Janumet (Sitagliptin and Metformin HCl)

Janumet is a prescription dipeptidyl peptidase-4 inhibitor medication combined with biguanide that is used for the treatment of patients with type 2 diabetes. It is used to help those patients get better glycemic control. This medication is meant to be used alongside healthy dietary changes and exercise routines.

• Uses Combination of Two Other Proven Medications
• May be More Effective Than Using Metformin Alone
• Taken Orally
• Helps Body Use Insulin Effectively
• Lowers High Blood Sugar Levels
• Trusted Manufacturer (Merck Sharp & Dohme Corp.)

This medication is designed to be taken orally twice per day. Each tablet should be consumed with a meal. Different patients may be prescribed different doses based on their tolerability and how the medication is affecting them. However, the maximum daily intake is limited to 100 mg of sitagliptin and 2000 mg of metformin HCl. Patients who have not taken metformin before are usually recommended to start with a dose of 50 mg/500 mg twice per day. This dose is then usually escalated gradually. The usual starting dose is 50 mg sitagliptin twice daily (100 mg total per day) along with their current metformin dose for patients already taking metformin. Those taking 850 mg of metformin two times a day generally begin Janumet at 50 mg/1000 mg twice daily.

Never split or divide these tablets. The patient should take the missed dose as soon as possible if a dose of Janumet is missed in most cases. However, the missed dose should be skipped and the regular schedule resumed if it is almost time for the next dose.

This medication has a black boxed warning for lactic acidosis. This risk is associated with the metformin in the medication. This condition can sometimes be fatal and is often indicated by signs such as muscle aches and nausea/vomiting. Advanced stages of this condition can lead to low blood pressure or temperature, along with delirium or difficulty maintaining balance. Patients suffering from this are considered to be having a medical emergency and should immediately go to the hospital to seek medical attention. Do not use Janumet if you have severe kidney or liver disease. The presence of these conditions increases the chance of lactic acidosis.

Patients should stop using this medication and contact their doctor immediately if they experience symptoms that may indicate lactic acidosis, such as:

• Feeling unusually cold in the hands or feet
• Dizziness or lightheadedness
• Slow or irregular heartbeat
• Extreme tiredness or weakness
• Unexplained muscle pain
• Difficulty breathing
• Unusual sleepiness or confusion
• Stomach pain
• Nausea/vomiting

The risk of developing this condition is higher for patients with severe kidney issues or those who have had their kidneys affected by X-ray tests that use injectable dyes. The risk is also greater for patients with liver or heart problems. This includes issues like stroke/heart attack and severe infections. Those aged 65 or older also have an increased risk of developing lactic acidosis. The same goes for patients who are drinking alcohol or are dehydrated. Surgery may also increase the risk.

Other Precautions and Warnings

Pancreatitis and heart failure may also be triggered by the use of this medication in some rare instances. This is why patients should let their doctor know ahead of time if they have a history of gallstones or pancreatitis. They should also let them know if they have a history of alcoholism or high blood triglyceride levels. A history of heart failure and kidney or liver problems should also be reported before starting the medication.

A doctor should be contacted right away if the patient begins experiencing difficulty breathing (especially when lying down) or swelling (especially in the limbs). Unusual tiredness and weight increases should also be reported right away.

It is not known how this medication affects unborn babies in pregnant mothers taking the medication or those who are breastfeeding. This medication should not be started without consulting a doctor if the patient is pregnant, intending to become pregnant, or breastfeeding. Notify your healthcare provider immediately if pregnancy occurs during treatment with this medication. This medication may cause ovulation in some women who have not yet gone through menopause. Patients should also tell their doctor if they have low vitamin B12 in their blood.

Let your doctor know of the history of any conditions you may have had before starting this medication to make sure it is safe to use. The same goes for any other medications or supplements being taken at the time.

Common side effects of Janumet may include:

• Headache
• Stuffy or runny nose/sore throat or mild respiratory symptoms
• Upset stomach
• Gas/indigestion
• Diarrhea
• Nausea/vomiting
• Feeling tired or weak
• Low blood sugar (especially when taken with insulin or sulfonylurea medications)

Contact a healthcare provider if any of these side effects become severe or persistent.

Serious Side Effects

Serious side effects may also take place on more rare occasions. These include side effects like kidney problems or vitamin B12 deficiency (especially when this medication has been used for a long time). Other rare but possible serious side effects include hypoglycemia and joint pain. Skin reactions or serious allergic reactions may also occur in some cases. Anyone experiencing serious side effects should get medical help immediately.

There have been some drug interactions that have been found to be clinically significant with Janumet. These include:

• Carbonic anhydrase inhibitors (these may increase the risk of lactic acidosis)
• Drugs that reduce metformin clearance
• Alcohol (these can increase metformin’s effect on lactate metabolism and raise the risk of lactic acidosis)
• Iznsulin or insulin secretagogues (e.g., sulfonylureas)
• Drugs affecting blood sugar control (these may reduce Janumet’s effectiveness)
  Always consult a medical professional first before combining any medications or other supplements.

The tablets should be stored at room temperature—within a temperature range of 68°F to 77°F. This is the equivalent of 20°C to 25°C. They should also be kept out of reach from children and away from moisture and direct light. This medication should be left in its original container until use. MyRx Outlet safely and compliantly packs and ships all medications directly to patients’ homes in the U.S.

At MyRx Outlet, we are committed to delivering safe, high-quality medications that you can trust. We adhere to strict regulations in every country we operate in, ensuring that your order is handled by a licensed Canadian pharmacy or a trusted partner overseas. Each medication has been legally approved by Health Canada or other respected authorities. To purchase Janumet at a discounted rate, call 1-888-551-2467.