Janumet

Janumet is a brand-name prescription drug approved by the FDA to treat type 2 diabetes in adults. It combines two active ingredients, sitagliptin & metformin 50 500, to improve blood sugar control. This combination helps in reducing the risk of complications like kidney damage and heart disease. Janumet is available in immediate-release tablets with two strengths: 50 mg/500 mg and 50 mg/1000 mg. The dosage depends on individual needs and existing treatments. It should be taken regularly, with meals, to minimize stomach upset. Janumet can cause these common side effects, including diarrhea, nausea, and low blood sugar. It’s important to inform your doctor about any pre-existing health conditions and other medications you’re taking. Monitoring kidney function and blood sugar levels is essential during treatment.

Janumet is a combination medication used to manage high blood sugar levels in individuals with type 2 diabetes mellitus. This medication is crucial in preventing serious diabetes complications such as kidney damage and blindness and reducing the likelihood of heart attacks or strokes. Janumet may be prescribed as a standalone treatment or in conjunction with other diabetes medications. It is most effective when paired with a healthy diet and regular exercise regimen.

The dosage of Janumet is tailored to the individual’s condition, blood sugar levels, and any other medications they may be taking. It is recommended to take Janumet with meals to lessen the chances of experiencing an upset stomach. Consistent daily intake at the same time is critical to maximizing its benefits. It is crucial to adhere to the diet and exercise program advised by your healthcare provider, as lifestyle factors significantly impact diabetes management.

Common side effects associated with Janumet include diarrhea, nausea, vomiting, upset stomach, headache, and sore throat. If you are also taking insulin or sulfonylureas, you may be at risk for low blood sugar levels (hypoglycemia), so it’s vital to recognize and address this potential side effect. Janumet is not suitable for everyone. Patients with a history of kidney, liver, or heart disease, pancreatic issues, or those who consume alcohol heavily should consult their doctor before taking Janumet. It’s also important to inform your healthcare provider about all other medications you are taking to avoid adverse interactions. Women who are pregnant or breastfeeding should seek medical advice before starting Janumet. Regular monitoring of kidney function and blood sugar levels is essential during treatment with Janumet.

• It is used in the treatment of type 2 diabetes.

[Important Warning: Janumet should not be used by patients with type 1 diabetes.]

Forms & Strengths of Janumet?

Janumet comes in the form of an immediate-release (short-acting) oral tablet and has two following strengths:

• 50 mg/500 mg (sitagliptin/metformin)
• 50 mg/1000 mg (sitagliptin/metformin)

What Are the Recommended Janumet Doses for Different Patients?

The recommended dosage for Janumet can vary from person to person and depends on various factors such as age, medical condition, needs, and patient’s response to treatment. The medication dosage given below is generalized, and if your doctor has recommended a dosage that is different from the one mentioned below, you should follow their instructions and not make any changes to your medication dosage, duration, type, or brand without consulting them.

If You’re Already Taking Metformin

• Initial Dose of Janumet: 50 mg/1000 mg twice daily (sitagliptin/metformin)
• Maximum Daily Dose: 100 mg/2000 mg once daily (sitagliptin/metformin)

If You Aren’t Already Taking Metformin

• Initial Dose of Janumet: 50 mg/500 mg twice daily (sitagliptin/metformin)
• Maximum Daily Dose: 100 mg/2000 mg once daily (sitagliptin/metformin)

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

When you are considering taking Janumet, follow these guidelines to ensure a safe and efficient use:

