JANUMET/JANUMET XR (Sitagliptin/Metformin)

What is this medication? 

JANUMET/JANUMET XR (Sitagliptin/Metformin)
Antidiabetic, Biguanide, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor

JANUMET/JANUMET XR (Sitagliptin/Metformin) is indicated for the treatment of Type 2 Diabetes.

ALERT: WARNING
Metformin has been associated with lactic acidosis resulting in death, hypothermia, hypotension and arrhythmias.  If metformin-associated lactic acidosis is suspected, immediately discontinue medication and institute general supportive measures.  Prompt hemodialysis is recommended.

How does this medication work? 

Janumet and Janumet XR is an antidiabetic medication consisting of metformin a biguanide and sitagliptin a dipeptidyl peptidase 4 inhibitor.  Metformin decreases the production of glucose from the liver, reducing intestinal absorption of glucose and improves insulin sensitivity.  Sitagliptin inhibits dipeptidyl dipeptidyl peptidase 4 (DPP-4) enzymes which increases incretin hormone levels that increase insulin synthesis and release from the pancreas while reducing glucagon secretion.

How should I take this medication? 

Oral: Initial doses should be based on the current dose of sitagliptin and metformin; titrate gradually per glycemic response. Total daily dose should be administered in 2 equally divided doses (immediate-release tablets) or once daily (extended-release tablets). Maximum dose: Sitagliptin 100 mg/metformin 2 g per day.

Note: Patients already on metformin: Initial: Sitagliptin 100 mg/day plus current daily dose of metformin. Patients currently on metformin 1.7 g/day (eg, 850 mg twice daily) may receive an initial dose of sitagliptin 100 mg/metformin 2 g per day.

Note: Patients not on metformin: Initial: Sitagliptin 100 mg/metformin 1 g per day.

Conversion from immediate release to extended release: Convert using same total daily dose (up to the maximum recommended dose), but adjust frequency as indicated for immediate (twice daily) or extended (once daily) release products.

How to Take: Take with meals, the same time each day.  Swallow the tablet whole, do not break, crush, or chew.

What should I watch for while using this medication? 

Before starting JANUMET/JANUMET XR (Sitagliptin/Metformin), make sure your physician is aware of any allergies or medications you currently take, and activities you perform.  Sitagliptin/Metformin have been associated with arthralgia, bullous pemphigoid, hypersensitivity reactions including Stevens-Johnson syndrome, lactic acidosis, pancreatitis, vitamin B12 deficiency, and worsening renal function.  Sitagliptin/Metformin should not be used in unstable or hospitalized patients with heart failure.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication? 

Headache, upper respiratory tract infection, abdominal pain, diarrhea, nausea, vomiting, hypoglycemia.

Note this is not a complete list of side effects for JANUMET/JANUMET XR (Sitagliptin/Metformin), only common ones.