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Janumet is the brand name for sitagliptin and metformin and is available as an oral tablet.

Janumet is available as an oral tablet that contains one of the following:

• sitagliptin 50 mg and metformin HCl 500 mg tablets
• sitagliptin 50 mg and metformin HCl 1000 mg tablets

Janumet is a DPP-4 inhibitor / Biguanide and is used to treat type 2 diabetes.

Janumet is a combination of two different diabetes medications. Metformin is a biguanide. It works by lowering the amount of sugar your liver releases into your blood and lowering the amount of sugar that gets absorbed into the body through your gut. It also helps your body respond better to insulin. Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor. It blocks the action of DPP-4, a protein that normally breaks down insulin in the body. By blocking DPP-4, the medication allows insulin to stick around in your body longer to help control your blood sugar levels.

Janumet is dosed as follows:

• Janumet (immediate-release tablets): The typical starting dose is 50 mg/500 mg (sitagliptin/metformin) by mouth twice daily with meals
• Janumet XR (extended-release tablets): The typical starting dose is 100 mg/1,000 mg (sitagliptin/metformin) by mouth once daily with a meal

Your dose might differ if you were taking metformin by itself before you started Janumet.

Janumet is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if you have any of the following:

• Severe renal impairment: eGFR below 30 mL/min/1.73 m2
• Metabolic acidosis, including diabetic ketoacidosis.
• History of a serious hypersensitivity reaction (e.g., anaphylaxis or angioedema) to Janumet, sitagliptin, or metformin

Common side effects of Janumet:

• Diarrhea
• Upper respiratory tract infection
• Headache

Serious side effects are rare with Janumet. Contact your healthcare provider immediately if you experience any of the following.

• Inflammation of the pancreas: upper belly pain, nausea, vomiting
• Buildup of lactic acid in the body: sudden drop in blood pressure, low body temperature, slow heart rhythm, feeling weak, stomach pain, nausea
• Kidney problems: urinating less, itching, swelling of the ankles or feet
• Heart failure: shortness of breath, unusually fast weight gain, swelling of the legs or feet
• Severe allergic reaction: hives, blisters, trouble breathing, swelling of the face or throat

The following medications may interact with Janumet:

• Carbonic anhydrase inhibitors may increase risk of lactic acidosis
• Consider more frequent monitoring
• Drugs that reduce metformin clearance (such as ranolazine vandetanib, dolutegravir, and cimetidine) may increase the accumulation of metformin. Consider the benefits and risks of concomitant use
• Alcohol can potentiate the effect of metformin on lactate metabolism
• Warn patients against excessive alcohol intake

Merck & Co., Inc.

It is not known if Janumet can harm your unborn baby. Janumet should only be used during pregnancy if the benefit to you is worth the possible risk to your baby.

• Sitagliptin/Metformin HCI