• This medication is only part of a treatment plan that also includes a healthy, nutritious diet, regular physical exercise, weight management, special medical care, and close monitoring of blood sugar levels.
• Before using Janumet tablets, it is essential to read and follow the instructions given in the patient information & if available, the medication guide. If you have difficulty understanding any part of the leaflet or have any questions or concerns regarding the medication use, you should talk to your doctor.
• Do not use Sitagliptin tablets more or less than prescribed, in large quantities, or more frequently than instructed by your doctor, as it can cause unwanted side effects. You may require regular blood tests while using Janumet to ensure that it is effective in treating your condition and whether you should continue using it.
• Take Janumet by mouth with meals, exactly as directed by your doctor, two times a day with meals. Unless instructed otherwise, drink plenty of water while taking it.
• Your doctor may recommend starting Janumet at a low dose and gradually increasing it to decrease the risk of unwanted side effects. To ensure safe and efficient medication use, follow your doctor’s instructions carefully.
• Adjust the amount of Janumet you take based on your current treatment, how well it works, and how well you tolerate it. Tell your physician or medical provider about all the medicines you are using or plan to use, including all prescription, over-the-counter drugs, herbs or vitamin supplements.
• The most you should take in a day is 100 mg of sitagliptin and 2000 mg of metformin hydrochloride (HCl).
• Do not cut or split Janumet tablets before using them. If you have difficulty swallowing them whole, you should let your healthcare provider know. 
• Janumet tablet may not dissolve completely inside your body, and part of it may appear in your poop. This is a normal side effect, and it does not make sitagliptin less effective. However, you should tell your doctor if you notice the tablet in your stool several times.
• If you are not already taking metformin, start with 50 mg sitagliptin and 500 mg metformin HCl twice daily. Increase the dose slowly to minimize stomach upset from metformin.
• If you are already taking metformin, start Janumet with 50 mg sitagliptin twice daily (100 mg total daily dose) and the same dose of metformin you are currently taking. For those taking metformin HCl 850 mg twice daily, the suggested starting dose of Janumet is 50 mg sitagliptin and 1000 mg metformin HCl twice daily.
• While using Janumet, you may experience hypoglycemia or low blood sugar. Symptoms may include hunger, confusion, irritability, anxiety, and shakiness. To quickly treat signs and symptoms of hypoglycemia, you should carry a reliable source of sugar with you at all times and consume a fast-acting source of sugar such as candy, non-diet soda, crackers, and raisins.
• If you have persistent or severe hypoglycemia, your doctor may prescribe you to a glucagon emergency injection kit. Make sure your caregiver and family members know how to administer it in case of an emergency.
• To get the most benefit from Janumet, you should maintain consistency in dosage & try to take it around the same time every day to help you remember taking it.
• You should check your levels of blood glucose in your blood on a regular basis and maintain a record of them. Share this report with your doctor to help you and your doctor decide if this medication is working as well as it should, and it is not causing any side effects. Tell your doctor immediately if levels of your blood sugar are too high or too low. You may require an adjustment in dosage.
• When your body is under stress due to illness, surgery, physical exercise, alcohol use, or skipping meals, it can affect your blood sugar levels. You should ask your doctor before making changes to your medication dose or schedule.
• Tell your doctor if your condition does not seem to get better or if it worsens.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Janumet combines two medications, sitagliptin and metformin, to manage type 2 diabetes. Sitagliptin increases incretin hormones, which stimulate insulin release and inhibit excess glucose production in the liver. Metformin Hydrochloride reduces liver glucose production and enhances muscle cell sensitivity to insulin. Together, they help regulate blood sugar levels, improve insulin utilization, and decrease excessive glucose production, contributing to more effective diabetes control combined with diet and exercise.

Here are some common side effects of Janumet that usually don’t require immediate medical attention, as your body may adjust to the medication over time:

• Headache: This is a common initial reaction when you buy Janumet tablets for diabetes.
• Nausea and Vomiting: These stomach issues are frequent but usually decrease as your body becomes accustomed to the drug.
• Diarrhea: Some individuals may experience loose stools, which often stabilize over time.
• Upper Respiratory Infection: Symptoms such as a runny nose, sore throat, or cough may occur but usually resolve without specific treatment.
• Abdominal Pain: You might feel discomfort or pain in the stomach area, which often lessens as your body adjusts to Janumet.

