Short answer: Januvia (sitagliptin) and Tradjenta (linagliptin) are once-daily DPP-4 tablets for blood sugar in adults with type 2 diabetes.12 The main label difference is kidneys: Januvia is 100 mg, lowered to 50 or 25 mg as kidney function falls; Tradjenta is 5 mg with no kidney dose change. Neither label reports a trial against the other.
| Januvia (sitagliptin) | Tradjenta (linagliptin) | |
|---|---|---|
| Dose | 100 mg once a day1 | 5 mg once a day2 |
| Kidney dose changes | 50 mg at eGFR 30 to under 45; 25 mg under 30 or on dialysis1 | None2 |
| Kidney checks | Before starting and periodically after1 | No dose-related kidney checks in the dosing section2 |
| Children | Approved for adults1 | Not established; a 26-week trial in ages 10 to 17 did not show effectiveness2 |
| Most common side effects | Stuffy or runny nose with sore throat 5.2% vs 3.3% (on its own)1 | Stuffy or runny nose with sore throat 7.0% vs 6.1%; diarrhea 3.3% vs 3.0%; cough 2.1% vs 1.4%2 |
| Pancreatitis in trials | 0.1 per 100 patient-years in both sitagliptin and control groups1 | 15.2 vs 3.7 per 10,000 patient-years on comparators2 |
| Boxed warning | None1 | None2 |
| Missed dose | Take when remembered unless the next dose is due1 | Take when remembered unless the next dose is due2 |
Januvia is cleared mostly by the kidneys, so its label lowers the dose as eGFR falls and asks for kidney checks before starting and periodically, more often in people 65 and older.1 The Tradjenta label recommends no dose change for kidney or liver impairment.2 In 133 people with severe kidney impairment, any low blood sugar was 63% on Tradjenta vs 49% on placebo, mostly without symptoms.2
Both list pancreatitis, low blood sugar with insulin or a sulfonylurea, allergic reactions, severe joint pain, bullous pemphigoid and heart failure among their warnings. Januvia also lists acute kidney failure.12 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Your prescriber will weigh kidney function and other medicines. More detail: Januvia side effects, Tradjenta side effects, the Januvia and Tradjenta dosing schedules, and the Sitagliptin and Linagliptin guides.