The link between Januvia and pancreatitis has been established using dozens of post-marketing case reviews of patients taking the medication.  The primary ingredient in this drug, sitagliptin, is effective for the treatment of type 2 diabetes.  It doesn’t produce the weight gain or hypoglycemia that other medications often do, but it can still cause life threatening inflammation.  Sitagliptin is particularly troublesome to researchers because it has been implicated in necrotizing and hemorrhagic cases, which are more dangerous than most other acute cases.

Sitagliptin is an inhibitor of the DPP-4 enzyme, a protein that plays an important role in the regulation of blood glucose
.  Normally, DPP-4 reduces the concentration of incretins in the body, which can be harmful for people with diabetes.  Incretins are hormones that stimulate the release of insulin into the blood, and are therefore important for keeping blood glucose at a manageable level.  Because people with type 2 diabetes are insulin resistant, they require additional insulin to lower blood glucose and need to maintain higher levels of incretin hormones to promote homeostasis.  By inhibiting the action of the DPP-4 enzyme, incretin concentrations are higher, which promotes greater levels of insulin.

Approved for use in 2006 by the FDA, Januvia has recently been under intense scrutiny due to reports that Januvia use and pancreatitis were somehow linked.  At first, doctors thought that the correlation was without cause, because people with diabetes often suffer from this disease as a secondary complication.  However, after eighty-eight post-marketing cases were reported to the FDA in a span of just three years, the agency released a safety alert and called for a label warning patients and doctors of the possible link.

Pancreatitis has many causes, but it always starts when digestive enzymes are activated inside the pancreas. It normally presents with severe abdominal pain that may radiate to other parts of the body, like the back.  Nausea and vomiting are also common, and are particularly bad after eating.  Heart rate may be elevated as well, and dehydration may be present if there is internal bleeding. Occasionally, a fever is also present.  Even though most acute cases of this disease are not life threatening, Januvia and severe pancreatitis have been linked, including necrotizing and hemorrhagic forms of the disease.  Necrotizing cases are similar to other acute forms of the disease, except that tissue death may compromise the organ or result in rapid fluid loss.  Hemorrhagic cases can also result in extreme fluid loss.  If not treated immediately, the patient may go into hypovolemic shock, which will put them in imminent danger of death or coma.  Mortality rates of the disease are much higher when tissue death is present.

Anyone who has taken Januvia and suffered from this disease should consider speaking to a drug injury attorney.  This condition requires extensive treatment which is uncomfortable and usually expensive.  Research into the drug suggests that the drug’s manufacturer, Merck, did not check their medication for safety thoroughly enough before placing it on the market.  Victims who have suffered as a result may be able to attain compensation with the help of an experienced attorney.  Terry Bryant is a drug injury lawyer who excels at representing victims of pharmaceutical company negligence. Call for a free initial consultation where you will find out if there is enough evidence to seek restitution that can pay for medical treatment or replace lost wages.