Tell your doctor if any of these side effects become bothersome or if it persists. If you are concerned about the risks associated with Janumet use, you should talk to your doctor beforehand and discuss with them the ways in which you can prevent and manage them.

Mild side effects of Janumet: In some cases, Janumet can cause mild side effects in some users. These side effects disappear on their own within a few days or weeks as your body adjusts to the medication. It is important to mention that this list is not exhaustive, and there may be other side effects associated with the use of Janumet. Your doctor has recommended you to use sitagliptin after determining that the benefits of this drug outweigh its risks. Some mild side effects of Janumet are as follows: 

• Upper Respiratory Infection: This can recur or persist but is generally manageable.
• Diarrhea: Continuing episodes of diarrhea can occur, requiring adjustments in diet or hydration. To prevent dehydration, you should consume plenty of fluids. 
• Abdominal Pain: Ongoing mild abdominal discomfort may be experienced by some users.
• Low Level of Vitamin B12: Janumet can affect how vitamin B12 is absorbed, possibly leading to lower levels.
• Nausea and Vomiting: While these can decrease over time, they might continue intermittently. If you have severe or persistent nausea/vomiting, you should call your doctor and drink plenty of liquids to prevent dehydration.
• Headache: Persistent headaches may occur, though they often reduce in frequency and intensity.

These side effects may be short-lived and could last only a few days or weeks. However, if they continue for a longer time, become annoying, or get worse, it’s important to talk to your doctor or pharmacist.

Serious side effects of Janumet: Rarely, Janumet can cause severe side effects in some individuals, which require medical attention and can become fatal if not treated properly. You should call your doctor, healthcare provider, or 911 if you experience any of the side effects mentioned below. 

• • Heart failure: In some clinical studies, it was found that DPP inhibitors, including Janumet, can cause an increased risk of heart failure. Share your medical history with your doctor before starting to use this medication, especially if you have a history of cardiovascular conditions. Signs & symptoms of heart failure may include:
    • Fatigue
    • Cough
    • Swelling (edema) of the legs or ankles
    • Rapid unintentional weight gain
  • Severe joint pain, signs may include:
    • Tenderness
    • Stiffness
    • Swelling around the affected joint
  • Bullous pemphigoid (a rare but potentially severe skin reaction) signs may include:
    • Blisters on your groin, palms, abdomen, or soles of your feet
    • Discoloration or redness around the affected area
    • Itching
  • Pancreatitis (inflammation of the pancreas): Although rare, some patients using this medication had inflammation in the pancreas. Stop using Janumet and immediately call your doctor if you experience any of the following symptoms of pancreatitis. Signs may include:
    • Diarrhea
    • Vomiting
    • Nausea
    • Loss of appetite
    • Jaundice
  • Sudden kidney problems such as kidney failure: This medication has a risk of kidney failure, especially in people who have a history of renal issues, so tell your complete medical history with your doctor. The risk is greater in geriatric patients. You may be required to undergo regular kidney function tests while using this medication. Signs of kidney problems may include:
    • Shortness of breath
    • Swelling of the feet or ankles
    • Nausea
    • Confusion
    • Urinating a lesser amount than usual
  • Lactic Acidosis: It is a rare but potentially life-threatening side effect of Janumet, occurring when there is an excessive buildup of lactic acid in the bloodstream. This condition can result in severe metabolic imbalances and requires immediate medical attention. Symptoms include unusual muscle pain, difficulty breathing, abdominal discomfort accompanied by nausea or vomiting, a persistent feeling of fatigue or weakness, and a sense of coldness, particularly in the extremities. Dizziness or lightheadedness and a slow or irregular heartbeat may also be present.
• Allergic Reaction: While these issues are uncommon, they can be serious and may occur suddenly. These reactions can manifest as skin rashes, itching, or hives, and may show more severe symptoms such as swelling of the face, tongue, lips, or throat, leading to difficulty in breathing or swallowing. In some cases, individuals may experience extreme dizziness or a rapid and weak pulse.
• Hypoglycemia (Low Blood Sugar): Hypoglycemia, or low blood sugar, is a significant risk when taking Janumet, especially when combined with other diabetes medications or if meals are missed or delayed. This condition can lead to symptoms such as trembling, sweating, a rapid heartbeat, intense hunger, confusion, and difficulty concentrating. Mood changes like irritability, headaches, and dizziness are also common, and in severe cases, hypoglycemia can cause seizures or loss of consciousness.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Janumet might not be suitable for everyone, especially if you have certain health conditions or factors. Before starting Janumet, discuss your health history with your doctor. Here are some important warnings to consider when you buy Janumet diabetes medicine:

