Janumet XR
Janumet XR (sitagliptin / metformin) is a combination medication for adults with Type 2 diabetes. It contains two different diabetes medications that help improve blood sugar control. One is sitagliptin, a DPP-4 inhibitor, and the other is metformin, a biguanide. Janumet XR is an extended-release tablet that you take once a day. To get the most out of the medication, take it along with a balanced diet and regular exercise. Some side effects are diarrhea, upper respiratory tract infection, and headache. Currently, this medication is brand name only; there's no generic version available.
What is Janumet XR (sitagliptin / metformin)?
What is Janumet XR (sitagliptin / metformin) used for?
How Janumet XR (sitagliptin / metformin) works
Janumet XR (sitagliptin / metformin) is a combination of two diabetes medications.
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Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor. It blocks the action of DPP-4, a protein that normally breaks down insulin in the body. By blocking DPP-4, insulin can stick around in the body longer. It also stops your body from making glucagon, a hormone that raises blood sugar. This helps control your blood sugar levels.
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Metformin is a biguanide that works in a few ways to lower blood sugar. It stops the liver from making sugar. And it lowers the amount of sugar your body absorbs from food. Metformin also helps your body use its natural insulin better.
Drug facts
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Side effects of Janumet XR (sitagliptin / metformin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Diarrhea (8%)
- Upper respiratory tract infection (6%)
- Headache (6%)
Less Common Side Effects
- Nausea
- Vomiting
- Stomach pain
Note: Side effects were reported for the immediate-release version of Janumet. It could be slightly different for Janumet XR.
Janumet XR (sitagliptin / metformin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Inflammation of the pancreas (pancreatitis): upper belly pain that spreads to your back, nausea, vomiting
- Buildup of lactic acid in the body: rapid breathing, fast heartbeat, feeling weak or tired, nausea, stomach pain, muscle pain, confusion
- Kidney problems: urinating less, itching, swelling of the ankles or feet
- Heart failure: shortness of breath, unusually fast weight gain, swelling of the legs or feet
- Severe allergic reaction: hives, blisters, trouble breathing, swelling of the face or throat
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The following Janumet XR (sitagliptin / metformin) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
blurred vision
chills
cold sweats
confusion
cool, pale skin
dizziness
fast heartbeat
headache
increased hunger
loss of consciousness
mental cloudiness
nightmares
not thinking clearly
seizures
shakiness
slurred speech
unusual tiredness or weakness
Rare
Decreased appetite
fast, shallow breathing
general feeling of discomfort
muscle pain or cramping
sleepiness
stomach discomfort
Incidence not known
Blistering, peeling, or loosening of the skin
darkened urine
hives or welts, itching, or skin rash
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loss of appetite
pains in the stomach, side, or abdomen, possibly radiating to the back
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
severe joint pain
sores, ulcers, or white spots in the mouth or on the lips
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Bloated or feeling of fullness
excess air or gas in the stomach or intestines
indigestion
lack or loss of strength
muscle aches
passing gas
stuffy or runny nose
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Janumet XR (sitagliptin / metformin)
Pros
- Only need to take once a day
- Combines the effects of two diabetes medications into one tablet
- Less likely to cause weight gain and low blood sugar compared to other diabetes medications
Cons
- Only available as a fixed dose, so can be hard to make dose adjustments
- Not a good option for people with severe kidney problems
- Not approved for people with Type 1 diabetes
Pharmacist tips for Janumet XR (sitagliptin / metformin)
- Take Janumet XR (sitagliptin / metformin) once a day, at any time of day. Take it with food to lower the risk of side effects like nausea and upset stomach. It's recommended to take the medication with your evening meal. This could help you remember to take it every day.
- Swallow Janumet XR (sitagliptin / metformin) tablets whole. Don't split, crush, or chew them. Otherwise, the medication could get released into your body too quickly and raise your risk of side effects. If you have trouble swallowing pills whole, talk to your prescriber.
- Follow your diabetes care team's instructions to check your blood sugar regularly. Write down your results and share your log with your prescriber. This helps them see how well the medication is working. They can adjust your diabetes treatment plan based on the trends they see.
