[NP-Clinical] Januvia

[Denise B]

I have prescribed Januvia several times to my geriatric diabetic population. 
  I can tell you with assurance that the only dose reduction is to 50mg for 
significant renail impairment, otherwise 100mg for everyone.   So far, I've 
only seen success with it and have never had to reduce the dose.

My only concern is that there is an estrogen product out there called 
"Enjuvia" which makes me wonder how long it will take before pharmacists or 
patients get the two confused.

Denise


>From: AnnMarie Roetzer <annmarieroetzer at yahoo.com>
>Reply-To: NP Clinical <np-clinical at nurse.net>
>To: NP Clinical <np-clinical at nurse.net>
>Subject: [NP-Clinical] Januvia
>Date: Mon, 8 Jan 2007 10:31:43 -0800 (PST)
>
>Hello group -
>
>   Just wondering how many people have been using this medication with 
>success.  I had been using it during my last clinical rotation and had seen 
>success with it, but I have rarely seen in used by the PCPs in the area.
>
>   Last week I was working as a nurse at the hospital and one of the 
>cardiologist decided to prescribe this for a patient.  He was 44 y/o A1C of 
>10.6 and had just had an MI.  However even though the recommended dose is 
>100mg daily (which is adjusted for renal failure, which the patient had 
>none) he sent the patient home on 25mg daily.
>
>   I questioned it and he said that is the most appropriate dose.  Is he 
>wrong, just hesistant to use the medication or am I just confused?  Seems 
>to me that without contraindications the drug should be prescribed at the 
>recommended dose.  Anyone who can help out with this would be appreciated.  
>I felt uncomfortable sending the pateint home with a sub-optimal dose, but 
>couldn't really do much about it.  Even the pharmacist at the hospital 
>didnt know anything about the drug since it is currently not carried by the 
>hospital.
>
>   Thanks,
>   AnnMarie
>
>
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