin in the neck, knees, elbows and other joints. The classic early signs of this disease include frequent infections of the kidneys, skin, and bladder, long healing cuts, fatigue, intense hunger and constant thirst, frequent urination, and blurred vision. Early symptoms may appear slightly for several years, after which their severity increases and severe health problems arise.

If you suspect the development of diabetes mellitus type II, you should consult a doctor because such a health disorder can have long-term complications, including cardiovascular, skin and kidney diseases, damage to the nerves and eyes, and hearing impairment.

Although diabetes cannot be completely cured, people with this disorder can keep it under control, receiving rational treatment and adhering to a healthy lifestyle.

Type 2 diabetes: signs, symptoms, treatment

Good afternoon, friends, today we will talk about a fairly common disease today - type 2 diabetes. From the article you will learn the causes leading to the development of the disease, what are the symptoms and how to treat diabetes. But first, a few words about the history of diabetes.

What is diabete

Another well-known doctor Arethaius, who lived before our era, said that diabetes is a mysterious disease. His words can be confirmed now, because the cause of diabetes and its complications is still not solved.

Diabetes is translated from Greek as "outflow" and, therefore, diabetes means "losing sugar". This reflects the main symptom of this disease - the output of sugar through urine. This dangerous endocrine disease provokes a violation of carbohydrate metabolism.

There are about 285 million people with diabetes in the world. In Russia today there are about 3 million patients, and how many more are those who are not aware of this! Indeed, it is not typical for many people to go to a doctor for the purpose of prophylaxis and to be tested when nothing is bothering.

Signs of Diabetes

The main signs of diabetes are:

  • constant thirst;
  • increased fatigue;
  • too active fluid intake;
  • rapid removal of fluid from the body;
  • increased appetite;
  • drowsiness and fatigue;
  • reduced visual acuity;
  • hands and feet are often cold;
  • long crayfish and cuts heal;
  • itching in the perineum and genitals;
  • chronic gingivitis (inflammation of the gums);
  • abundant soft dental deposits;
  • rapidly progressive periodontal disease;
  • unhealthy skin (pustular rash).

Causes of diabetes

Diabetes develops in those who have a hereditary predisposition to it. If both parents are sick, then the risk rises to 30%.

In addition, those who often use junk food, who love sweet soda, sweet pastry, eat an inordinate amount of sweetness, are at great risk of joining the ranks of diabetics.

If a person often suffers from flu, ARVI and carries them on his feet, he also risks becoming a diabetic, because a viral infection can provoke the development of this disease.

The provocateur of diabetes mellitus can be stressful, since many hormones are released into the blood during anxiety. Unpredictable changes in blood glucose levels negatively affect the pancreas and deplete insulin.

Causes of diabetes in women

It is dangerous if a woman during her pregnancy gained weight over 17 kg and her baby was born with a weight of 4.5 kg or more. Even if after birth all the blood counts returned to normal, it is necessary to conduct regular examinations, because in 10-15 years, type II diabetes can develop.

If a woman was diagnosed with gestational diabetes mellitus during pregnancy, then 5 years after giving birth, the risk of type II diabetes increases significantly.

So, risk factors for type 2 diabetes:

  • overweight;
  • heredity, especially on the maternal line;
  • food with artificial additives;
  • hypodynamia;
  • depression and stress;
  • low levels of good cholesterol;
  • high blood levels of triglyceride (fat);
  • high pressure;
  • bad ecology;
  • manifestations of diabetes during pregnancy;
  • if the birth weight of the child was more than 4 kg.

It is important to minimize the main of these factors in order to avoid the onset and development of diabetes, and if you already have elevated levels of blood sugar, then take steps to get rid of diabetes.

Prediabetes (hyperglycemia)

At the earliest stages, diabetes may not manifest itself at all, and a blood test for sugar content may not diagnose it (normally it should not exceed 5.5 mmol / l). Therefore, many people are in an asymptomatic, pre-diabetic state, when glucose levels in the blood and urine are slightly higher than normal (in medical language this is called hyperglycemia).

Diabetes, Metformin, Diabetes Vision

The disease can develop several years, but then manifest itself, and most often type 2 diabetes appears after 40 years.

There is also type I diabetes, in which insulin (a hormone that regulates blood sugar) is produced in an insufficient amount by the pancreas. In this case, the person is insulin-dependent, he is prescribed constant injections of insulin and he is under regular medical supervision.

With type II diabetes (it will be discussed today), which is much more common, the pancreas continues to produce insulin. But the cells of the body lose the ability to properly perceive and use it. Insulin ceases to perform its function, penetrate into the cells of the body, the splitting of carbohydrates slows down, and the blood is poorly supplied with glucose, the main source of energy. That's why a person with diabetes gets tired faster.

Pre-diabetes (the borderline between normal body function and diabetes) can be corrected with the help of diet and exercise.

Glucometer - a device for measuring blood sugar levels

However, if the diagnosis - prediabetes is made, you will have to control your condition. It is impossible to focus on your own well-being, since the vast majority of people do not feel the difference between glucose levels from 4 to 12-13 mmol / l.

So you have to buy a blood glucose meter - a device with which home blood sugar is measured 2-3 times a day at home. The meter itself includes a meter, a pen with a one-time finger-piercing lancet, test strip containers (they will have to be re-purchased regularly) and spare lancets.

