July 14, 2008

Januvia 3rd Most Heavily Marketed Drug - VT Drug Disclosure Document

UPDATE (April 2, 2013): Before you take Byetta, Victoza, Onglyza, or Januvia please read about the new research that shows that they, and probably all incretin drugs, cause severely abnormal cell growth in the pancreas and precancerous tumors. You'll find that information HERE.

Original Post:

As a good example of what a poor job the medical press does in telling us the truth about drug company activity, when an alert reader sent me the link to the actual VT state report on drug company expenditures, I learned that in Vermont, Januvia is the third most heavily marketed drug in terms of drug company money spent promoting it. In fact, it is the single most heavily promoted drug for a medical condition. The two other most heavily promoted drugs were the psychiatric drugs being pushed on kids.

Yet not a single piece of reporting that discussed the Vermont report mentioned Januvia! More importantly, buried in the report, and again, not reported in the media, was the fact that the third group of doctors who were paid the most by the drug companies were family doctors--specialists in internal medicine--who received an average of $13,209 apiece from drug companies.

Not so surprisingly, it is those internists who are writing the bulk of the prescriptions for Januvia--internists who, by the way, do not have a clue what this extremely dangerous drug does, besides lowering blood sugar.

In fact, Januvia lowers blood sugar by impeding the action of an enzyme, DPP-4, which is an essential part of the immune systems mechanism for destroying cells that have become cancerous. In particular, DPP-4 is heavily involved in destroying metatastic melanocytes which cause melanoma, it also is involved in controlling the cancerous cells that cause ovarian and prostate cancer. I have been pointing this out for more than a year.

Recently I received an email from a reader who pointed me to a letter from a physician, Dr. Mark R. Goldstein to Annals of Internal Medicine on the subject of how DPP-4 inhibitors may promote cancer. You can read that letter HERE

I contacted Dr. Goldstein and he wrote me back, "My interpretation and analysis of the New Drug Application submitted to the FDA for Januvia (reference # 8 in my letter), is that Januvia promoted 10 cancers for every 1000 subjects treated for a year. Compared to placebo, the annualized cancer incidence increased from 9 to 19 of 1000 subjects treated for a year.

"There may be 3 million taking Januvia at this time and it is highly advertised. Extrapolating the data from the New Drug Application suggests that this has the potential to cause 30,000 extra cancers each year in the US. Since there are about 1.5 million new cases of cancer each year in this country, 30,000 more doesn't make much of a "blip" on the radar screen."

It is nothing more than "a blip" and that means the drug companies know that the connection of their drug to cancers is not likely to show up, since family doctors won't even connect new cancers in their patients with a diabetes drug they prescribed two or three years before and the overburdened FDA doesn't track cancer incidence in people prescribed new drugs.

But think of the toll paid by the 30,000 people who may die because their family doctor prescribed this new, not very effective, but highly dangerous drug after being paid all those thousands of dollars by drug companies and being targeted by the many millions of dollars those drug companies spend promoting those drugs.

The whole Vermont report is available HERE. As you read it remember that Vermont is a tiny state with very few doctors. The drug company doctor payoffs documented here are only a tiny fraction of those going on in larger states with more population and more doctors. For that matter, they are a small number of the drug company doctor payoffs in Vermont, since they only had to list (by specialty only) the top 100 doctors.

And please, if you or someone you love is freshly diagnosed with diabetes and put on Januvia, ask your family doctor if they are aware of the research connecting DPP-4 inhibition with cancer and direct them to Dr. Goldstein's article with its cites of the research literature. And if the doctor still insists Januvia is safe, ask them how much they received from Merck the past year. And how many visits they get every month from Merck sales reps.


The Old Man and His Dog said...

Cancer incidence more than doubled? compared to placebo? from 9 to 19? after a year?

I feel sick. I'm still on Janumet.

renegadediabetic said...

Reality is that the new, brand name drugs are more profitable than the generics. Hence the recent advertizing blitz on januvia. I'll just stick with my metformin.

What does it say about the state of our health when they are advertizing diabetes drugs and glucose meters on prime time TV?

Jenny said...

"What does it say about the state of our health when they are advertizing diabetes drugs and glucose meters on prime time TV?"

It says that 1 in 4 people who are over 60 have Type 2 diabetes and they the main group still watching TV.

We are nothing more than a profit center to the medical industry. If we get heart disease we earn more money for them. If we get kidney failure they can sell us dialysis. If we get amputations, they can sell us hospital services and surgery.

The only wrench in the works would be if we lowered our blood sugar through an effective diet, but they are making sure that their wholly owned subsidiary, the American Diabetes Association, doesn't do anything that might let that happen.

Arun.N.M. said...

Congrats Jenny for the post on Januvia.Januvia is as agressively marketed here in India as in US,may be not on prime time TV but everywhere else. True we need long term safety data before unleashing on the public not so useful drug.
Dont judge ADA that badly.They are doing some good work too.

Alex said...

I was taking 50 mg of Januvia for 2 month and lost very much undesirable 10 lbs (I am 5'7" and was 148lbs when I started taking it). In addition, my liver enzymes shot through the roof (a known side effect??). After I stopped taking it, I continue losing weight, which absolutely petrifies me. Does anybody happens to know how long Januvia stays in your body after it has been terminated? Please help me get some kind of traction on this as I am at my wits' end..


_ Alex

Jenny said...


Based on its impact on my blood sugar, it took 2 weeks for Januvia to completely wash out of my body.

Alex said...

Jennie, thnx for your response...Are you at liberty to disclose how much of Januvia you were taking and for how long, so I can try to correlate it to my case? It's been almost 4 weeks since I have stopped taking it and I am still losing weight. Also, are the elevated liver enzymes a known side effect of this drug?

Thanks again..

_ Alex

Jenny said...

I was taking one 100 mg pill a day for about 3 months.

Liver enzyme elevation is not listed as a side effect for Januvia, but that doesn't mean all that much given the very short testing period and the small population involved in the pre-approval testing.

Galvus, which is a competing oral DPP-4 inhibitor DID worsen liver enzymes. It is a very similar drug to Januvia.

Please report your experiences to the MEDWATCH program of the FDA as this is the only way they will learn of side effects. Ask your doctor to report it too, though in my experience few doctors will.


Alex said...

I was wondering if Januvia could possibly effect my thyroid and make it hyperactive? Have you heard or read of this specific side effect?

Thanks again..

_ Alex

Jenny said...


I have not heard of a thyroid-Januvia relationship. Mostly people report rashes, joint and back pain, stomach bloating, continual runny noses, sinus headaches, slow healing.

Here are many reports of problems with Januvia posted on the old Diabetes Monitor blog.

Januvia and Galvus Blog.

Sorry I can't help you get to the bottom of this problem, but this really is a situation where your doctor should be acting more aggressively to diagnose the problem.

Anonymous said...

Has anyone reported increased glucose levels with Januvia?
Still taking metformin (850 x3)with the Januvia (100Mg) but stopped taking glipizide. Blood glucose dramatically increased.

Anonymous said...

The Januvia didn't make your BG go up, it's a lack of glipizide that did that.

Anonymous said...

I was just prescribed this drug by my doctor.. THANK GOD it was too costly to buy because that made me research ways to get it discounted.. I found discounts but most importantly I found alot of scarry blogs.. I will not take this drug if it is given away for free.. Thank you for posting this info.. I am printing a copy to give to my Doctor.. Lets hope shes open to reading it