Combination therapy refers to the use multiple medications to fight a particular condition like type II diabetes. In this article, the focus is on combination therapy used to manage type II diabetes. The practice isn’t new and has been effective in many patients. Nowadays, there are many type 2 diabetes medications which work in different ways; hence combination therapy can be very effective. The medical care practitioner will pick the best drugs which will be effective in controlling blood glucose levels in a particular patient such as Janumet.

What is Janumet used for?

Janumet is a prescription drug available in the form of a tablet and given to patients who have been on a maximum dose of Metformin but their blood glucose hasn’t been effectively controlled. Still, it may be prescribed to patients already taking Metformin and Januvia as separate tablets.

As mentioned above, it’s a combination of medication which contains two drugs, namely:

  1. Metformin – it is an antidiabetic drug known as biguanide and works in a number of ways to lower blood sugar levels. To start with, it minimizes the quantity of glucose produced by cells in the liver. Additionally, it makes the muscle cells more sensitive to insulin and finally it slows the absorption of glucose from the intestines into the blood after food consumption.
  2. Januvia (the active ingredient is sitagliptin)- it belongs to a class of medication by the name DPP-4 inhibitor. It lowers blood glucose levels by hindering breakdown of two incretin hormones by the name glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). The hormones are naturally released after eating food. They trigger the pancreas to produce more insulin to respond to elevated blood sugar levels. Furthermore, they lower the release of glucagon (it’s a hormone that stimulates glucose production by the liver) and affects the brain which makes one feel full, hence reducing food consumption. Through these actions, blood glucose level is regulated, but the patient might be faced with Janumet side effects.

What to Remember While on the Therapy

  1. Continue with regular exercises and healthy eating; this medication helps regulate the blood sugar levels and you shouldn’t substitute it for healthy eating as well as physical activity.
  2. Some patients may experience inflammation of the pancreas (pancreatitis) caused by Januvia and other medicines which work in a similar manner. Signs may include severe abdominal pain, nausea, and vomiting
  3. If you are scheduled for a surgery under a general anesthetic and you diabetic, inform the physician since blood glucose levels need to be controlled by insulin, so you should stop taking the drug 48 hours before the surgery
  4. Inform the doctor if you are due for an X-ray which will involve an injection of iodinated dye, as you have to temporally stop using the drug and wait for 48 hours after the X-ray. The doctor will run tests on the patient’s kidney to confirm their functionality before you continue with the medication
  5. Metformin can prompt a rare but serious complication called lactic acidosis (too much acid in the blood). Individuals who are at risk of this condition have decreased kidney function, people who take alcohol while on the medication and take alcohol on an empty stomach or those with liver problems. Sign and symptoms of lactic acidosis are rapid breathing, nausea, vomiting and feeling weak. If you encounter any of the sign, stop taking the drug and contact the medical care provider.
  6. It’s a clear indication from the above explanation that alcohol intake should be avoided at whatsoever cost while on the medication. Apart from lactic acidosis, it can trigger low blood sugar levels. If an alcoholic and it’s difficult to quit drinking alcohol, inform the doctor since Janumet may not be the best for you, although the physician has the final say on this
  7. The safety of this medicine hasn’t been established during pregnancy and it’s highly discouraged. Insulin or Metformin alone is preferred in pregnancy as it provides more stable control of blood glucose levels. If you conceive while on the medication or plans to, let the doctor know
  8. It’s unclear if Januvia passes into breast milk, Metformin doesn’t; the manufacturer of Janumet warns breastfeeding mothers against using the drug. Consult the health care practitioner for more medical advice.

Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.