The procedure is painless, the result is instantaneous - on the display of the device. Measurement results are preferably recorded. Carefully read the instructions for the device, and after purchase, check it for accuracy. It will be possible to capture him for an appointment with a doctor so that he will observe how exactly you are taking measurements and, if necessary, made remarks.

Talk about how to improve your condition if it is close to diabetes.

1. Fight overweight
Completeness is a major risk factor. Especially you should be alerted by the fact that the waist is quickly spreading. The fat roller in this area consists of fat, which is broken down into fatty acids, quickly penetrates the bloodstream and slows down the effect of insulin.

That is why it is important to keep your weight under control, especially for middle-aged people. Enough to reduce its performance by 7-8% and immediately reduces the risk of metabolic disorders and the development of type II diabetes.

2. Proper nutrition
After 40 years, when the body's metabolism slows down, you need to monitor the caloric intake. It is after 40 years, every 10 years, metabolism is reduced by about 7.5%. First of all, you should exclude from your daily diet foods that contain easily digestible carbohydrates. And this is all pastries and sweets - cakes and pastries, ice cream, buns and muffins. There are rarely, only in the case of a holiday.

From bakery products you can eat whole-grain bread, increase in your diet foods containing fiber - beans, nuts, fruits and vegetables. The fact is that the addition of fiber (and it should be eaten at least 30-35 g per day) activates the function of the pancreas, and hence the production of insulin, and thus prevents the development of type II diabetes.

It is equally important to eliminate harmful products containing primarily saturated fats and trans-fatty acids (fatty meats, smoked meats, sausages, mayonnaise, animal fat, fried foods). They prevent the development of insulin by the pancreas. Even if it is produced enough, the body still can not fully use it.

However, nutrition without any fat will not be complete, therefore, as an alternative, you can eat foods that contain polyunsaturated or monounsaturated fats. These products include all seafood, olive and vegetable oil. On the day they are recommended to use at least 25 g.

3. Active lifestyle
Any physical activity speeds up the body's metabolism. It is proved that if you spend daily walking at a fast pace or running for at least half an hour a day, then the probability of diabetes is reduced by 40%!

And it is not surprising that when the muscles work, they consume sugar in the blood, which is the fuel for working muscles. Thus, the level of glucose decreases. Not to mention the fact that physical education and sports contribute to weight loss and the acquisition of a more slender body. If you are bored with doing exercises, there is nowhere to run, due to the fact that there is no clean park or a corner of nature nearby, then sign up for a dance.

Besides the fact that dance movements reduce the level of glucose in the blood, they also have a positive effect on the entire nervous system of a person. Often diabetes progresses precisely against the background of depression, when a person tries to seize a bad mood and consumes a lot of sweets.

Exercise is very important for patients with diabetes - thanks to them, the susceptibility of body cells to glucose is increased. Best normal walking. If you have never played sports, just start with 10 minutes. walk or gymnastics, regularly increasing the time of classes up to 30 minutes. in a day.

However, if you are diagnosed with diabetes, then exercise should be under the supervision of specialists and before each session to do an analysis of the level of glucose in the blood. If the rate is low, then before classes and after them you need to have a little snack to prevent hypoglycemia (a condition in which the sugar level drops sharply, which may result in a hypoglycemic coma).

4. Laugh at Health
Try not to succumb to despondency, watch humorous programs, good comedies, meet and chat with friends. Since scientists have proved that laughter and good mood improves the condition of a patient with diabetes mellitus and lowers the percentage of sugar in the blood.

6. Temper
Since diabetics have lowered immunity, they need to take preventive measures to avoid the flu and cold. Welcome walks and exercises in the fresh air, water procedures, but not dousing with cold water, even if it concerns only the legs. Pouring is stress, and the patient's body reacts to it with an instant increase in blood sugar!

7. Folk remedies for the treatment of diabetes
Folk medicine has accumulated vast experience in the treatment of diabetes mellitus and is used for this many tools that reduce blood sugar levels. The following herbs are used: stinging nettle, dandelion, lilac buds, black elderberry, alder leaf, quinoa, birch buds, chicory, burdock root, tricolor violet, St. John's wort, barberry fruits, blueberry leaves, wild rose, elder flowers, mustard seed, strawberry leaves hawthorn, horsetail, linden flowers.

8. Treatment and prevention of type 2 diabetes
Patients with type II diabetes are usually treated on an outpatient basis. In this case, commonly used tablets hypoglycemic drugs. They improve the sensitivity of the tissues of the body to insulin, as well as slow down the process of extinction of beta cells of the pancreas that produce this hormone.

To monitor the effectiveness of the treatment, it is not enough to measure the level of glucose in the blood every day with a home glucometer. It is necessary once again in a quarter to pass the analysis in the laboratory to determine the level of glycated hemoglobin (or hemoglobin A1C). This analysis shows exactly whether the diabetic "sinned" in the past 3-4 months or led a "righteous" lifestyle.

The rate of glucose in diabetes mellitus type II fully coincides with the norms established for a healthy person. For capillary blood it is 3.3-5.5 mmol / l, for venous blood it is -3.5-6.1 mmol / l. The analysis is given in the morning on an empty stomach.

Do not forget to keep such important indicators as blood pressure, sugar level and cholesterol in the blood under control. At least once a year, check these figures, if you have crossed the 40 year mark, in time to notice and prevent such a serious disease as diabetes.