The Medical Letter on Drugs and Therapeutics
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Sitagliptin and Simvastatin (Juvisync)

The FDA has approved Juvisync (Merck), a fixed-dose combination of the antihyperglycemic DPP-4 inhibitor sitagliptin (Januvia) and the HMG-CoA reductase inhibitor simvastatin (Zocor, and others).

ACTIVITY — Statins have been shown to lower the risk of cardiovascular disease in patients with diabetes, even though they may cause small increases in glycated hemoglobin (A1C) and fasting blood glucose levels.1 DPP-4 inhibitors are generally used as alternatives to a sulfonylurea or pioglitazone (Actos) for addition to metformin (Glucophage, and others) in patients who do not achieve their A1C goal with metformin alone; the addition of a DPP-4 inhibitor modestly reduces A1C (0.5-0.8%) and appears to be well tolerated, but the long-term safety of these agents remains to be established.

DOSAGE AND COSTJuvisync ... more      

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