Janumet® (sitagliptin/metformin) Tablets for Type 2 Diabetes

What Janumet® Is and How It Works

Janumet® combines sitagliptin, a DPP‑4 inhibitor, with metformin, a biguanide. It helps adults with type 2 diabetes improve blood sugar when diet and exercise are not enough. Tablets are available in immediate‑release and extended‑release (XR) forms. If you are comparing janumet 50 1000 price or reviewing janumet cost without insurance, this page explains how the medication works and how to use it safely.

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How it works: sitagliptin increases incretin hormones by blocking DPP‑4, which boosts insulin release and lowers glucagon when glucose is high. Metformin lowers hepatic glucose production and improves insulin sensitivity in muscle and fat. Together, the two agents reduce fasting and post‑meal glucose. Janumet is taken by mouth with meals (immediate‑release twice daily; XR once daily).

Typical strengths include 50/500 mg and 50/1000 mg combinations, with XR options for once‑daily use. Your prescriber selects a strength based on prior therapy, A1C goals, kidney function, and tolerability.

For more background on expected effects, see Does Janumet Cause Weight Loss Its Impact On Diabetes Management and dosing guidance in Understanding Janumet Dosage How To Take It Safely And Effectively. You can also explore our Type 2 Diabetes hub for related therapies.

Dosage and Usage

• Starting dose (immediate‑release): often 50/500 mg twice daily with meals. Your prescriber may adjust every 1–2 weeks based on response and tolerability.
• Starting dose (XR): often 100 mg sitagliptin total daily with metformin XR 1000–2000 mg once daily with the evening meal.
• Maximum daily amounts: sitagliptin 100 mg; metformin XR or IR commonly up to 2000 mg daily, as tolerated.
• Renal considerations: dosing depends on kidney function. Metformin is not used with severe renal impairment; sitagliptin may require adjustment.
• Administration tips (IR): take twice daily with meals to reduce stomach upset.
• Administration tips (XR): take once daily with the evening meal. Swallow XR tablets whole; do not crush, split, or chew.
• Missed dose (IR): take when remembered unless it is near the next dose. Do not double doses.
• Missed dose (XR): take the missed dose the same day with food if remembered; skip if close to the next scheduled dose.
• Transitioning from metformin alone: a lower metformin total daily dose may be used initially, then titrated up to limit gastrointestinal effects.
• Glucose targets: monitoring guides adjustments. Your care team will individualize A1C and fasting/post‑meal goals.

Storage and Travel

• Store tablets at 20–25°C (68–77°F) in the original bottle, away from moisture.
• Keep the container tightly closed and out of reach of children and pets.
• For travel, pack in carry‑on luggage with the pharmacy label visible for screening.
• Carry a small supply in a separate bag as a backup in case of delays.
• Do not split XR tablets. Use a reminder to keep your once‑daily schedule when crossing time zones.

Benefits and Savings

Janumet reduces A1C through two complementary mechanisms. Many patients see improved fasting and post‑meal glucose with a low risk of hypoglycemia when not used with insulin or a sulfonylurea. Metformin is weight‑neutral to modestly weight‑reducing, and sitagliptin is generally weight‑neutral. XR dosing can simplify routines with once‑daily tablets.

These combinations let clinicians optimize the sitagliptin 100 mg daily target while individualizing the metformin dose. That flexibility supports sustained glycemic control and may reduce treatment inertia.

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Side Effects and Safety

• Very common: gastrointestinal upset (nausea, diarrhea, gas, abdominal discomfort), especially when starting or increasing metformin.
• Common: headache, mild upper respiratory symptoms, fatigue, and changes in taste.
• Less common: decreased vitamin B12 levels over time; your clinician may monitor levels if symptoms arise.
• Rare but serious: lactic acidosis with metformin in high‑risk settings (severe renal impairment, hypoxia, severe infection, dehydration, or heavy alcohol use).
• Pancreatitis has been reported with sitagliptin; seek care for persistent, severe abdominal pain.
• Severe joint pain, allergic reactions, or skin blistering (bullous pemphigoid) are uncommon but require medical attention.
• Hypoglycemia risk increases if combined with insulin or sulfonylureas; dose adjustments of those agents may be needed.

Tell your care team about kidney or liver disease, planned contrast imaging, surgery, alcohol intake, and all other medicines. Metformin may be paused around iodinated contrast or acute illness per clinical guidance.

Onset Time

Glycemic effects begin within the first 1–2 weeks as metformin titration starts. Fasting glucose often improves first, followed by post‑meal readings. A1C changes become clearer by 4–12 weeks as the dose is optimized and adherence stabilizes. Weight impact is typically neutral; some individuals may see small weight loss related to metformin.

Compare With Alternatives

Januvia (sitagliptin alone) offers once‑daily dosing without metformin. Janumet may provide greater A1C reduction because metformin acts on hepatic glucose production and insulin sensitivity. Metformin alone remains first‑line for many; adding sitagliptin can further reduce A1C when metformin alone is not enough.

Rybelsus® (oral semaglutide) is a GLP‑1 receptor agonist taken once daily on an empty stomach. It can deliver stronger A1C and weight effects but has specific fasting administration requirements and gastrointestinal tolerability considerations.

Trulicity® (dulaglutide) is a once‑weekly injectable GLP‑1 RA that often lowers A1C and weight more than DPP‑4 inhibitors. Mounjaro® (tirzepatide) is another once‑weekly injectable with robust glucose and weight effects. These options may be considered when broader metabolic benefits are desired or when oral therapy is insufficient.

Choice depends on A1C goals, weight considerations, comorbidities, route preferences, and tolerability. Your prescriber will tailor therapy based on these factors.

Combination Therapy

• With insulin: may improve control; consider reducing insulin dose to lower hypoglycemia risk.
• With a sulfonylurea (e.g., glyburide, glipizide): monitor closely and consider dose reductions to avoid low blood sugar.
• With an SGLT2 inhibitor: complementary mechanisms can improve A1C and weight; monitor hydration and kidney function.
• With statins and blood pressure medications: common in cardiometabolic care; continue routine monitoring.
• Avoid duplication with another DPP‑4 inhibitor; do not combine sitagliptin with similar agents.

Patient Suitability and Cost‑Saving Tips

Janumet is for adults with type 2 diabetes. It is not for type 1 diabetes or diabetic ketoacidosis. It may not be appropriate with severe renal impairment, significant liver disease, unstable heart failure, or conditions that increase lactic acidosis risk. Discuss alcohol use, as excessive intake increases metformin‑related risks.

XR tablets can improve convenience for those who prefer once‑daily dosing. Individuals sensitive to gastrointestinal effects may benefit from a slower metformin titration and taking tablets with the largest meal.

Cost‑saving ideas include selecting a multi‑month supply to reduce per‑tablet costs, aligning refills to limit shipping touches, and choosing strengths that minimize the number of tablets taken daily. Reorder reminders can help maintain continuity and avoid last‑minute purchases.

If lifestyle needs change, your clinician may adjust the dose or add another agent to match evolving A1C goals. Periodic vitamin B12 checks may be considered with long‑term metformin use.

Authoritative Sources

Merck product information for Janumet and Janumet XR

Health Canada Product Monograph: JANUMET

FDA Prescribing Information: JANUMET/JANUMET XR

Order Janumet® from CanadianInsulin: add to cart, upload your prescription, and we ship with prompt, express, cold‑chain handling.

This page is for educational purposes and does not replace medical advice. Always consult a qualified healthcare professional for diagnosis and treatment decisions.