• Low Vitamin B12: Janumet can cause your vitamin B12 levels to drop. If your B12 levels are already low, you could be at a higher risk for this side effect. Your doctor can check your B12 levels to ensure they’re normal. If they’re too low, you might need to take a supplement.
• Heart Failure: If you have heart failure, Janumet could make it worse. Talk to your doctor about whether Janumet is suitable for you.
• Liver Problems: If you have liver damage, you might be at a higher risk for certain side effects. Your doctor might recommend a different medication depending on your liver function.
• Imaging Tests: If you’re getting an imaging test or scan that uses contrast dye, you may need to avoid Janumet. Some contrast dyes contain iodine, which can interact with Janumet.
• Upcoming Surgery: If you have surgery planned, your doctor may temporarily stop your Janumet treatment. This is because the combination of taking Janumet and eating less before surgery can lower your blood sugar too much.
• Kidney Problems: If you have kidney damage, you might be at a higher risk for a serious side effect called lactic acidosis. Janumet can also cause further kidney damage. If your kidney problems are severe, your doctor might not prescribe Janumet and will monitor your kidney function if you take it.
• Hypoglycemia (Low Blood Sugar): If you’re already taking medication that lowers blood sugar, you could be at an increased risk of low blood sugar, a side effect of Janumet. Monitor your blood sugar levels and be aware of symptoms of low blood sugar.
• Allergic Reaction: If you’ve had an allergic reaction to Janumet or any of its ingredients, your doctor will likely not prescribe it for you. Ask about other medications that might be better options for you.

What Is the Boxed Warning for Janumet?

Janumet comes with a serious warning, known as a boxed warning, which is the highest level of alert issued by the Food and Drug Administration (FDA). This warning highlights the risk of a condition called lactic acidosis. Lactic acidosis occurs when there’s an excessive buildup of lactic acid in your body, which can be fatal if not addressed promptly.

Janumet, a medication used primarily to manage type 2 diabetes, combines two active ingredients: metformin and sitagliptin. Here are some key precautions to consider when you consider to buy Janumet:

High Triglycerides: If you have high triglycerides (a type of fat in the blood), it’s important to tell your doctor.

Gallstones: If you have gallstones, inform your doctor. They’ll explain to you if Janumet is the right medication for you.

Pancreatitis: Janumet may also lead to a severe condition called pancreatitis. If you have or have had inflammation of your pancreas (pancreatitis), inform your doctor. Call your doctor right away if you have severe stomach pains with or without vomiting.

Age: Treatment with metformin should not be initiated in patients ≥80 years of age unless measurement of creatinine clearance demonstrates that renal function is not reduced. Please consult with a healthcare professional for advice tailored to your specific circumstances.

What Are the Other Important Janumet Precautions?

There are several other precautions that are also associated with Janumet tablets for diabetes. This includes:

Alcoholism: Drinking alcohol in a high amount while on Janumet can raise your chances of getting lactic acidosis as a side effect. It’s best to avoid drinking it with these medications. But If you want to drink alcohol, discuss with your doctor how much (if any) is safe to have while on this medication.

Pregnant or Breastfeeding: If you are pregnant, breastfeeding, or planning to become pregnant or breastfeeding, speak with your healthcare provider. They will explain the potential risks and advantages of using Janumet in your situation. 

