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Janumet
Janumet is a prescription medication that combines two active ingredients: sitagliptin and metformin. It is primarily used to improve blood sugar control in adults with type 2 diabetes mellitus. Sitagliptin is a DPP-4 inhibitor that helps to increase the levels of incretin hormones, which in turn increases insulin release and decreases glucagon levels after meals. Metformin is a biguanide that decreases hepatic glucose production and improves insulin sensitivity. The combination of these two medications provides a comprehensive approach to managing blood sugar levels.
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Frequently Asked Questions
How long does it take for Janumet to work?
Patients may start to see improvements in blood sugar levels within 1 to 2 weeks, but optimal effects may take several weeks to develop.
Can I take Janumet while pregnant?
Janumet should be used during pregnancy only if the benefits outweigh the risks. Consult your healthcare provider for personalized advice.
What should I do if I miss a dose of Janumet?
If you miss a dose, take it as soon as you remember. If it is close to the time of your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Are there any dietary restrictions while taking Janumet?
It's important to maintain a balanced diet and monitor carbohydrate intake, as this can help manage blood sugar levels effectively while on Janumet.
Is Janumet safe for long-term use?
Janumet can be safe for long-term use under the supervision of a healthcare provider, with regular monitoring for potential side effects and effectiveness in controlling blood sugar levels.
Comprehensive Drug Guide
How Does Janumet Work?
- Sitagliptin: Inhibits the enzyme DPP-4, which is responsible for breaking down incretin hormones. By increasing the levels of these hormones, sitagliptin enhances insulin secretion from the pancreas and decreases glucagon release, leading to lower blood sugar levels.
- Metformin: Decreases glucose production by the liver and enhances insulin sensitivity in muscle and fat tissues, resulting in improved glucose uptake and lower blood sugar levels.
Common Dosages
- 50 mg of sitagliptin / 1000 mg of metformin
- 100 mg of sitagliptin / 1000 mg of metformin
- 50 mg of sitagliptin / 500 mg of metformin
Typical Dosing
- The usual starting dose is 50 mg of sitagliptin and 1000 mg of metformin taken twice daily with meals.
- Doses may be adjusted based on individual blood sugar levels and tolerability, but the maximum recommended dose is typically 100 mg of sitagliptin and 2000 mg of metformin per day.
Typical Dosing
FDA Approved Indications
- Improvement of glycemic control in adults with type 2 diabetes mellitus, as an adjunct to diet and exercise.
Who Shouldn't Take Janumet?
- Known hypersensitivity to sitagliptin, metformin, or any components of the formulation.
- Severe renal impairment (eGFR < 30 mL/min) or acute or chronic metabolic acidosis.
- Diabetic ketoacidosis.
Advice From The Pharmacist
- Take Janumet with meals to reduce the risk of gastrointestinal side effects, such as nausea and diarrhea.
- Monitor blood sugar levels regularly to assess the effectiveness of the medication.
- Maintain a healthy diet and regular exercise program to help control blood sugar levels.
- Be aware of the signs of lactic acidosis (a rare but serious side effect of metformin), including unusual tiredness, weakness, and muscle pain. Seek medical attention if these symptoms occur.
Side Effects of Janumet
Common Side Effects
- Nausea
- Diarrhea
- Stomach upset
- Headache
- Upper respiratory tract infections
Uncommon/Severe Side Effects
- Lactic acidosis (symptoms include muscle pain, breathing difficulties, stomach pain, and feeling cold or dizzy)
- Pancreatitis (symptoms include severe abdominal pain that may radiate to the back)
Risks and Warnings of Janumet
- Renal Function: Renal function should be monitored regularly, as metformin can accumulate in cases of renal impairment, increasing the risk of lactic acidosis.
- Pancreatitis: Patients should be aware of the symptoms of pancreatitis and report any severe abdominal pain to their healthcare provider immediately.
- Vitamin B12 Deficiency: Long-term use of metformin can lead to vitamin B12 deficiency; monitoring levels may be necessary.
Interactions with Janumet
Common Drug Interactions
- Other diabetes medications: Use caution when combining with other antidiabetic drugs, as this may increase the risk of hypoglycemia.
- Renal medications: Caution is advised when using medications that may affect renal function, as these can increase the risk of lactic acidosis with metformin.
- Alcohol: Excessive alcohol consumption can increase the risk of lactic acidosis; moderation is advised.
Alternatives to Janumet
- Other DPP-4 inhibitors: Such as linagliptin or saxagliptin.
- Other combinations: Metformin can also be combined with other classes of medications, such as sulfonylureas (e.g., glimepiride) or GLP-1 receptor agonists (e.g., liraglutide).
- Insulin therapy: In some cases, insulin may be needed for better glycemic control.
