What is Janumet?

Janumet is an oral prescription medicine that helps lower blood sugar levels in adults with type 2 diabetes. The tablets contain two prescription medicines, Sitagliptin and Metformin.

What is it used for?

Janumet is used alongside a healthy diet and regular exercise to regulate blood sugar levels in adults with type II diabetes.

How does the drug work?

Janumet lowers your blood sugar levels by helping your pancreas make more insulin, helping your body more effectively use the insulin that it makes, and helping to decrease excess sugar that your liver makes. Each tablet contains a combination of two antidiabetic drugs, Sitagliptin and Metformin. These two medicines work together to help you better regulate your blood sugar levels. Sitagliptin belongs to a group of medicines called DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors), which help improve your level of insulin when your blood sugar level is too high, especially after a meal. Sitagliptin also helps you decrease the amount of sugar made by your body and is unlikely to cause low blood sugar (hypoglycemia), a common side effect of antidiabetic drugs. Metformin belongs to a group of medicines called biguanides, and it helps you lower the amount of sugar made by your liver. Together, these medicines help you to achieve your goal of better blood sugar control.

How to take this medication

The drug can be taken:

• alone, if you are not already taking Metformin or any combination of Sitagliptin and Metformin.
• in combination with a Sulfonylurea drug if you are not already taking Metformin with a Sulfonylurea medication.
• with a premixed or long-to-intermediate-acting insulin.
• in combination with Pioglitazone if you are not already taking Metformin and Pioglitazone.

Janumet should be taken with meals to lower your chance of having an upset stomach. Swallow the tablets whole, without breaking or cutting the tablets before swallowing. Continue to take it for as long as your doctor tells you. It is important not to miss any doses.

Dosage

Dosing can be different for different people. Make sure that you take your medicine exactly as your doctor prescribed it to you. Your dose will most likely be individualized to you, based on your current lifestyle, your tolerability, and the drug’s effectiveness.

The maximum recommended dose is Metformin 2000mg and Sitagliptin 100mg, taken orally, every day. If you are currently not being treated with Metformin, a typical dose is 500mg of Metformin and 50mg of Sitagliptin, orally, twice a day. If you are currently being treated with metformin, a typical dose is 50mg of Sitagliptin with your current Metformin dose, taken orally, twice a day. 1000Mg of Metformin and 50mg of Sitagliptin, taken orally, twice a day is recommended for people who are already taking a high daily dose of Metformin.

Warnings and Precautions

Before you begin taking Janumet, tell your doctor if you:

• Have or have had pancreatitis (inflammation of your pancreas).
• Have or have had severe kidney problems.
• Have or have had liver problems.
• Have or have had heart problems, including congestive heart failure.
• Drink alcohol very often, or drink a lot of alcohol in a short-term (“binge” drinking).
• Need to get an injection of dye or contrast agents for an imaging or scanning procedure. Your dosing may need to be stopped for the time being.
• Have any other medical conditions.
• Are currently pregnant or plan to become pregnant. It is not clear if Janumet can harm your unborn baby. If you are pregnant or planning to become pregnant, make sure to talk with your doctor about what the best way to control your blood sugar levels are while you are pregnant.
• Are breast feeding or are planning to breastfeed. It is not clear if the drug passes into your breast milk. Talk with your doctor about options for the best way to feed your baby while you are taking Janumet.

Stop taking it immediately if you get the following symptoms of lactic acidosis:

• You feel tired and very weak.
• You have unusual muscle pains.
• You have problems with breathing.
• You have stomach pain, along with nausea and vomiting or diarrhea.
• You feel cold, specifically in your arms and legs.
• You feel dizzy or lightheaded.
• You develop a slow or irregular heartbeat.
• Your medical condition abruptly changes.

Cases of pancreatitis (inflammation of the pancreas), which may be severe and lead to death, have been reported in some patients.

Cases of a skin condition called bullous pemphigoid that can require hospital treatment have been documented in some patients, as well. Let your doctor know immediately if you begin to develop blisters or any breakdown of your skin (erosion). Your doctor might tell you to stop taking Janumet or to modify your dose.