Steglatro and Januvia are both medicines used to treat type 2 diabetes, but they work in different ways.
- Steglatro is ertugliflozin (an SGLT2 inhibitor). It works by helping your kidneys remove more glucose in the urine. Good for lowering blood sugar and may have benefits for heart/kidney health in some people. Common side effects include more urination, genital or urinary infections, dehydration, and dizziness. Rare but important risks include ketoacidosis (even with normal blood sugar) and, very rarely, serious infections.
- Januvia is sitagliptin (a DPP-4 inhibitor). It helps boost incretin hormones, which increases insulin release and lowers glucagon after meals, helping to lower blood sugar. Side effects are usually mild but can include stuffy nose, sore throat, headache, and sometimes stomach upset. There is a (rare) risk of pancreatitis and, with some people, joint pain.
- Using them together: They can be prescribed together. Some people take them as separate pills, and there is also a fixed-dose combination pill that contains ertugliflozin and sitagliptin (a combination product sometimes marketed under a name like Steglujan). This can simplify dosing for people who need both mechanisms.
- Who might benefit from the combination: If you’re not achieving your blood sugar goals on one medicine, or your doctor wants to use two different mechanisms to control sugars, they might add one of the other or use the fixed-dose combo.
- Important safety notes:
- Kidney function matters: SGLT2 inhibitors (like ertugliflozin) work best with adequate kidney function and may be stopped or not started if kidney function is reduced. Sitagliptin dosing is adjusted based on kidney function.
- Both drugs can increase the risk of hypoglycemia when used with insulin or sulfonylureas; dose adjustments of those other meds may be needed.
- Not for type 1 diabetes or for diabetic ketoacidosis. Avoid in pregnancy unless advised by a clinician.
- Tell your doctor about kidney disease, pancreatitis, or a history of severe infections, since these can affect treatment choices.
If you’re asking because you’re considering starting one or both, or you’ve been prescribed them and want to know how they fit together, tell me a bit more about:
- Are you currently taking metformin or other diabetes medications?
- Do you know your kidney function (eGFR/CrCl)?
- What is your target A1C and any specific health concerns (heart/kidney disease, recurrent infections, etc.)?
I can help translate that into how these drugs might fit your situation, or help compare options with your healthcare provider.