Older Adults: People aged 65 years or older might have a higher risk of lactic acidosis. Discuss your risk with your doctor.

There are three major contraindications of Janumet (sitagliptin) listed below: 

• Severe kidney problems (when the estimated glomerular filtration rate (eGFR) is below 30 mL/min/1.73 m^2).
• Metabolic acidosis, including diabetic ketoacidosis (a severe diabetic complication).
• Previous severe allergic reactions to Janumet, sitagliptin, or metformin, such as anaphylaxis (a severe allergic reaction) or angioedema (swelling under the skin).

Follow these guidelines if you miss a dose of Janumet:

• If you miss a dose, it’s usually not an issue. However, repeatedly missing doses or not following your doctor’s advice for healthy habits can lead to high blood sugar levels, possibly requiring hospitalization in severe cases.
• If you forget to take a pill, take it as soon as you remember. If a significant amount of time has passed and your next dose is close, skip the missed dose and continue with your regular schedule.
• Do not double up on doses. If necessary, contact your doctor for guidance on how to handle the missed dose for your specific medication.
• If you often forget to take your medication dose, it is best recommended to consult your doctor. They will most likely recommend you use a medication reminder on your phone to help you remember to take your medication daily.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Contact your doctor right away if you have taken too much of Janumet, as it may cause lactic acidosis. Other signs of overdose may include:

• Severe nausea, diarrhea, vomiting
• Rapid breathing
• Irregular or slow heartbeat
• Severe drowsiness

[Note: If you consumed more than the recommended dose, get medical help right away, or call the Poison Help line at 1-800-222-1222.]

When you buy Janumet diabetes medicine from Canada, you should know the storage guidelines of this medication:

• Store Janumet (sitagliptin/metformin) at room temperature, away from moisture and light.
• Avoid exposing it to extreme heat or cold.
• Keep the medication in its original container with the lid tightly closed.
• Ensure it’s out of reach of children and pets.
• Do not use Janumet if it’s past its expiration date. Instead, dispose of it safely using the guidelines provided by your pharmacist, local waste disposal company, or healthcare provider.
• The best way to dispose of unwanted and outdated medications is to give them away in a medicine take-back program.
• You should eliminate unnecessary medications in such a way that does not let children, pets, and other people consume them.

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Janumet (sitagliptin/metformin) can interact with various medications and substances. Before using this medication, tell your doctor about all the medications you are using or plan to use alongside Janumet, including all prescription, and non-prescription medicines, over-the-counter drugs, herbs, and vitamin supplements. This information helps you and your doctor determine potential drug interactions of Janumet (sitagliptin). Here are some notable interactions:

• Insulin and Insulin-Secreting Agents: When Janumet is taken alongside insulin or other insulin-secreting agents, such as sulfonylureas, there is a heightened risk of hypoglycemia (low blood sugar). The combination may lower blood glucose levels more than desired, necessitating close monitoring and potential dosage adjustments.
• Sulfonylureas: Sulfonylureas, like glimepiride or glyburide, are commonly used to manage type 2 diabetes by stimulating the pancreas to produce more insulin. When combined with Janumet, the risk of hypoglycemia increases, so careful monitoring of blood sugar levels is important.
• Beta-Blockers: Beta-blockers, commonly prescribed for high blood pressure and heart conditions, can obscure certain hypoglycemia symptoms, like a rapid heartbeat. This can make it more challenging to detect low blood sugar episodes while taking Janumet, necessitating careful monitoring and regular blood sugar checks.
• Cimetidine: This is a medication used to treat heartburn and ulcers, and can increase the concentration of metformin in the blood. This may increase the risk of metformin-related side effects, such as lactic acidosis, a rare but serious condition. Dose adjustments or alternative medications may be necessary.
• Certain Diuretics (Thiazides): Thiazide diuretics, often used to manage hypertension, can decrease the effectiveness of Janumet by increasing blood sugar levels. If you are taking both medications, your healthcare provider may need to monitor your blood glucose more closely and adjust your treatment plan accordingly.
• Iodinated Contrast Agents: These agents, used in some radiographic studies (e.g., CT scans), can increase the risk of kidney dysfunction when combined with metformin. This combination can also lead to lactic acidosis, especially in patients with existing kidney issues. It’s typically advised to temporarily stop Janumet before and after such procedures.
• Alcohol: Consuming alcohol can interfere with blood sugar levels, leading to both hypoglycemia and hyperglycemia. Additionally, it increases the risk of lactic acidosis, particularly when taken in conjunction with metformin. Limiting alcohol intake or avoiding it altogether is recommended while taking Janumet.
• Certain Antibiotics or Heart Medications: Some antibiotics and heart medications can affect how Janumet is metabolized in the body. This can either increase the levels of the drug in your system, leading to a higher risk of side effects, or decrease its effectiveness. Always inform your healthcare provider about any new medications to avoid potential interactions.