- Tell your healthcare team about any surgeries or imaging tests or if you've had one in the past 2 days. Janumet XR (sitagliptin / metformin) can interact with contrast dyes that some procedures use. This can cause kidney problems. To be safe, your care team can tell you if you need to stop taking the medication before your procedure. Then, they'll tell you when it's safe to start taking it again.
- It's best to avoid alcohol with Janumet XR (sitagliptin / metformin). Alcohol can make some side effects, like headaches and stomach upset, worse. Also, drinking too much alcohol while taking the medication can raise your risk of a serious condition called lactic acidosis. Talk to your prescriber about your drinking habits.
- With Janumet XR (sitagliptin / metformin), it's also important to eat balanced, nutritious meals and stay active. This helps improve your blood sugar levels even more and helps you get the most out of your treatment plan. Ask your care team for guidance on how to best manage your diabetes.
Common questions about Janumet XR (sitagliptin / metformin)
It's recommended to take Janumet XR (sitagliptin / metformin) with your evening meal. This helps lessen your chance of having stomach upset during the day. After you take the medication at night, it works throughout the night and into the next day. If this doesn't work for you, you can actually take the medication at any time of day, as long as you stay consistent. If you have trouble finding a time that works for you, ask your prescriber or pharmacist.
No. Don't take Janumet XR (sitagliptin / metformin) twice a day. It's meant to be taken just once a day. If you need to take two tablets of the medication for your dose, take them together (one after another). Don't take Janumet XR (sitagliptin / metformin) more often than once a day. Otherwise, it could raise your risk of side effects like low blood sugar.
It's possible to lose a little weight while taking Janumet XR (sitagliptin / metformin). This is because the metformin in this medication can have a beneficial effect on weight. Studies show that weight loss with Janumet XR (sitagliptin / metformin) might be about the same as with metformin alone. Be sure to eat a balanced diet and stay active. This is important for managing both diabetes and weight. If you have questions about how Janumet XR (sitagliptin / metformin) might affect your weight, talk to your prescriber.
Janumet XR (sitagliptin / metformin) can start lowering blood sugar within the first week of treatment. But it can take 3 to 6 months to see its full effect on your A1C, which is your average blood sugar over 3 months. Everyone's experience with medications is different. So, ask your prescriber if you have questions about how fast Janumet XR (sitagliptin / metformin) is working for you.
Traces of Janumet XR (sitagliptin / metformin) can stay in your system for a few days after your last dose. This time frame is based on the medication's half-life. The half-life is an estimation of how long it takes the body to clear the medication from your system. The body uses the kidneys to help get rid of Janumet XR (sitagliptin / metformin). So if you have kidney problems, the medication might stay a bit longer in your system. If you have questions about how long this medication stays in your system, talk to your prescriber.
As of summer 2025, there's no generic version of Janumet XR (sitagliptin / metformin) yet. It's currently only available as a brand-name medication.
Janumet and Janumet XR are both combination medications for Type 2 diabetes. They both contain sitagliptin (a DPP-4 inhibitor) and metformin (a biguanide). Janumet is the immediate-release version and it's taken twice a day. Janumet XR is the extended-release version. It's taken just once a day and lasts throughout the day. If you're taking Janumet and have trouble remembering to take your second dose each day, ask your prescriber if you can switch to Janumet XR.
Zituvimet XR and Janumet XR are brand-name combination medications for adults with Type 2 diabetes. They both have the same two active ingredients into one pill — sitagliptin and metformin. The main difference is which pharmaceutical company makes each one. Zituvimet XR is made by Zydus Lifesciences, and Janumet XR is made by Merck. Talk to your prescriber to learn more about other similarities and differences.
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Risks and warnings for Janumet XR (sitagliptin / metformin)
Janumet XR (sitagliptin / metformin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Lactic acidosis
- Risk factors: Kidney problems | Liver problems | Heart problems | Age 65 or older | Drinking a lot of alcohol | People with food or fluid restrictions | Using contrast dye for surgery or other procedures
Janumet contains metformin. Although rare, metformin can cause a serious condition called lactic acidosis (too much lactic acid in the blood). This condition can lead to other health problems that can be life-threatening. Tell your prescriber about all your medical conditions and medications before you start treatment. They can check your risk for lactic acidosis.
Call your care team right away if you notice fast breathing, trouble breathing, an unusual heartbeat, a very upset stomach, or muscle pain. Also reach out if you feel very sleepy, tired, weak, dizzy, or cold. These can be signs that you have too much lactic acid in your blood. Your care team can work to help treat this condition.
