sitagliptin / metformin
Zituvimet (sitagliptin / metformin) is a combination medication that's used to manage blood sugar in adults living with Type 2 diabetes. This medication is used in addition to a balanced diet and exercise. Zituvimet (sitagliptin / metformin) is taken by mouth twice a day with meals. Diarrhea, upper respiratory tract infection, and headache are some potential side effects.
What is Zituvimet (sitagliptin / metformin)?
What is Zituvimet (sitagliptin / metformin) used for?
- Type 2 diabetes
How Zituvimet (sitagliptin / metformin) works
Zituvimet (sitagliptin / metformin) is a combination of two different diabetes medications.
- Metformin is a biguanide. It works by lowering the amount of sugar your liver releases into your blood and the amount of sugar that gets absorbed into the body through your gut. It also helps your body respond better to insulin.
- Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor. It blocks the action of DPP-4, a protein that normally breaks down hormones that tell the body to make insulin. By blocking DPP-4, the medication allows insulin to stick around in your body longer to help control your blood sugar levels.
Drug facts
Side effects of Zituvimet (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
Zituvimet (sitagliptin / metformin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Buildup of lactic acid in the body: sudden drop in blood pressure, low body temperature, slow heart rhythm, feeling weak, stomach pain, nausea
- Inflammation of the pancreas: upper belly pain, nausea, vomiting
- Heart failure: shortness of breath, unusually fast weight gain, swelling of the legs or feet
- Kidney problems: urinating less, itching, swelling of the ankles or feet
- Severe allergic reaction: hives, blisters, trouble breathing, swelling of the face or throat
The following Zituvimet (sitagliptin / metformin) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Low vitamin B12 level—pain, tingling, or numbness in the hands or feet, muscle weakness, dizziness, confusion, trouble concentrating
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Severe joint pain
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Gas
- Headache
- Nausea
- Runny or stuffy nose
- Sore throat
- Upset stomach
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Pros and cons of Zituvimet (sitagliptin / metformin)
Pros
Cons
- Must take with meals
- Might not be a good option for people with kidney or liver problems
- Risk of lactic acidosis
Pharmacist tips for Zituvimet (sitagliptin / metformin)
- Take Zituvimet (sitagliptin / metformin) with meals. This helps lower your risk of stomach side effects (upset stomach).
- Swallow the Zituvimet (sitagliptin / metformin) tablets whole. Don't break or cut them. Contact your prescriber to talk about your options if you have trouble swallowing your pills.
- Avoid alcohol while you're taking Zituvimet (sitagliptin / metformin). Drinking alcohol with this medication can put you at risk of having too much acid in your body (lactic acidosis) and low blood sugar.
- Let your healthcare team know if you have a scheduled surgery or imaging procedure that will use contrast dye or if you've had one within the past 48 hours. Zituvimet (sitagliptin / metformin) can interact with the contrast, which can harm your kidneys. Follow your care team's instructions if you need to stop the medication before your procedure and restart it afterwards to protect your kidneys.
- Check your blood sugar as instructed by your healthcare team and write down your results. Share your log with your primary care provider at your follow-up visits. This helps guide your diabetes treatment.
- To get the most benefit from your diabetes treatment, take Zituvimet (sitagliptin / metformin) every day, have meals that are nutritious and balanced, and regularly exercise. Make a plan with your healthcare team for a routine that works best for you.
- Zituvimet (sitagliptin / metformin) can make it easier for some people to become pregnant. Discuss the potential for an unintended pregnancy with your primary care provider.
Common questions about Zituvimet (sitagliptin / metformin)
Yes, you should take each dose of Zituvimet (sitagliptin / metformin) with a meal. This can help lower your risk of having an upset stomach.
No. Don't break, cut, or chew Zituvimet (sitagliptin / metformin) tablets. It has a special coating that shouldn't be broken. Contact your prescriber if you're having trouble swallowing Zituvimet (sitagliptin / metformin). Your prescriber can talk with you about your options or alternative medications that might be easier for you to take.
Zituvimet (sitagliptin / metformin) isn't FDA-approved for weight loss. But some people who took a combination of sitagliptin and metformin during clinical studies noticed some weight loss. The amount of weight loss that people who took the combination had was similar to that of people who took metformin alone. So weight loss might be the results from having a nutritious diet and exercise plan that's recommended with this medication. Also keep in mind that everyone can have different experiences with Zituvimet (sitagliptin / metformin). Discuss with your primary care provider about weight management.
There isn't enough information to know whether Zituvimet (sitagliptin / metformin) is safe during pregnancy. But researchers do know that poorly controlled diabetes (e.g., high blood sugar) can lead to risks to the pregnancy. Talk to your healthcare team about the safest options to treat your diabetes during pregnancy.
Zituvimet and Janumet are two brand-name medications that both combine metformin and sitagliptin into one pill. These two brand-name medications are made by different pharmaceutical companies: Janumet is made by Merck, and Zituvimet is made by Zydus Lifesciences. Both medications are used to treat Type 2 diabetes in adults.
