Diabetes Self-Management Articles

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Tools of the Trade 2012

by Alwa Cooper

Availability: Belviq is available in 10-mg doses, and is usually taken twice a day.

Product: Phentermine and topiramate extended-release (Qsymia)

Manufacturer: Vivus, Inc.
(888) 998-4887

What it does: Qsymia is also approved for long-term weight management, as an addition to a reduced-calorie diet and exercise. Qsymia combines two drugs — phentermine, an appetite suppressant, and topiramate, usually prescribed to control seizures. Phentermine was originally prescribed as part of the unsafe diet drug fen-phen; topiramate makes people feel full longer, increases calorie burning, and makes food taste less appealing. Like Belviq (see above), Qsymia is approved for people with a BMI of 30 or greater or who have a BMI between 27 and 29 and have at least one weight-related condition. People with glaucoma, overactive thyroid, recent or unstable heart disease, recent stroke, or who are taking a type of antidepressant known as an MAOI should not take Qsymia. The drug can cause birth defects and should not be used by women who are pregnant. The most common side effects of Qsymia are tingling of the hands and feet, dizziness, insomnia, constipation, and dry mouth.

Availability: Qsymia is available in tablets of 7.5 mg phentermine/46 mg topiramate extended-release and 15 mg phentermine/92 mg topiramate extended-release, and should be taken once a day.

Product: Pioglitazone

Manufacturer: Mylan
(724) 514-1800

What it does: Pioglitazone is a drug in the class known as thiazolidinediones (the use of the other, rosiglitazone [Avandia], was restricted by the FDA in 2010), which works by increasing the body’s insulin sensitivity. Pioglitazone has been available since 1999 under the brand name Actos, but this year Mylan Pharmaceuticals and Ranbaxy Labs reached a settlement with Takeda, the manufacturer of Actos, to produce a generic version. Generic pioglitazone will carry the same boxed warnings about increased risk of heart failure and bladder cancer as the brand-name version.

Availability: Pioglitazone is available in 15-, 30-, and 45-mg tablets.

Product: Sitagliptin and metformin extended release (Janumet XR)

Manufacturer: Merck
(800) 444-2080

What it does: Janumet XR combines the DPP-4 inhibitor sitagliptin (Januvia) with the extended-release version of metformin. Like all drugs that contain metformin, Janumet XR comes with a boxed warning about lactic acidosis. The drug should not be taken by people with existing kidney problems, and people taking it should be monitored regularly for pancreatitis and worsening kidney function.

Availability: Janumet XR should be taken with food once a day, preferably in the evening, and is available in tablets of 100 mg sitagliptin/1,000 mg metformin extended-release, 50 mg sitagliptin/500 mg metformin extended-release, and 50 mg sitagliptin/1,000 mg metformin extended-release.

Product: Sitagliptin and simvastatin (Juvisync)

Manufacturer: Merck
(800) 444-2080

What it does: Juvisync combines sitagliptin (Januvia) and simvastatin (Zocor) in one pill; sitagliptin is a DPP-4 inhibitor, and simvastatin, a statin, lowers LDL (“bad”) cholesterol. Common side effects of Juvisync include upper respiratory infection, stuffy or runny nose and sore throat, headache, muscle and stomach pain, constipation, and nausea.

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