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About Janumet (Sitagliptin - Metformin)

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Also known as:  Sitagliptin - Metformin.

Description

Janumet is indicated for the treatment of non-insulin-dependent diabetes mellitus where the use of both antihyperglycemic agents is appropriate.

This oral antidiabetic consists of a combination of two active ingredients, Sitagliptin and Metformin. Sitagliptin slows down the inactivation of incretin hormones that improve insulin production while reducing hepatic glucose production. Metformin, while also decreasing the production of glucose in the liver, improves insulin sensitivity and lowers the amount of glucose absorbed into the intestine.

Indications

Improvement of glycemic control during the treatment of type 2 diabetes mellitus when a dietary regimen with an exercise program is not enough.

MOA (mechanism of action)

Sitagliptin is an inhibitor of Dipeptidyl peptidase-4 (DPP-4), an enzyme that inactivates incretin hormones (glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide) that stimulate insulin production from beta cells and reduce glucagon secretion from pancreatic alpha cells. By prolonging active incretin levels Sitagliptin enhances insulin release and decreases glucagon levels.

Metformin belongs to the biguanide class and it lowers both basal and postprandial plasma glucose. Thanks to its ability to increase peripheral glucose uptake and utilization it lowers levels of hepatic glucose and reduces glucose absorption in the intestine while also improving insulin sensitivity.

Dosage

The medication is taken orally with food (in order to prevent gastrointestinal disorders). Janumet should be swallowed whole with some water. Follow your doctor's recommendations on the dosage of this medication.

Maximum dose: 100 mg Sitagliptin/2000 mg Metformin a day.

Missed dose

If you miss a dose you should take it as soon as you remember about your missing. If it is the time for the next dose you should continue your regular dosing schedule. Do not take a double dose to make up for a forgotten one.

Overdose

An excessive dose of Janumet may lead to lactic acidosis. If an overdose occurs and you are feeling unwell, you should seek emergency medical attention or contact your healthcare provider immediately.

Storage

Store at room temperature between 20°C and 25°C (68°F and 77°F) away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Janumet are:

  • diarrhea
  • upper respiratory tract infection
  • headache
  • hypoglycemia
  • nausea or vomiting
  • abdominal pain
  • pancreatitis
  • low levels of vitamin B12
  • flatulence
  • indigestion
  • asthenia
  • hepatic enzyme elevations
  • renal disorders
  • bullous pemphigoid
  • constipation
  • joint pain

Side effect occurrence does not only depend on medication you are taking but also on your overall health and other factors.

Contraindications

Do not take Janumet if:

  • you are allergic to Sitagliptin or Metformin or any other ingredients in the formulation;
  • you have a severe renal or hepatic disorder;
  • you have a history of alcoholism or heart disorders;
  • you have type 1 diabetes mellitus or diabetic ketoacidosis;
  • you have a history of pancreatitis without consulting a doctor;
  • you have a history of angioedema without consulting a doctor;
  • you are over the age of 65 (consult your doctor).
Warnings and precautions

Stop taking Janumet if you’re going to be administered intra-arterial iodinated contrast, undergo surgery or your body is exposed to stress due to infection, fever or trauma.

Reduce alcohol consumption during the treatment with Janumet.

Taking Janumet with carbonic anhydrase inhibitors may lead to lactic acidosis and it requires more frequent monitoring.

Taking Janumet with drugs that reduce Metformin clearance (e.g., ranolazine, vandetanib, dolutegravir, and cimetidine) may lead to high accumulation of Metformin. You may need to consider an alternative treatment.

Taking Janumet with insulin or insulin secretagogues may lead hypoglycemia and it requires a dosage adjustment. 

Taking Janumet with diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid may lead to hyperglycemia and it requires more frequent monitoring.

Q: What is Janumet used for?

A: Janumet is used to control type 2 diabetes mellitus as an adjunct to diet and exercise in order to improve glycemic control.

Q: How should I take Janumet?

A: Janumet should be swallowed whole with some water. The initial recommended dose is 50 mg Sitagliptin/500 mg Metformin twice daily.

Q: Can Janumet be taken by pregnant or breastfeeding women?

A: Janumet is not recommended for use in pregnant or breastfeeding women.

Q: Can Janumet be taken by children?

A: Janumet is not recommended for use in patients under the age of 18.

Target Point Shipping Method Tracking Delivery Time Price
Worldwide Shipping

Worldwide Shipping

Registered Mail  Not trackable 14-21 business days USD 15.00 per order
EMS  Trackable, where available 5-9 business days USD 25.00 per order

Delivery time is:

Registered Mail - 14-21 business days, price - USD 15.00, no signature is required on delivery.
EMS - 5-9 business days, price - USD 25.00, signature is required on delivery.
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