Janumet
Janumet (sitagliptin / metformin) is a medication for adults with Type 2 diabetes. It contains two different diabetes medications that work together to help control blood sugar. One is sitagliptin, a DPP-4 inhibitor, and the other is metformin, a biguanide. The Janumet immediate-release tablets are taken by mouth twice a day. It works best when used with a balanced meal plan and exercise routine. Some side effects are diarrhea, upper respiratory tract infection, and headache. There's only a brand-name version of Janumet; there's no generic version yet.
What is Janumet (sitagliptin / metformin)?
What is Janumet (sitagliptin / metformin) used for?
How Janumet (sitagliptin / metformin) works
Janumet (sitagliptin / metformin) is a combination of two diabetes medications. It works to help lower blood sugar.
- 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.
- Metformin is a biguanide that works in a few ways. 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 (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
Janumet (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 (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 (sitagliptin / metformin)
Pros
- 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
- Can lower A1C by up to 2% in 6 months
Cons
- Must take twice a day with meals
- 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 (sitagliptin / metformin)
- Swallow the Janumet (sitagliptin / metformin) tablet whole. Don't split, cut, crush, or chew it. Speak to your prescriber if you have trouble swallowing pills whole.
- Take Janumet (sitagliptin / metformin) with a meal. This helps lower the risk of side effects like nausea and diarrhea.
- Check your blood sugar regularly as your diabetes care team told you to. Write down your results and share them with your prescriber. This helps them see how well the medication is working for you. It also helps them figure out the diabetes treatment plan that works best for you.
- It's a good idea to avoid alcohol while taking Janumet (sitagliptin / metformin). Alcohol can sometimes make some side effects, like headaches and stomach upset, worse. Also, drinking too much alcohol with this medication can put you at risk of a very serious condition called lactic acidosis. Talk to your prescriber about how much alcohol you drink.
- Let your healthcare team know if you're going to have surgery or an imaging test or if you've had one in the past 2 days. Janumet (sitagliptin / metformin) can interact with contrast dyes that some procedures use. This can cause problems for your kidneys. Your care team can tell you if you need to stop taking the medication before your procedure and when it's safe to start taking it again.
- Along with taking Janumet (sitagliptin / metformin), it's important to eat a balanced diet and exercise regularly as part of your diabetes treatment plan. When you do all three, it helps improve your blood sugar. This helps you get the most out of your treatment. Ask your care team about how to best manage your diabetes.
Common questions about Janumet
You can take Janumet at any time of day, but it's important to be consistent. Also keep in mind that you need to take the medication twice a day, each time with a meal. So, it could be a good idea to take Janumet with breakfast and with dinner each day. If you're not sure when to take your medication, talk to your prescriber or pharmacist.
Some people might lose a little weight while taking Janumet. The metformin in Janumet can have beneficial effects on weight for some people. Studies show that the amount of weight loss with Janumet is about the same as with metformin alone. Keep in mind that making healthy changes to diet and staying active are key parts of managing diabetes. They can also play a role in managing your weight. If you have questions about how this medication could affect your weight, talk to your prescriber.
No, Janumet isn't a GLP-1 medication. Instead, it's a combination medication with two different types of diabetes medications in it. One is sitagliptin, which is a DPP-4 inhibitor, and the other is metformin, a biguanide. GLP-1 agonists and Janumet both help lower blood sugar, but they work in different ways. Talk with your prescriber to see which type of diabetes medication is right for you.
No. Don't crush the Janumet tablets or cut them in half. The tablets don't have a score line (an indented line down the middle of the tablet). This means that it's not a good, or safe, idea to try to split it. It could result in halves with uneven amounts of medication, and you could get hurt. If you have trouble swallowing the tablets whole, speak with your prescriber.
You should avoid drinking alcohol while taking Janumet. Drinking alcohol can make some side effects, like an upset stomach and headaches, feel worse. It can also make your blood sugar drop too much, particularly if you haven't eaten or have just exercised. This can be dangerous. What's more, drinking a lot of alcohol during treatment can raise your risk of a very serious problem called lactic acidosis. Because of this, it's best to talk to your prescriber about your drinking habits while you're taking this medication.
Janumet can start to help lower your blood sugar within the first week of treatment. But it can take 3 to 6 months of taking the medication regularly to see its full effect on your A1C. Your A1C is a way to measure what your average blood sugar has been over 3 months. Keep in mind that everyone can have a different experience with medications. So, it's a good idea to talk to your prescriber to learn more about how fast Janumet might work for you.
Zituvimet and Janumet are brand-name medications for adults with Type 2 diabetes. They have the same active ingredients. They both combine the same two diabetes medications into one pill — sitagliptin and metformin. The main difference is which pharmaceutical company makes each one. Zituvimet is made by Zydus Lifesciences, and Janumet is made by Merck. Talk to your prescriber to learn more about other similarities and differences.
No, Janumet isn't the same as Januvia. Januvia has one active ingredient in it — sitagliptin. But Janumet has two — sitagliptin and metformin. For people who need to take Januvia and metformin for better blood sugar control, Janumet can be a convenient option. This is because you don't have to take two different pills. Talk to your prescriber to compare Janumet to Januvia and see which is right for you.
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Risks and warnings for Janumet (sitagliptin / metformin)
Janumet (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 your medical history and your other medications before you start treatment. They can check if you're at risk of 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 (sitagliptin / metformin) had an inflamed pancreas (pancreatitis). It's not clear if people who've had pancreatitis before are more likely to get it again with treatment. To be safe, tell your prescriber if you've had pancreatitis before.
Stop taking Janumet (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 (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 you understand 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 (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 (sitagliptin / metformin). This medication isn't a good choice for people with severe kidney issues. During treatment, your prescriber will check your blood regularly. This helps them make sure your kidneys are okay. If your kidneys get worse, you might need to stop taking the medication.
Low vitamin B12 levels
- Risk factors: Long-term use of Janumet (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.
Tell your care team 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 (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 having low blood sugar while taking Janumet (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 this medication. For most people, the pain goes away after they stop taking it. Talk to your prescriber right away 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 looks like an itchy, blistering rash. Usually, the blisters or sores go away once you stop taking the medication and get treated.
Talk to your care team if you have itchy skin, a rash with blisters, or sores while taking Janumet (sitagliptin / metformin). You might need to stop taking the medication and see a dermatologist.
Serious allergic reactions
Although it's rare, some people can have a serious allergic reaction to Janumet (sitagliptin / metformin). This can include life-threatening reactions like peeling, blistering skin and anaphylaxis. Allergic reactions most often happen within the first 3 months of treatment. But they can also happen at any time.
Be sure to 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 might have an allergic reaction if you take Janumet (sitagliptin / metformin).
Stop taking Janumet (sitagliptin / metformin) and get medical help right away if you have an allergic reaction. Look out for a widespread rash, hives, blisters, peeling skin, trouble breathing, or swelling in your face or throat.
Janumet (sitagliptin / metformin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/500mg | 60 tablets | $326.65 | $5.44 |
| 50mg/1000mg | 60 tablets | $326.44 | $5.44 |
Typical dosage for Janumet (sitagliptin / metformin)
The typical starting dose is 50 mg/500 mg (sitagliptin/metformin) by mouth twice daily with meals.
Your dose might differ if you were taking metformin by itself before you started Janumet.
The maximum daily dose for Janumet is 100 mg/2,000 mg (sitagliptin/metformin).
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Interactions between Janumet (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 (sitagliptin / metformin) cost?
$326.44
Janumet (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 (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 (sitagliptin / metformin)?
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