Janumet (Sitagliptin/Metformin)
Medication information written by Dr. Conner Sheehy, PharmD, BCPS
Updated - December 20, 2020
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Along with diet and exercise, the prescription drug Janumet (Sitagliptin/Metformin) is given to patients with Type 2 diabetes to improve blood sugar levels.
On this page, you'll find information about this medication including Janumet dosage, side effects, and interactions.
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Janumet (Metformin and Sitagliptin) Medication Information
Uses
Janumet is a prescription medication that treats diabetes mellitus type 2. It contains a combination of the drugs metformin and sitagliptin.
People with type 2 diabetes do not have enough insulin to meet their needs. People with this condition either do not produce enough insulin or their bodies are resistant to the effects of insulin. Without enough insulin, blood glucose is too high and can cause damage to the blood vessels.
Diabetes can damage small vessels (microvascular damage) and large vessels (macrovascular damage). In microvascular damage, the affected organs are the kidneys, the eyes, and the nerves. Macrovascular damage includes ischemic heart disease, peripheral vascular disease, and cerebral vascular disease.
The first ingredient in Janumet, metformin, works by decreasing the amount of glucose produced by the liver.
The second ingredient, sitagliptin, inhibits an enzyme called dipeptidyl peptidase IV (DPP-IV). DPP-IV breaks down enzymes that regulate insulin and blood sugar in people with diabetes.
Janumet should be used in addition to diet and exercise to manage type 2 diabetes mellitus.
Dosage
Janumet is available in the tablet sizes:
- Sitagliptin/Metformin 50/500 mg
- Sitagliptin/Metformin 50/1000 mg
Your doctor will determine the best dose of Janumet for you. It is taken twice daily.
The maximum dose of sitagliptin is 100 mg per day. The maximum dose of metformin is 1000 mg per day.
Side Effects
- Abdominal pain
- Diarrhea
- Headache
- Low blood sugar
- Nausea
- Upper respiratory tract infection
- Vomiting
Precautions
Metformin is known to cause a severe and sometimes life-threatening condition called lactic acidosis. The condition is rare, but the risk is increased in people who drink large amounts of alcohol, are older than 65, and those with liver problems.
Tell your doctor if you have a history of liver or kidney problems. Janumet should not be used in people with severe kidney dysfunction.
You may need to stop Janumet before invasive procedures or imaging procedures that require iodinated contrast imaging.
Tell your doctor if you have a history of heart failure or pancreatitis.
Long-term use of metformin increases the risk of vitamin B12 deficiency. Your doctor may do a lab test for this.
Interactions
Tell your doctor or pharmacist if you are taking any of these medications:
- Alcohol
- Carbonic anhydrase inhibitors
- Cimetidine
- Dolutegravir
- Insulin
- Iodinated contrast agent
- Ranolazine
- Sulfonylureas
- Vandetanib
Storage
Store Janumet at room temperature, 20-25°C (68-77°F).
Pharmacist Tips
- Take Janumet with food to reduce the risk of stomach upset and diarrhea.
- Familiarize yourself with the symptoms of low blood sugar (hypoglycemia) while you are taking anti-diabetic medications.
- Do not split, crush, or chew Janumet. Swallow it whole with a full glass of water.
Janumet FAQs
Should Janumet be taken with or without food?
Take Janumet with food to lower the risk of stomach upset and diarrhea.
Can Janumet be used in people with type 1 diabetes?
No. Janumet can only be used for type 2 diabetes.
What if I miss a dose of Janumet?
Take the dose if it’s within six hours of your normal administration time. Do not double up.
Related Products
References
- Janumet [package insert]. Whitehouse Station, NJ: Merck; 2019.
Author: Dr. Conor Sheehy, PharmD, BCPS
Dr. Sheehy is a board-certified pharmacotherapy specialist. He has worked in multiple practice settings, including retail and hospital pharmacies, and in medical clinics. He specializes in anticoagulation, psychiatric medications, and diabetes medications. He strives to empower his patients to understand their medications and improve their overall medical care.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
