Active Ingredients: Sitagliptin (Januvia) and Metformin. Janumet is used for treating type 2 diabetes.
Already Taking Metformin? Janumet can lower blood sugar more than metformin alone. Janumet is a powerful type 2 diabetes medicine that combines 2 prescription medicines, sitagliptin (JANUVIA) and metformin, and can lower blood sugar more than the most commonly prescribed medicine (metformin). In clinical studies, nearly twice as many patients reached an A1C less than 7% taking Janumet compared to those taking metformin alone. Janumet tablets contain 2 prescription medicines: sitagliptin (JANUVIA®) and metformin. Once-daily prescription Janumet XR tablets contain sitagliptin (the medicine in Januvia) and extended-release metformin. Janumet or Janumet XR can be used along with diet and exercise to lower blood sugar in adults with type 2 diabetes.
When diabetes is out of control, it means your blood sugar (blood glucose) is too high. High blood sugar may not make you feel sick. But even if you have no symptoms, controlling your blood sugar is important for your health. That's because high blood sugar can lead to serious problems over time. When your blood sugar is not controlled, too much sugar stays in your blood for a long time. That can damage blood vessels and nerves. A main goal of treating diabetes is to lower your blood sugar to help reach your A1C goal. While lowering your blood sugar is important, you should also be careful of it going too low. It is also important to control your cholesterol and blood pressure levels.
Janumet targets 3 key factors to lower blood sugar:
Janumet helps control blood sugar throughout the day, including after meals. Janumet is not likely to cause weight gain and low blood sugar (hypoglycemia) by itself
Janumet contains a combination of metformin and sitagliptin. Metformin and sitagliptin are oral diabetes medicines that help control blood sugar levels. Metformin works by decreasing glucose (sugar) production in the liver and decreasing absorption of glucose by the intestines. Sitagliptin works by regulating the levels of insulin your body produces after eating. Janumet is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. Janumet is not used to treat type 1 diabetes.
The difference is that Janumet is taken twice daily, while Janumet XR is taken once daily. Prescription Janumet tablets and Janumet XR tablets are both prescription medications that can be used along with diet and exercise to help lower blood sugar in adults with type 2 diabetes.
Before you take Janumet, tell your doctor if you:
Take Janumet exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Take Janumet with meals. Do not crush, chew, or break an extended-release tablet. Swallow it whole. Janumet tablets may not completely dissolve in the body. Part of the tablet may appear in your stool. This is a normal side effect of Janumet and will not make the medicine less effective. Call your doctor if you see a tablet in your stool several times. You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda). Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency. Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness. Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule. Janumet is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Dosing may be different for different people. Make sure you take the medicine exactly as your doctor tells you to. The dosage of Janumet should be individualized on the basis of the patient's current regimen, effectiveness, and tolerability while not exceeding the maximum recommended daily dose of 100 mg sitagliptin and 2000 mg metformin hydrochloride (HCl). Initial combination therapy or maintenance of combination therapy should be individualized and left to the discretion of the health care provider. Janumet should generally be given twice daily with meals, with gradual dose escalation, to reduce the gastrointestinal (GI) side effects due to metformin. Janumet must not be split or divided before swallowing. The starting dose of Janumet should be based on the patient's current regimen. Janumet should be given twice daily with meals.
The following doses are available:
The recommended starting dose in patients not currently treated with metformin is 50 mg sitagliptin/500 mg metformin HCl twice daily, with gradual dose escalation recommended to reduce gastrointestinal side effects associated with metformin. The starting dose in patients already treated with metformin should provide sitagliptin dosed as 50 mg twice daily (100 mg total daily dose) and the dose of metformin already being taken. For patients taking metformin 850 mg twice daily, the recommended starting dose of Janumet is 50 mg sitagliptin/1000 mg metformin HCl twice daily. No studies have been performed specifically examining the safety and efficacy of Janumet in patients previously treated with other oral antihyperglycemic agents and switched to Janumet. Any change in therapy of type 2 diabetes should be undertaken with care and appropriate monitoring as changes in glycemic control can occur.
Get emergency medical help if you have signs of an allergic reaction to Janumet: (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Stop taking this medicine and call your doctor right away if you have symptoms of pancreatitis: severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, or fast heartbeats.
Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Stop taking this medicine and get emergency medical help if you have even mild symptoms such as:
Call your doctor at once if you have any of these serious side effects:
Common Janumet side effects may include:
This is not a complete list of side effects and others may occur.
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 other medicines. Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects. This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.
Janumet is contraindicated in patients with:
It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects. Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and appear quickly. It usually occurs when other serious health problems are present, such as a heart attack or kidney failure. Symptoms of lactic acidosis include: abdominal or stomach discomfort, decreased appetite, diarrhea, fast, shallow breathing, a general feeling of discomfort, muscle pain or cramping, and unusual sleepiness, tiredness, or weakness. If you have more than one of these symptoms together, you should get emergency medical help right away.
This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms of low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Talk to your doctor about the best way to treat low blood sugar. Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar.
There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and a list of all your medicines. Pancreatitis may occur while you are using this medicine. Check with your doctor right away if you have a sudden and severe stomach pain, chills, constipation, nausea, vomiting, loss of appetite, fever, or lightheadedness.
Check with your doctor right away if you have more than one of these symptoms: chest pain, decreased urine output, dilated neck veins, extreme fatigue, irregular breathing, irregular heartbeat, shortness of breath, swelling of the face, fingers, feet, or lower legs, tightness in the chest, trouble breathing, or weight gain. These may be signs of heart failure. This medicine may cause serious allergic reactions, including anaphylaxis, angioedema, or certain skin conditions (Stevens-Johnson syndrome). These reactions can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, blistering, peeling, or loosening of the skin, fever or chills, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.
This medicine may cause severe and disabling joint pain. Call your doctor right away if you have severe joint pain while using this medicine. This medicine may cause bullous pemphigoid. Tell your doctor if you have large, hard skin blisters while using this medicine. Let your doctor or dentist know that you are taking this medicine. Your doctor may advise you to temporarily stop taking this medicine before you have major surgery or diagnostic tests, including procedures that use contrast dye. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter) medicines and herbal or vitamin supplements.
Janumet is very effective. As we mentioned, metformin and sitagliptin combination is used to treat high blood sugar levels caused by type 2 diabetes. Metformin reduces the absorption of sugar from the stomach, reduces the release of stored sugar from the liver, and helps your body use sugar better. Sitagliptin helps to control blood sugar levels by increasing substances in the body that make the pancreas release more insulin. It also signals the liver to stop producing sugar (glucose) when there is too much sugar in the blood. This is because for those who are unsure of the main cause of type 2 diabetes is that your body doesn’t make enough insulin and also fails to use the insulin properly – so blood sugar levels increase. So what is needed for this type of condition is that your body needs assistance to properly produce sufficient insulin. What Metformin does is that it works by helping to restore the body’s proper response to insulin being naturally produced. Meaning it helps the body to properly use the insulin produced. On the other hand, Metformin also decreases the amount of sugar that your liver makes and also reduces the amount of sugar your stomach/intestines absorb, thereby overall reducing the blood sugar spikes. Similarly, since type 2 diabetes also occurs due to insufficient production of insulin, sitagliptin helps to increase the natural substance called Incretins. Incretins is a substance that helps to increase the release of insulin. Sitagliptin also decreases the amount of sugar your liver makes, again as an overall helping to regulate spikes in blood sugar levels. As you can see the main causes of type two diabetes is effectively reduced from Janumet as a 2-in-1 combination, which is one of the main benefits of this medication. On the other hand, this medication is taken in the form of a tablet, which eliminates the pain of injecting different insulin for type 2 diabetes. This medication is also relatively easy to use and carry over insulin injections and related gadgets. Nevertheless, the 2-in-1 combination reduces the number of pills or injections you will have to take daily.
Through normal retail and other channels, costs for Janumet can be expensive. Janumet costs will also vary depending on your medication needs, and even the state you live in. Therefore calculating exact costs per individual can be difficult.
Janumet is a prescription medicine which means one cannot just buy Janumet online without a consultation with a medical provider as the first step. Janumet is also not available over the counter. However, people who need a Janumet prescription can use online consultutation to connect with a licensed medical provider who can prescribe Janumet if safe and appropriate to do so.
So what message should you take from all of this information? The benefits of Janumet are numerous and, many could argue, outweigh any potential risks. If you want to buy and take Janumet or have recently been prescribed the medication and have concerns about its possible negative effects, take the time to discuss your concerns with your endocrinologist and diabetes care team.