| Diabetes Mellitus, Non-Insulin-Dependent
Cycloset vs Januvia
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Cycloset vs Januvia with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsJanuvia has a higher rate of injection site reactions vs Cycloset based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Januvia but not Cycloset, including UnitedHealthcare
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Category
Cycloset
Januvia
At A Glance
Oral
Daily
Dopamine D2 receptor agonist
Oral
Once daily
DPP-4 inhibitor
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Diabetes Mellitus, Non-Insulin-Dependent 1.6 mg to 4.8 mg once daily within 2 hours after waking in the morning with food; initiate at 0.8 mg, increase by one tablet per week to maximal tolerated dose; limit to 1.6 mg daily with moderate CYP3A4 inhibitors; avoid with strong CYP3A4 inhibitors.
Diabetes Mellitus, Non-Insulin-Dependent 100 mg orally once daily, with or without food.
Renal impairment (eGFR 30 to <45 mL/min/1.73 m2) 50 mg once daily.
Severe renal impairment or ESRD (eGFR <30 mL/min/1.73 m2) 25 mg once daily; may be administered without regard to the timing of dialysis.
Contraindications
- Known hypersensitivity to bromocriptine, ergot-related drugs, or any excipient in CYCLOSET
- Syncopal migraine
- Postpartum patients
- Lactating patients
- History of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema
Adverse Reactions
Most common (>=5%) Nausea, fatigue, vomiting, headache, dizziness, rhinitis, constipation, sinusitis, diarrhea, asthenia, somnolence, dyspepsia, amblyopia, anorexia
Serious Hypotension, psychotic disorders, somnolence, syncope, fibrotic-related complications, cardiovascular events (myocardial infarction, stroke)
Postmarketing Hallucinations, retroperitoneal fibrosis, pulmonary fibrosis, pleural effusion, pericarditis, pericardial effusions, cardiac valvulopathy, psychotic and psychiatric disorders, impulse control/compulsive behaviors, neuroleptic-like malignant syndrome
Most common (>=5%) Nasopharyngitis, upper respiratory tract infection, headache.
Serious Pancreatitis, heart failure, acute renal failure, hypoglycemia (with sulfonylurea or insulin), hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid.
Postmarketing Anaphylaxis, angioedema, rash, urticaria, cutaneous vasculitis, Stevens-Johnson syndrome, hepatic enzyme elevations, acute pancreatitis, worsening renal function, acute renal failure, tubulointerstitial nephritis, severe arthralgia, bullous pemphigoid, constipation, vomiting, myalgia, pain in extremity, back pain, pruritus, mouth ulceration, stomatitis, rhabdomyolysis.
Pharmacology
CYCLOSET (bromocriptine mesylate) is a sympatholytic dopamine D2 receptor agonist; timed morning administration in type 2 diabetes is associated with increased insulin sensitivity and glucose disposal and reduced fasting and postprandial hyperglycemia without raising plasma insulin levels.
Sitagliptin is a DPP-4 inhibitor that slows inactivation of incretin hormones (GLP-1 and GIP), increasing insulin release and decreasing glucagon levels in a glucose-dependent manner; it is selective for DPP-4 and does not inhibit DPP-8 or DPP-9 activity at therapeutic concentrations.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Cycloset
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (2/12) · Qty limit (6/12)
Januvia
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (9/12) · Qty limit (12/12)
UnitedHealthcare
Cycloset
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Januvia
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Cycloset
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (2/3) · Qty limit (2/3)
Januvia
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Cycloset.
No savings programs available for Januvia.
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CyclosetView full Cycloset profile
JanuviaView full Januvia profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.