Janumet

sitagliptin-metformin

Brand(s):

• Janumet

Manufacturer:

• MSD Pharmaceuticals Pvt. Ltd.

Disease(s):

• Type 2 Diabetes

Metformin and Sitagliptin Tablets

What is this Medication?

Metformin and Sitagliptin tablets are a combination oral medication used to manage blood sugar levels in adults with type 2 diabetes. They work in different ways to achieve this goal.

Metformin primarily reduces the amount of sugar your liver produces and lessens the absorption of sugar from your intestines. Sitagliptin works by improving how your body responds to its own insulin production after meals, helping your body use the insulin more effectively to regulate blood sugar.

This medication is used in conjunction with diet and exercise. It's crucial to remember that it's not intended for treating type 1 diabetes.

Important Information for Your Healthcare Professional

Before starting this medication, you should inform your doctor about any pre-existing health conditions or allergies. You should not use this medicine if you:

• Are allergic to metformin (brand names include Actoplus Met, Avandamet, Fortamet, Glucophage, Riomet) or sitagliptin (Januvia).
• Have kidney or liver disease.
• Are experiencing diabetic ketoacidosis (seek immediate medical attention for this condition; insulin treatment is required).

Metformin carries a risk of a serious condition called lactic acidosis, a build-up of lactic acid in the body. This risk is heightened if you have liver or kidney disease, congestive heart failure, a severe infection, are dehydrated, or consume excessive alcohol. Discuss your individual risk factors with your doctor.

It's also essential to disclose a history of heart disease, pancreatitis, or if you are over 80 and haven't had your kidney function checked recently. If you require any imaging tests involving injected dye (like X-rays or CT scans), you'll need to temporarily discontinue this medication. Always inform your healthcare providers about your medication use.

While some oral diabetes medications might increase the risk of heart problems, it's equally important to note that untreated diabetes can severely damage your heart and other organs.

This medication is categorized as FDA pregnancy category B. This means it's not expected to harm an unborn baby, but you should still inform your doctor if you're pregnant or planning a pregnancy. The effects of metformin and sitagliptin on breastfeeding are unknown; consult your doctor before using this medication while breastfeeding.

How to Take This Medication

Always follow your doctor's instructions precisely. Do not adjust the dosage or frequency without consulting your doctor. Take this medication with meals. Extended-release tablets should be swallowed whole; do not crush, chew, or break them.

Regular blood sugar monitoring is essential, along with other potential blood tests as directed by your doctor. Learn to recognize the symptoms of low blood sugar (hypoglycemia): headache, hunger, weakness, sweating, tremor, irritability, or difficulty concentrating.

Be extra vigilant about monitoring your blood sugar during periods of stress, illness, travel, increased exercise, alcohol consumption, or skipped meals. These factors can significantly impact your blood glucose levels and may necessitate adjustments to your dosage. Keep a readily available source of sugar (e.g., orange juice, glucose gel, candy, milk) in case of hypoglycemia. For severe hypoglycemia, an injection of glucagon may be necessary. Your doctor can provide a glucagon emergency kit and instructions for its use.

This medication is only one component of a comprehensive diabetes management plan, which also encompasses diet, exercise, weight management, foot care, and eye care. Adherence to all aspects of your treatment plan is crucial.

Missed Dose

Take the missed dose as soon as you remember, with food. If it's almost time for your next dose, skip the missed one and do not double up on the next dose.

Potential Drug Interactions

It's imperative to inform your doctor about all other medications you are taking, including:

• Acetazolamide (Diamox)
• Cimetidine (Tagamet), Ranitidine (Zantac)
• Morphine (MS Contin, Kadian, Oramorph)
• Topiramate (Topamax)
• Trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra) or vancomycin (Vancocin, Lyphocin)
• Glipizide (Glucotrol, Metaglip), Glimepiride (Amaryl, Avandaryl, Duetact), Glyburide (DiaBeta, Micronase, Glucovance)
• Heart or blood pressure medications such as amiloride (Midamor), digoxin (Lanoxin), furosemide (Lasix), nifedipine (Nifedical, Procardia), procainamide (Procan, Pronestyl, Procanbid), quinidine (Quin-G), triamterene (Dyrenium).

Certain medications can elevate blood sugar levels, potentially leading to hyperglycemia. These include:

• Isoniazid
• Diuretics (water pills)
• Steroids (prednisone and others)
• Heart or blood pressure medications (Cartia, Cardizem, Covera, Isoptin, Verelan, and others)
• Niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others)
• Phenothiazines (Compazine and others)
• Thyroid medications (Synthroid and others)
• Birth control pills and other hormones
• Seizure medications (Dilantin and others)
• Diet pills or medications for asthma, colds, or allergies

This is not an exhaustive list. Many other medications can influence the blood sugar-lowering effects of this medication. Always inform your doctor of all medications you use, including over-the-counter, vitamins, and herbal products. Do not start new medications without consulting your physician.

Monitoring While Taking This Medication

Avoid alcohol consumption as it can lower blood sugar and increase the risk of lactic acidosis.

Possible Side Effects

Lactic acidosis is a potentially fatal side effect. It can develop gradually. Seek immediate medical attention if you experience even mild symptoms, including muscle pain or weakness, numbness or coldness in extremities, breathing difficulties, stomach pain, nausea and vomiting, slow or irregular heartbeat, dizziness, or extreme weakness/fatigue.

Allergic reactions require immediate emergency medical help. Symptoms include hives, breathing difficulties, and swelling of the face, lips, tongue, or throat.

Contact your doctor immediately if you experience any of these serious side effects:

• Pancreatitis: severe upper stomach pain radiating to the back, nausea and vomiting, loss of appetite, rapid heart rate.
• Reduced or absent urination.
• Shortness of breath (even with mild exertion), swelling, or rapid weight gain.
• Severe skin reaction: fever, sore throat, facial or tongue swelling, burning eyes, skin pain, followed by a red or purple rash spreading (especially on the face or upper body), causing blistering and peeling.

Less serious side effects may include:

• Diarrhea, constipation, mild nausea, upset stomach.
• Headache, weakness, back pain, joint or muscle pain.
• Cold symptoms: runny or stuffy nose, sneezing, sore throat.

Storage

Store this medication at room temperature, away from moisture and heat.