Inflammation of the pancreas (pancreatitis)
Although rare, some people taking Janumet XR (sitagliptin / metformin) had an inflamed pancreas (pancreatitis). It's not clear if people who've had pancreatitis in the past are more likely to get it again during treatment. To be safe, tell your prescriber if you've had pancreatitis before.
Stop taking Janumet XR (sitagliptin / metformin) and get medical help right away if you feel belly pain that won't go away or that spreads to your back. This can happen with or without nausea and vomiting. These can be signs of pancreatitis that a healthcare professional should check out.
Risk of heart failure
- Risk factors: History of heart failure | History of kidney issues
Some clinical studies found that there might be a link between DPP-4 inhibitor (like sitagliptin) and heart failure. People in these studies had or were at risk of heart disease.
It's not clear if Janumet XR (sitagliptin / metformin) raises the risk of heart failure. To be safe, tell your prescriber about your full medical history before starting this medication. This is especially important if you have a history of or are at risk of heart failure. They can help explain the risks and benefits of treatment.
Get medical help right away if you notice any symptoms related to heart failure. This includes shortness of breath, fast or irregular heartbeat, swelling in the ankles or feet, rapid weight gain, and chest pain.
Sudden kidney problems
- Risk factors: Older adult | History of kidney issues
Some people had worsening kidney function while taking Janumet XR (sitagliptin / metformin). In some cases, acute (sudden) kidney failure happened and people needed dialysis to manage it.
Tell your prescriber about all your health problems before starting Janumet XR (sitagliptin / metformin). This medication isn't a good choice for people with severe kidney issues. During treatment, your prescriber will regularly check that your kidneys are okay with blood tests. If your kidneys get worse, you might need to stop taking the medication.
Low vitamin B12 levels
- Risk factors: Long-term use of Janumet XR (sitagliptin / metformin) | Lower than average calcium absorption | Lower than average vitamin B12 absorption
The metformin in Janumet can lower how much vitamin B12 your body absorbs. This can make your vitamin 12 levels drop, which could lead to anemia (a low red blood cell count). To be safe, your prescriber might check for low vitamin B12 and anemia with a blood test every 1 to 3 years.
Let your care team know if you feel tired or dizzy, have weak muscles, or feel tingling or numbness. These could be signs of low vitamin B12. If blood tests show your levels are low, your prescriber might recommend a vitamin B12 supplement to get your levels back up.
Low blood sugar (hypoglycemia) when taken with certain diabetes medications
- Risk factors: Also using insulin | Also taking sulfonylureas like glipizide
When you take Janumet XR (sitagliptin / metformin) with certain other diabetes medications, you have a higher chance of low blood sugar (hypoglycemia). These diabetes medications are insulin and sulfonylureas like glipizide. Very low blood sugar can be dangerous.
Be sure you know how to recognize and treat low blood sugar. Look for symptoms like feeling shaky, very hungry, confused, or weak. You also might be nervous or anxious, have a fast heartbeat, or sweat. Talk to your healthcare team if you're worried about low blood sugar while taking Janumet XR (sitagliptin / metformin).
Joint pain
Some people who've taken a DPP-4 inhibitor like the sitagliptin in Janumet have had severe and disabling joint pain. This has happened within one day to years after starting the medication. For most people, the pain goes away after they stop taking it. Talk to your prescriber if you feel any discomfort in your joints.
Severe skin reaction
Some people who've taken a DPP-4 inhibitor, like the sitagliptin in Janumet, have had a skin reaction called bullous pemphigoid. It's an itchy, blistering rash. Usually, the blisters or sores go away once you stop taking the medication and get treated.
Let your care team know if you have itchy skin, a rash with blisters, or sores while taking Janumet XR (sitagliptin / metformin). You might need to stop taking the medication and see a dermatologist.
Serious allergic reactions
It's rare, but some people can have a serious allergic reaction to Janumet XR (sitagliptin / metformin). This can include life-threatening reactions like peeling, blistering skin and anaphylaxis. Allergic reactions can happen within the first 3 months of treatment. But they can also happen at any time.
