In October of 2011 the FDA approved Juvisync, the first-ever combination drug intended to treat BOTH Type II Diabetes and elevated cholesterol. Juvisync is available only by prescription and is manufactured by the pharmaceutical giant, Merck & Co. As a pharmacist I approach such new combination medications with a measure of enthusiasm, but also with a measure of concern. In this article I will briefly discuss what Juvisync is, how it is intended to be used, and some potential concerns.
Juvisync is a combination of the following two prescription drugs:
1. Sitagliptin: Sitagliptin belongs to a family of medications used to treat Type II Diabetes, a condition which affects over 20 million Americans. Specifically, sitagliptin is a DPP-4 Inhibitor and has been marketed by itself to treat diabetes under the brand name Januvia (originally approved back in 2006). Sitagliptin works by increasing the production of insulin in our body and reducing the production of glucose, thus helping patients with diabetes lower their blood sugar. When used alone, sitagliptin does not tend to produce hypoglycemia (a dangerously low blood sugar), which is a significant advantage over older therapies.
2. Simvastatin: Simvastatin belongs to a family of medications used to treat elevated cholesterol levels known as ‘statins.’ Simvastatin interferes with the normal manufacturing of cholesterol in our body, and thereby reduces total cholesterol. Additionally, statins help to specifically reduce our ‘bad’ cholesterol (LDL cholesterol) while increasing our ‘good’ cholesterol (HDL cholesterol). Simvastatin was orignally marketed under the brand name ‘Zocor’ but has been available generically now for several years.
The Rationale: Why make Juvisync? Why not just take the two products separately?
Here are some arguments in favor of the combination:
First of all there is the benefit of convenience. It is simply easier to take 1 tablet than 2 or more.
Second, there is the benefit of compliance. Statistically we will be more consistent and faithful in taking our medications the fewer the number of pills we have to take.
Third, there is the benefit of cost. If a patient is already taking Januvia and also needs to take something for their cholesterol, it is quite possible that switching to Juvisync might save them some money (assuming that the copay you pay at the pharmacy is the same whether you are taking Januvia or getting the combination product Juvisync).
Finally, this combination targets 2 of the major contributing factors to heart disease, which is still the #1 cause of all deaths in the U.S. Juvisync takes out two giants with 1 stone.
Should you take Juvisync? This question requires a little deeper look into exactly what DPP-4 inhibitors are and also what Statin drugs do. For that purpose I invite you to read two other articles I have written:
What are DPP-4 Inhibitors?
What are Statins?