| Diabetes Mellitus, Non-Insulin-Dependent
Januvia vs Kombiglyze XR
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Januvia vs Kombiglyze 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 signalsKombiglyze has a higher rate of injection site reactions vs Januvia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Kombiglyze but not Januvia, including UnitedHealthcare
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Category
Januvia
Kombiglyze
At A Glance
Oral
Once daily
DPP-4 inhibitor
Oral
Once daily
DPP4 inhibitor + biguanide
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
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.
Diabetes Mellitus, Non-Insulin-Dependent Administer once daily with the evening meal; individualize starting dose based on current regimen; max 5 mg saxagliptin/2,000 mg metformin HCl extended-release once daily; limit saxagliptin to 2.5 mg daily with strong CYP3A4/5 inhibitors; swallow tablets whole.
Contraindications
- History of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema
- Severe renal impairment (eGFR below 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- History of serious hypersensitivity reaction to saxagliptin, metformin HCl, or any ingredient in KOMBIGLYZE XR, including anaphylaxis, angioedema, or exfoliative skin conditions
Adverse Reactions
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.
Most common (>=5%) Upper respiratory tract infection, urinary tract infection, headache (saxagliptin); diarrhea, nausea/vomiting (metformin)
Serious Lactic acidosis, pancreatitis, heart failure, hypoglycemia with insulin or insulin secretagogues, hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid, vitamin B12 decrease
Postmarketing Pancreatitis, anaphylaxis, angioedema, exfoliative skin conditions, rhabdomyolysis, bullous pemphigoid, cholestatic and hepatocellular liver injury
Pharmacology
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.
Kombiglyze XR combines saxagliptin, a competitive DPP4 inhibitor that slows incretin hormone (GLP-1, GIP) inactivation to enhance glucose-dependent insulin release and suppress glucagon, and metformin HCl, a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity.
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Most Common Insurance
Anthem BCBS
Januvia
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (9/12) · Qty limit (12/12)
Kombiglyze
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Januvia
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Kombiglyze
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Januvia
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Kombiglyze
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Januvia.
No savings programs available for Kombiglyze.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.