Tell your prescriber if you've had an allergic reaction to other DPP-4 inhibitors or "gliptins." Examples are Januvia (sitagliptin) and saxagliptin (Onglyza). It's not clear if you could also have an allergic reaction to Janumet XR (sitagliptin / metformin).
Stop taking Janumet XR (sitagliptin / metformin) and get medical help right away if you have an allergic reaction. This can look like a widespread rash, hives, blisters, peeling skin, trouble breathing, or swelling in your face or throat.
Janumet XR (sitagliptin / metformin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/500mg | 60 tablets | $326.67 | $5.44 |
| 50mg/1000mg | 60 tablets | $326.22 | $5.44 |
| 100mg/1000mg | 30 tablets | $326.30 | $10.88 |
Typical dosage for Janumet XR (sitagliptin / metformin)
The typical starting dose is 100 mg/1,000 mg (sitagliptin/metformin) by mouth once daily with a meal.
Your dose might differ if you were taking metformin by itself before you started Janumet XR.
The maximum daily dose for Janumet XR is 100 mg/2,000 mg (sitagliptin/metformin).
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Interactions between Janumet XR (sitagliptin / metformin) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Acetrizoic Acid
- Diatrizoate
- Ethiodized Oil
- Iobenzamic Acid
- Iobitridol
- Iocarmic Acid
- Iocetamic Acid
- Iodamide
- Iodipamide
- Iodixanol
- Iodohippuric Acid
- Iodopyracet
- Iodoxamic Acid
- Ioglicic Acid
- Ioglycamic Acid
- Iohexol
- Iomeprol
- Iopamidol
- Iopanoic Acid
- Iopentol
- Iophendylate
- Iopromide
- Iopronic Acid
- Ioseric Acid
- Iosimide
- Iotasul
- Iothalamate
- Iotrolan
- Iotroxic Acid
- Ioxaglate
- Ioxitalamic Acid
- Ipodate
- Metrizamide
- Metrizoic Acid
- Tyropanoate Sodium
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aspirin
- Balofloxacin
- Besifloxacin
- Bupropion
- Capmatinib
- Chloroquine
- Chlorpropamide
- Ciprofloxacin
- Dasabuvir
- Dofetilide
- Dolutegravir
- Enoxacin
- Fleroxacin
- Flumequine
- Gatifloxacin
- Gemifloxacin
- Glimepiride
- Glipizide
- Glyburide
- Hydroxychloroquine
- Ioversol
- Lanreotide
- Levofloxacin
- Lomefloxacin
- Metformin
- Moxifloxacin
- Nadifloxacin
- Nateglinide
- Norfloxacin
- Octreotide
- Ofloxacin
- Ombitasvir
- Paritaprevir
- Pasireotide
- Pazufloxacin
- Pefloxacin
- Pioglitazone
- Prulifloxacin
- Repaglinide
- Ritonavir
- Rufloxacin
- Simeprevir
- Sitagliptin
- Sparfloxacin
- Tafenoquine
- Thioctic Acid
- Tolazamide
- Tolbutamide
- Tosufloxacin
- Vandetanib
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Atenolol
- Betaxolol
- Bisoprolol
- Bitter Melon
- Carteolol
- Carvedilol
- Celiprolol
- Colesevelam
- Esmolol
- Fenugreek
- Furazolidone
- Glucomannan
- Guar Gum
- Iproniazid
- Isocarboxazid
- Labetalol
- Levobunolol
- Linezolid
- Methylene Blue
- Metipranolol
- Metoprolol
- Moclobemide
- Nadolol
- Nebivolol
- Nialamide
- Oxprenolol
- Patiromer
- Penbutolol
- Phenelzine
- Pindolol
- Practolol
- Procarbazine
- Propranolol
- Psyllium
- Ranolazine
- Rasagiline
- Rifampin
- Safinamide
- Selegiline
- Sotalol
- Timolol
- Tranylcypromine
- Verapamil
How much does Janumet XR (sitagliptin / metformin) cost?
$326.22
Janumet XR (sitagliptin / metformin) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Janumet XR (sitagliptin / metformin) will not be safe for you to take.
- Poor kidney function
- Metabolic acidosis (including diabetic ketoacidosis)
- Allergic reaction to sitagliptin or metformin
What are alternatives to Janumet XR (sitagliptin / metformin)?
News about Janumet XR (sitagliptin / metformin)
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