Always consult your healthcare provider or pharmacist about potential interactions before starting a new medication, including Janumet. They will be able to provide you with personalized advice based on your specific health situation.

[Note: This isn’t a complete list, and there could be other drugs that interact with Janumet. Tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Other Interactions of Janumet?

Apart from medications, Janumet can interact with certain herbs, supplements, food items, and beverages, which can reduce its effectiveness or cause undesirable side effects. You should not use certain substances while using Janumet. To prevent such interactions, your doctor may suggest you make changes in your lifestyle and diet. Janumet can also interact with several diseases, such as:

• Pancreatitis
• Lactic acidosis
• Kidney disease
• Hypoglycemia
• Liver disease
• B12 deficiency
• Heart failure
• Allergic reactions
• Acute renal failure
• Bullous pemphigoid

There are several alternatives to consider when you buy Janumet online. You should not use a medication without consulting your doctor. Based on your condition, age, and needs, they will prescribe you the medication that works best for you. Some of them are listed below:

• Invokana (canagliflozin)
• Jentadueto (linagliptin/metformin)
• Actoplus Met (pioglitazone/metformin)
• Farxiga (dapagliflozin)
• Xigduo XR (dapagliflozin/metformin extended-release [ER])
• Amaryl (glimepiride)
• Trulicity (dulaglutide)
• Synjardy XR (empagliflozin/metformin ER)
• Glyxambi (empagliflozin/linagliptin)
• Glyburide/metformin
• Jardiance (empagliflozin)
• Kombiglyze XR (saxagliptin/metformin ER)
• Invokamet ER (canagliflozin/metformin ER)
• Precose (acarbose)
• Synjardy (empagliflozin/metformin)
• Glucotrol XR (glipizide extended release)
• Steglatro (ertugliflozin)
• Nesina (alogliptin)
• Novolog Flexpen (insulin aspart)
• Victoza (liraglutide)
• Actos (pioglitazone)
• Janumet XR (sitagliptin/metformin extended-release)
• Humalog Kwikpen (insulin lispro)
• Tresiba (insulin degludec)
• Ozempic (semaglutide)
• Humulin N (insulin NPH)
• Humalog Mix 50/50 (insulin lispro protamine/insulin lispro)
• Januvia (sitagliptin)
• Soliqua (insulin glargine/lixisenatide)
• Metformin
• Miglitol
• Levemir Flextouch (insulin detemir)
• Basaglar Kwikpen (insulin glargine)
• Diabeta (glyburide)
• Humulin 70/30 (insulin NPH/insulin regular)
• Jentadueto XR (linagliptin/metformin ER)
• Mounjaro (tirzepatide)
• Onglyza (saxagliptin)
• Rybelsus (semaglutide)
• Prandin (repaglinide)
• Tradjenta (linagliptin)
• Humulin R (insulin regular)
• Nateglinide
• Invokamet (canagliflozin/metformin)
• Kazano (alogliptin/metformin)
• Xultophy (insulin degludec/liraglutide)
• Metformin ER

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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