| Diabetes Mellitus, Non-Insulin-Dependent
Januvia vs Trijardy XR
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Januvia vs Trijardy Xr 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 signalsTrijardy Xr has a higher rate of injection site reactions vs Januvia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trijardy Xr but not Januvia, including UnitedHealthcare
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Category
Januvia
Trijardy Xr
At A Glance
Oral
Once daily
DPP-4 inhibitor
Oral
Daily
SGLT2i / DPP-4i / 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 Individualize starting dose based on current regimen; maximum 25 mg empagliflozin / 5 mg linagliptin / 2,000 mg metformin HCl once daily; take orally once daily with morning meal, swallow whole. Not recommended for initiation if eGFR <45 mL/min/1.73 m2; contraindicated if eGFR <30 mL/min/1.73 m2.
Contraindications
- History of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema
- Severe renal impairment (eGFR less than 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to empagliflozin, linagliptin, metformin HCl, or any excipient (anaphylaxis, angioedema, exfoliative skin conditions, urticaria, or bronchial hyperreactivity have occurred)
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, nasopharyngitis, diarrhea, constipation, headache, gastroenteritis
Serious Lactic acidosis, diabetic ketoacidosis, pancreatitis, volume depletion, genitourinary infections (urosepsis, pyelonephritis, Fournier's gangrene, genital mycotic infections), hypoglycemia with insulin or insulin secretagogues, lower limb amputation, hypersensitivity reactions, vitamin B12 deficiency, severe and disabling arthralgia, bullous pemphigoid, heart failure
Postmarketing Acute pancreatitis (including fatal), mouth ulceration, stomatitis, anaphylaxis, angioedema, exfoliative skin conditions, necrotizing fasciitis of the perineum, urosepsis, pyelonephritis, ketoacidosis, rhabdomyolysis, acute kidney injury, bullous pemphigoid, rash, urticaria, 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.
TRIJARDY XR combines three complementary mechanisms: empagliflozin (SGLT2 inhibitor) reduces renal glucose reabsorption and increases urinary glucose excretion; linagliptin (DPP-4 inhibitor) increases active incretin hormones (GLP-1, GIP) to stimulate glucose-dependent insulin release and reduce glucagon; and metformin HCl (biguanide) 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)
Trijardy Xr
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Januvia
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Trijardy Xr
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Humana
Januvia
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Trijardy Xr
- 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 Januvia.
No savings programs available for Trijardy Xr.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.