| Diabetes Mellitus, Non-Insulin-Dependent
Januvia vs Welchol
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Januvia vs Welchol 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 signalsWelchol has a higher rate of injection site reactions vs Januvia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Welchol but not Januvia, including UnitedHealthcare
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Category
Januvia
Welchol
At A Glance
Oral
Once daily
DPP-4 inhibitor
Oral
Daily
Bile acid sequestrant
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Familial hyperlipidemia
- Familial hypercholesterolemia - heterozygous
- 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.
Familial hyperlipidemia, Familial hypercholesterolemia - heterozygous 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Diabetes Mellitus, Non-Insulin-Dependent 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Contraindications
- History of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema
- Serum TG concentrations >500 mg/dL
- History of hypertriglyceridemia-induced pancreatitis
- History of bowel obstruction
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 (>=2%) Constipation, dyspepsia, nausea, asthenia, pharyngitis, myalgia (primary hyperlipidemia); constipation, dyspepsia, nausea, hypertension, back pain (type 2 diabetes)
Serious Hypertriglyceridemia, pancreatitis, gastrointestinal obstruction, vitamin K and fat-soluble vitamin deficiencies
Postmarketing Bowel obstruction, dysphagia, esophageal obstruction, fecal impaction, pancreatitis, hypertriglyceridemia, increased transaminases
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.
Colesevelam hydrochloride is a non-absorbed bile acid sequestrant that binds bile acids in the intestine, depletes the bile acid pool, upregulates hepatic cholesterol 7-alpha-hydroxylase, increases LDL receptor expression, and thereby lowers serum LDL-C; the mechanism by which it improves glycemic control in type 2 diabetes is unknown.
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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)
Welchol
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Januvia
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Welchol
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Januvia
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Welchol
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Januvia.
No savings programs available for Welchol.
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JanuviaView full Januvia profile
WelcholView full Welchol profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.