What is Janumet (Metformin 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.
The combination of metformin and sitagliptin is for people with type 2 diabetes who do not use daily insulin injections. This medication is not for treating type 1 diabetes.
Metformin and sitagliptin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Janumet (Metformin Sitagliptin)?

Do not use this medication if you are allergic to metformin or sitagliptin, if you have liver or kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, be sure your caregivers know ahead of time that you are taking metformin and sitagliptin.
Before taking metformin and sitagliptin, tell your doctor if you have liver or kidney disease, a history of pancreatitis, a history of heart disease, or if you are over 80 years old and have not recently had your kidney function checked.
Stop taking metformin and sitagliptin and call your doctor at once if you have severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, or fast heart rate.
Some people develop lactic acidosis while taking metformin. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or irregular heart rate, dizziness, or feeling very weak or tired.

What should I discuss with my healthcare provider before taking Janumet (Metformin Sitagliptin)?

Some people develop a life-threatening condition called lactic acidosis while taking metformin. You may be more likely to develop lactic acidosis if you have liver or kidney disease, congestive heart failure, a severe infection, if you are dehydrated, or if you drink large amounts of alcohol. Talk with your doctor about your individual risk.
Do not use this medication if you are allergic to metformin (Actoplus Met, Avandamet, Fortamet, Glucophage, Riomet) or sitagliptin (Januvia), if you have kidney or liver disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).
If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking metformin and sitagliptin. Be sure your caregivers know ahead of time that you are using this medication.
If you have any of these other conditions, you may need a dose adjustment or special tests:

• a history of pancreatitis
• a history of heart disease; or
• if you are over 80 years old and have not recently had your kidney function checked

Taking certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of treating your diabetes with metformin and sitagliptin.
FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of metformin and sitagliptin on the baby.
It is not known whether metformin and sitagliptin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Janumet Side Effects

What are the possible side effects of Janumet (Metformin Sitagliptin)?

This medication may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or irregular heart rate, dizziness, or feeling very weak or tired.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:

• pancreatitis – severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, fast heart rate
• feeling short of breath, even with mild exertion
• swelling or rapid weight gain
• fever, chills, body aches, flu symptoms; or
• a severe blistering, peeling, and red skin rash

Less serious side effects may include:

• runny or stuffy nose, sore throat
• headache, mild weakness; or
• mild nausea, vomiting, diarrhea, gas, stomach pain

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Janumet Interactions

What other drugs affect Janumet (Metformin Sitagliptin)?

You may be more likely to have hyperglycemia (high blood sugar) if you are taking metformin and sitagliptin with other drugs that raise blood sugar. Drugs that can raise blood sugar include:

• isoniazid
• diuretics (water pills)
• steroids (prednisone and others)
• phenothiazines (Compazine and others)
• thyroid medicine (Synthroid and others)
• birth control pills and other hormones
• seizure medicines (Dilantin and others); and
• diet pills, or medicines to treat asthma, colds or allergies

You may be more likely to have hypoglycemia (low blood sugar) if you are taking metformin and sitagliptin with other drugs that lower blood sugar. Drugs that can lower blood sugar include:

• some nonsteroidal anti-inflammatory drugs (NSAIDs)
• aspirin or other salicylates (including Pepto-Bismol)
• sulfa drugs (Bactrim and others)
• a monoamine oxidase inhibitor (MAOI)
• beta-blockers (Tenormin and others); or
• probenecid (Benemid)

Some medications may interact with metformin and sitagliptin. Tell your doctor if you are using any of the following drugs:

• amiloride (Midamor), furosemide (Lasix), triamterene (Dyrenium)
• cimetidine (Tagamet), ranitidine (Zantac)
• digoxin (Lanoxin)
• morphine (MS Contin, Kadian, Oramorph)
• nifedipine (Nifedical, Procardia)
• procainamide (Procan, Pronestyl, Procanbid), quinidine (Quin-G)
• trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra), vancomycin (Vancocin, Lyphocin); or
• glipizide (Glucotrol, Metaglip), glimepiride (Amaryl, Avandaryl, Duetact), glyburide (DiaBeta, Micronase, Glucovance), and others

This list is not complete and other drugs may interact with metformin and sitagliptin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

What should I avoid while taking Janumet (Metformin Sitagliptin)?

Avoid drinking alcohol while taking metformin and sitagliptin. Alcohol lowers blood sugar and may increase the risk of lactic acidosis while you are taking this medicine.

Janumet Dosage

How should I take Janumet (Metformin Sitagliptin)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Take metformin and sitagliptin with meals.
Your blood sugar will need to be checked often, and you may need other blood tests at your doctor’s office. Visit your doctor regularly.
Your dose needs may change if you become ill, have a fever or infection, or if you have surgery or a medical emergency. Your doctor may want you to stop taking metformin and sitagliptin for a short time if any of these situations affect you.
Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.
Know the signs of low blood sugar (hypoglycemia) and how to recognize them: hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure, or fainting (severe hypoglycemia can be fatal).
Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.
Your doctor may have you take extra vitamin B12 while you are taking metformin and sitagliptin. Take only the amount of vitamin B12 that your doctor has prescribed.
Metformin and sitagliptin is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, and eye care. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.
Store at room temperature away from moisture and heat.

What happens if I overdose on Janumet (Metformin Sitagliptin)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. You may have signs of low blood sugar, such as hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma.

What happens if I miss a dose of Janumet (Metformin Sitagliptin)?

Take the missed dose as soon as you remember (be sure to take the medicine with food). Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Sourced from everydayhealth.com