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Sitagliptin/Simvastatin: a first combination tablet to treat type 2 diabetes and hypercholesterolemia--a review of its characteristics.

Ramadan WH, Kabbara WK - Vasc Health Risk Manag (2015)

Bottom Line: In addition, when compared with insulin glargine, sitagliptin was less effective in decreasing glycosylated hemoglobin, but was associated with significantly lower rates of hypoglycemia.Juvisync should be used in patients requiring both sitagliptin and simvastatin.Both agents have shown good efficacy and acceptable safety profiles.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon.

ABSTRACT

Background: The purpose of this study was to review the current literature and information on the combination product Juvisync™ (sitagliptin + simvastatin), which was approved by the US Food and Drug Administration in October 2011.

Methods: PubMed (2001-2014) was searched for primary and review articles on sitagliptin, simvastatin, or the combination product. Drug manufacturing data and product labeling were also used. Studies of simvastatin, sitagliptin, or the combination were screened and analyzed to include relevant and recent papers. Selected English language trials were limited to those with human subjects and included both safety and efficacy outcomes.

Results: When compared with glipizide as add-on therapy to metformin, sitagliptin was noninferior but had lower rates of hypoglycemia and weight gain. In addition, when compared with insulin glargine, sitagliptin was less effective in decreasing glycosylated hemoglobin, but was associated with significantly lower rates of hypoglycemia. Further, trials have shown a beneficial effect of using statins in patients with diabetes mellitus with regard to decreasing cardiovascular risk, regardless of baseline lipid levels or the presence of a cardiac disease. Both medications have also demonstrated an acceptable side effect profile. However, caution is needed when coadministering with any drug that may increase simvastatin levels to reduce the risk of myopathy and rhabdomyolysis.

Conclusion: Juvisync should be used in patients requiring both sitagliptin and simvastatin. Both agents have shown good efficacy and acceptable safety profiles. Sitagliptin is a good option for diabetic patients to improve glycemic control with a lower risk of hypoglycemia and weight gain.

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Related in: MedlinePlus

Structural formula for sitagliptin.
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f1-vhrm-11-125: Structural formula for sitagliptin.

Mentions: Juvisync™, a medication approved by the US Food and Drug Administration (FDA), is a combination of sitagliptin and simvastatin in one pill. It was approved in October 2011 and is manufactured by MSD International GmbH for Merck and Co.15 Sitagliptin phosphate monohydrate is described chemically as 7-[(3R)-3-amino-1-oxo-4-(2,4,5-trifluorophenyl)butyl]-5,6,7,8-tetrahydro-3-(trifluoromethyl)-1,2,4-triazolo[4,3-a] pyrazine phosphate (1:1) monohydrate, with the structural formula shown in Figure 1.16 Simvastatin is butanoic acid, 2,2-dimethyl-,1,2,3,7,8,8a-hexahydro-3,7-dimethyl-8-[2-(tetrahydro-4-hydroxy-6-oxo-2H-pyran-2-yl)-ethyl]-1-naphthalenyl ester, [1S-[1α,3α,7β,8β (2S*,4S*),-8aβ]], with the structural formula shown in Figure 2.16 The combination pill is indicated for patients requiring both medications, and is considered have significant HbA1c-lowering ability and cardiovascular benefits as well. The objective of this article is to provide an overview of sitagliptin and simvastatin used separately and in combination, which led to the development of Juvisync.


Sitagliptin/Simvastatin: a first combination tablet to treat type 2 diabetes and hypercholesterolemia--a review of its characteristics.

Ramadan WH, Kabbara WK - Vasc Health Risk Manag (2015)

Structural formula for sitagliptin.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4334171&req=5

f1-vhrm-11-125: Structural formula for sitagliptin.
Mentions: Juvisync™, a medication approved by the US Food and Drug Administration (FDA), is a combination of sitagliptin and simvastatin in one pill. It was approved in October 2011 and is manufactured by MSD International GmbH for Merck and Co.15 Sitagliptin phosphate monohydrate is described chemically as 7-[(3R)-3-amino-1-oxo-4-(2,4,5-trifluorophenyl)butyl]-5,6,7,8-tetrahydro-3-(trifluoromethyl)-1,2,4-triazolo[4,3-a] pyrazine phosphate (1:1) monohydrate, with the structural formula shown in Figure 1.16 Simvastatin is butanoic acid, 2,2-dimethyl-,1,2,3,7,8,8a-hexahydro-3,7-dimethyl-8-[2-(tetrahydro-4-hydroxy-6-oxo-2H-pyran-2-yl)-ethyl]-1-naphthalenyl ester, [1S-[1α,3α,7β,8β (2S*,4S*),-8aβ]], with the structural formula shown in Figure 2.16 The combination pill is indicated for patients requiring both medications, and is considered have significant HbA1c-lowering ability and cardiovascular benefits as well. The objective of this article is to provide an overview of sitagliptin and simvastatin used separately and in combination, which led to the development of Juvisync.

Bottom Line: In addition, when compared with insulin glargine, sitagliptin was less effective in decreasing glycosylated hemoglobin, but was associated with significantly lower rates of hypoglycemia.Juvisync should be used in patients requiring both sitagliptin and simvastatin.Both agents have shown good efficacy and acceptable safety profiles.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon.

ABSTRACT

Background: The purpose of this study was to review the current literature and information on the combination product Juvisync™ (sitagliptin + simvastatin), which was approved by the US Food and Drug Administration in October 2011.

Methods: PubMed (2001-2014) was searched for primary and review articles on sitagliptin, simvastatin, or the combination product. Drug manufacturing data and product labeling were also used. Studies of simvastatin, sitagliptin, or the combination were screened and analyzed to include relevant and recent papers. Selected English language trials were limited to those with human subjects and included both safety and efficacy outcomes.

Results: When compared with glipizide as add-on therapy to metformin, sitagliptin was noninferior but had lower rates of hypoglycemia and weight gain. In addition, when compared with insulin glargine, sitagliptin was less effective in decreasing glycosylated hemoglobin, but was associated with significantly lower rates of hypoglycemia. Further, trials have shown a beneficial effect of using statins in patients with diabetes mellitus with regard to decreasing cardiovascular risk, regardless of baseline lipid levels or the presence of a cardiac disease. Both medications have also demonstrated an acceptable side effect profile. However, caution is needed when coadministering with any drug that may increase simvastatin levels to reduce the risk of myopathy and rhabdomyolysis.

Conclusion: Juvisync should be used in patients requiring both sitagliptin and simvastatin. Both agents have shown good efficacy and acceptable safety profiles. Sitagliptin is a good option for diabetic patients to improve glycemic control with a lower risk of hypoglycemia and weight gain.

Show MeSH
Related in: MedlinePlus