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La titulacin debe ser lenta, comenzando en rangos de 0.5 mg a 1 mg semanal , con incrementos mensuales cautelosos para permitir la adaptacin de los receptores y evitar la taquifilaxia o el abandono por intolerancia

This albumin binding dramatically extends the peptide half-life to approximately six days, which supports once-weekly subcutaneous administration

By inhibiting DPP-4, Januvia increases the levels of active incretin hormones in the bloodstream, which in turn enhances insulin secretion and suppresses glucagon release in a glucose-dependent fashion

Patients who frequently miss doses or delay injections beyond the weekly schedule may experience fluctuating appetite control

In addition to the intravenous infusion studies described above, it was found that daily prandial subcutaneous injections of GLP-1 7-36 amide (76 nmol 4 times daily) to obese human subjects over 5 days led to a 15% mean reduction in energy intake at each meal compared with placebo

Amado employs a titration strategystarting with a low dose and gradually increasing it over several monthsto minimize these side effects