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Risks and warnings for Zituvimet (sitagliptin / metformin)
Zituvimet (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 greater | Alcohol use | Using contrast dye for surgery or other procedures
Zituvimet (sitagliptin / metformin) contains metformin, a medication that can rarely cause a condition called lactic acidosis (too much lactic acid in the blood). This condition can lead to other health problems that can be life-threatening. Let your prescriber know about any health conditions you have and the other medications you take before you start Zituvimet (sitagliptin / metformin). They can check your risk for lactic acidosis.
Tell your care team right away if you notice that you're breathing fast or short of breath or if you have irregular heartbeat, very upset stomach, or muscle pain. Also contact your care team if you feel very sleepy, tired, weak, dizzy, or cold. These can be signs that you have too much lactic acid in your blood.
Pancreas problems
Although rare, some people who took Zituvimet (sitagliptin / metformin) developed inflammation in their pancreas (pancreatitis). It's not clear whether people who already have problems with their pancreas are at higher risk during treatment. Stop Zituvimet (sitagliptin / metformin) and get medical help if you notice symptoms of having an inflamed pancreas, such as belly pain that won't go away or that spreads to your back, nausea, and vomiting.
Heart failure
- Risk factors: History of heart failure | History of kidney issues
Some clinical studies suggest that there might be a link between treatment with a DPP-4 inhibitor (like sitagliptin) and heart failure. Since Zituvimet (sitagliptin / metformin) contains a DPP-4 inhibitor, it's important to be aware of the risk for heart failure. Make sure to let your care team know about your full medical history before you start this medication, especially if you have a history of heart failure. Contact your care team right away if you notice any symptoms related to heart failure, like shortness of breath, rapid or irregular heartbeat, swelling in ankles or feet, sudden weight gain, and chest pain.
Sudden kidney problems
- Risk factors: Age 65 or older | History of kidney issues
There have been some reports of worsening kidney function, such as acute (sudden) kidney failure, that sometimes required dialysis during treatment with Zituvimet (sitagliptin / metformin). This medication might not be the best option if you have kidney issues, so be sure to tell your primary care provider about your full medical history. Older adults might be at greater risk for sudden kidney problems. Your care team will check your blood work at least once a year to check your kidney function while you're taking this medication.
Low vitamin B12 levels
- Risk factors: Long-term use of Zituvimet (sitagliptin / metformin) | Lower than average calcium absorption | Lower than average vitamin B12 absorption
Zituvimet (sitagliptin / metformin) can lower how much vitamin B12 your body absorbs and drop your vitamin B12 levels. This can lead to anemia. Let your healthcare team know if you've had any low energy, muscle weakness, low appetite, or tingling or numbness on hands or feet that doesn't seem to go away. You might need to get blood tests done to check for vitamin B12 deficiency and related anemia. Your primary care provider might order these blood tests periodically (every 1 to 3 years) during treatment with Zituvimet (sitagliptin / metformin).
Low blood sugar (hypoglycemia) when taken with certain diabetes medications
- Risk factors: Changes in diet and exercise | Taking other medications for diabetes, especially insulin or glipizide | Drinking alcohol | Over age 65 | Liver or kidney problems
You're at risk of having low blood sugar if you take Zituvimet (sitagliptin / metformin) together with other diabetes medications, particularly insulin or a sulfonylurea. Very low blood sugar can be life-threatening. Symptoms of low blood sugar include feeling shaky, very hungry, confused, or weak; being nervous or anxious; having a fast heartbeat; or sweating. It's important to know how to recognize and treat low blood sugar. Talk to your healthcare team if you're concerned about having low blood sugar levels.
Joint pain
Some people who've taken medications containing a DPP-4 inhibitor like the sitagliptin in Zituvimet have reported severe and disabling joint pain. This joint pain can occur anytime after starting this medication, from one day to years. Talk to a healthcare professional if you have any discomfort in your joints.
Severe skin reaction
Some people who took a DPP-4 inhibitor medication like the sitagliptin in Zituvimet have had an itchy, blistering rash called bullous pemphigoid. The blisters or sores usually go away with appropriate treatment and once you stop taking Zituvimet (sitagliptin / metformin). Stop taking this medication and speak to your care team right away if you have itchy skin, rash with blisters, or sores.
Severe allergic reaction
Severe allergic reactions to Zituvimet (sitagliptin / metformin) are rare but possible. Though allergic reactions can happen at any time during treatment, people have reported a reaction within the first 3 months of starting the medication. Get medical help right away if you experience hives, blisters, peeling skin, trouble breathing, or swelling in your face or throat.
Zituvimet (sitagliptin / metformin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/500mg | 30 tablets | $108.70 | $3.62 |
| 50mg/1000mg | 180 tablets | $520.14 | $2.89 |
Typical dosage for Zituvimet (sitagliptin / metformin)
The typical starting dose is 50 mg/500 mg (sitagliptin/metformin) by mouth twice a day with meals.
Your dose might differ if you were taking metformin by itself before you started Zituvimet.
How much does Zituvimet (sitagliptin / metformin) cost?
Zituvimet (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 Zituvimet (sitagliptin / metformin) will not be safe for you to take.
- People with Type 1 diabetes
- Poor kidney function
- Metabolic acidosis (including diabetic ketoacidosis)
- Allergic reaction to sitagliptin or metformin
What are alternatives to Zituvimet (sitagliptin / metformin)?
Zituvimet (sitagliptin / metformin) images
