What is Janumet?

Janumet

Generic Name: metformin and sitagliptin (met FOR min and SI ta glip tin)

Brand Names: Janumet

What is Janumet?

Janumet contains a combination of metformin and 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.

Janumet is used along with diet and exercise to lower blood sugar in adults with type 2 diabetes. Janumet is not for treating type 1 diabetes.

Janumet may also be used for purposes not listed in this medication guide.

Important information about Janumet

You should not use Janumet if you are allergic to metformin (Glucophage) or sitagliptin (Januvia), 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, you will need to temporarily stop taking Janumet.

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: 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.

Before taking Janumet

Do not use Janumet 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).

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.

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 Janumet. Be sure your caregivers know ahead of time that you are using Janumet.

To make sure you can safely take Janumet, tell your doctor if you have a history of heart disease or pancreatitis, or if you are over 80 years old and have not recently had your kidney function checked.

Certain oral diabetes medications may increase your risk of serious heart problems. However, not treating your diabetes can damage your heart and other organs.

FDA pregnancy category B. Janumet is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether metformin and sitagliptin passes into breast milk or if it could harm a nursing baby. Do not use Janumet without telling your doctor if you are breast-feeding a baby.

See also: Janumet pregnancy and breastfeeding warnings (in more detail)

How should I take Janumet?

Take Janumet 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. Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.

Take Janumet with meals. Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating.

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.

Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, drink alcohol, or skip meals. These things can affect your glucose levels and your dose needs may also change.

Ask your doctor how to adjust your Janumet dose if needed. Do not change your medication dose or schedule without your doctor's advice.

Janumet 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.

Store Janumet at room temperature away from moisture and heat.

See also: Janumet dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember (be sure to take Janumet 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.

What happens if I overdose?

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 extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions). An overdose of metformin may cause lactic acidosis. Get emergency medical help if you have: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.

What should I avoid while taking Janumet?

Avoid drinking alcohol while taking Janumet. It lowers blood sugar and may increase your risk of lactic acidosis.

See also: Janumet and alcohol (in more detail)

Janumet side effects

Janumet 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 to Janumet: 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 while taking Janumet:

• 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; or
• swelling or rapid weight gain.

Less serious Janumet side effects may include:

• diarrhea, mild nausea, upset stomach;
• headache, weakness; or
• cold symptoms such as runny or stuffy nose, sneezing, sore throat.

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.

See also: Janumet side effects (in more detail)

What other drugs will affect Janumet?

Tell your doctor about all other medicines you use, especially:

• cimetidine (Tagamet), ranitidine (Zantac);
• morphine (MS Contin, Kadian, Oramorph);
• trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra), vancomycin (Vancocin, Lyphocin);
• glipizide (Glucotrol, Metaglip), glimepiride (Amaryl, Avandaryl, Duetact), glyburide (DiaBeta, Micronase, Glucovance); or
• 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).

You may be more likely to have hyperglycemia (high blood sugar) if you take Janumet with other drugs that can raise blood sugar, such as:

• isoniazid;
• diuretics (water pills);
• steroids (prednisone and others);
• heart or blood pressure medication (Cartia, Cardizem, Covera, Isoptin, Verelan, and others);
• niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others);
• phenothiazines (Compazine and others);
• thyroid medicine (Synthroid and others);
• birth control pills and other hormones;
• seizure medicines (Dilantin and others); or
• diet pills or medicines to treat asthma, colds or allergies.

You may be more likely to have hypoglycemia (low blood sugar) if you take Janumet with other drugs that can lower blood sugar, such as:

• probenecid (Benemid);
• some nonsteroidal anti-inflammatory drugs (NSAIDs);
• aspirin or other salicylates (including Pepto-Bismol);
• a blood thinner (warfarin, Coumadin and others);
• heart or blood pressure medication (Accupril, Altace, Lotensin, Prinivil, Vasotec, Zestril, and others);
• sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others);
• a monoamine oxidase inhibitor (MAOI); or
• other oral diabetes medications, especially acarbose (Precose), metformin (Glucophage), miglitol (Glyset), pioglitazone (Actos), or rosiglitazone (Avandia).

These lists are not complete and there are many other medicines that can increase or decrease the effects of Janumet on lowering your blood sugar. 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.