Metformin and Sitagliptin

Metformin and Sitagliptin Brand Names- Janumet | Janumet XR

What is Metformin and Sitagliptin

Metformin and sitagliptin is a combination product containing 2 oral antidiabetic agents, a dipeptidyl-peptidase-4 (DDP-4) inhibitor (sitagliptin) and a biguanide (metformin).

The combination is used for the treatment of adults with type 2 diabetes mellitus (DM). Sitagliptin, when added to metformin, significantly decreases A1C concentrations, fasting plasma glucose concentrations, and postprandial plasma glucose concentrations.

Metformin is first-line in the treatment of type 2 DM. In patients with established cardiovascular (CV) disease, heart failure (HF), or chronic kidney disease (CKD), a sodium-glucose co-transporter 2 (SGLT2) inhibitor or glucagon-like peptide-1 receptor agonist (GLP-1 RA) with proven CV benefit and reduction of CKD progression is recommended for add-on therapy, independent of baseline A1C or individualized A1C target.

In patients without indicators of high-risk or established CVD, HF, or CKD, DPP-4 inhibitors are a therapeutic option which are generally well tolerated, have a neutral effect on weight, and have minimal risk of hypoglycemia when used as monotherapy.

Indications

  • type 2 diabetes mellitus

For the treatment of type 2 diabetes mellitus uncontrolled by diet and exercise

to switch patients already taking metformin plus sitagliptin to the combination product

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. angioedema
  4. anorexia
  5. arthralgia
  6. asthenia
  7. back pain
  8. bullous rash
  9. cholestasis
  10. constipation
  11. diarrhea
  12. dysgeusia
  13. dyspepsia
  14. elevated hepatic enzymes
  15. exfoliative dermatitis
  16. flatulence
  17. folate deficiency
  18. headache
  19. heart failure
  20. hepatitis
  21. hypoglycemia
  22. infection
  23. lactic acidosis
  24. malaise
  25. megaloblastic anemia
  26. metabolic acidosis
  27. metallic taste
  28. myalgia
  29. nausea
  30. oral ulceration
  31. pancreatitis
  32. pemphigus
  33. peripheral edema
  34. pharyngitis
  35. pruritus
  36. rash
  37. renal failure (unspecified)
  38. rhabdomyolysis
  39. Stevens-Johnson syndrome
  40. stomatitis
  41. urticaria
  42. vasculitis
  43. vitamin B12 deficiency
  44. vomiting
  45. weight loss

Monitoring Parameters

  • blood glucose
  • CBC
  • glycosylated hemoglobin A1c (HbA1c)
  • LFTs
  • serum creatinine/BUN

Contraindications

  • acidemia
  • acute heart failure
  • acute myocardial infarction
  • adrenal insufficiency
  • alcoholism
  • anemia
  • arthralgia
  • breast-feeding
  • burns
  • cardiac disease
  • cardiogenic shock
  • children
  • dehydration
  • diabetic ketoacidosis
  • diarrhea
  • ethanol intoxication
  • exfoliative dermatitis
  • fever
  • gastroparesis
  • geriatric
  • GI obstruction
  • heart failure
  • hepatic disease
  • history of angioedema
  • hypercortisolism
  • hyperglycemia
  • hyperthyroidism
  • hypoglycemia
  • hypothyroidism
  • hypoxemia
  • ileus
  • infection
  • lactic acidosis
  • malnutrition
  • metabolic acidosis
  • pancreatitis
  • pernicious anemia
  • pituitary insufficiency
  • polycystic ovary syndrome
  • pregnancy
  • radiographic contrast administration
  • renal disease
  • renal failure
  • renal impairment
  • sepsis
  • serious rash
  • surgery
  • trauma
  • type 1 diabetes mellitus
  • vitamin B12 deficiency
  • vomiting

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abacavir; Lamivudine, 3TC
  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Acebutolol
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetazolamide
  • Acetohexamide
  • Acrivastine; Pseudoephedrine
  • Adefovir
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amlodipine; Benazepril
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Amphetamines
  • Amprenavir
  • Androgens
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Articaine; Epinephrine
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • atypical antipsychotic
  • Azelastine; Fluticasone
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Beclomethasone
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzphetamine
  • Beta-blockers
  • Betamethasone
  • Betaxolol
  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bortezomib
  • Brigatinib
  • Brimonidine; Timolol
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Budesonide
  • Budesonide; Formoterol
  • Bumetanide
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Capmatinib
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Carteolol
  • Carvedilol
  • Cephalexin
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloroquine
  • Chlorothiazide
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Chromium
  • Ciclesonide
  • Cimetidine
  • Cisapride
  • Clarithromycin
  • Clofarabine
  • Clonidine
  • Cobicistat
  • Codeine; Phenylephrine; Promethazine
  • Colesevelam
  • Conjugated Estrogens
  • Conjugated Estrogens; Bazedoxifene
  • Conjugated Estrogens; Medroxyprogesterone
  • Corticosteroids
  • Cortisone
  • Cyanocobalamin, Vitamin B12
  • Cyclosporine
  • Daclatasvir
  • Danazol
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deflazacort
  • Desloratadine; Pseudoephedrine
  • Dexamethasone
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Diazoxide
  • Dichlorphenamide
  • Dienogest; Estradiol valerate
  • Diethylpropion
  • Diethylstilbestrol, DES
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Disopyramide
  • Dobutamine
  • Dofetilide
  • Dolutegravir
  • Dolutegravir; Lamivudine
  • Dolutegravir; Rilpivirine
  • Donepezil; Memantine
  • Dopamine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Dorzolamide; Timolol
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Entecavir
  • Ephedrine
  • Epinephrine
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Erdafitinib
  • Erythromycin; Sulfisoxazole
  • Esmolol
  • Esterified Estrogens
  • Esterified Estrogens; Methyltestosterone
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estramustine
  • Estrogens
  • Estropipate
  • Ethacrynic Acid
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethotoin
  • Etonogestrel
  • Famotidine
  • Famotidine; Ibuprofen
  • Fenofibrate
  • Fenofibric Acid
  • Fexofenadine; Pseudoephedrine
  • Fibric acid derivatives
  • Fludrocortisone
  • Flunisolide
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluoxymesterone
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Fosamprenavir
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Furosemide
  • Gadoterate meglumine
  • Garlic, Allium sativum
  • Gemfibrozil
  • Glecaprevir; Pibrentasvir
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Green Tea
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Hydantoins
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydrocortisone
  • Hydroxychloroquine
  • Hydroxyprogesterone
  • Ibuprofen; Pseudoephedrine
  • Indacaterol; Glycopyrrolate
  • Indapamide
  • Indinavir
  • Insulin Aspart
  • Insulin Aspart; Insulin Aspart Protamine
  • Insulin Degludec
  • Insulin Degludec; Liraglutide
  • Insulin Detemir
  • Insulin Glargine
  • Insulin Glargine; Lixisenatide
  • Insulin Glulisine
  • Insulin Lispro
  • Insulin Lispro; Insulin Lispro Protamine
  • Insulin, Inhaled
  • Insulins
  • Iodipamide Meglumine
  • Ionic Contrast Media
  • Ioxaglate Meglumine; Ioxaglate Sodium
  • Irbesartan
  • Isophane Insulin (NPH)
  • Isoproterenol
  • Labetalol
  • Lamivudine, 3TC
  • Lamivudine, 3TC; Zidovudine, ZDV
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Lamotrigine
  • Lanreotide
  • Ledipasvir; Sofosbuvir
  • Lente Insulin
  • Leuprolide; Norethindrone
  • Levobetaxolol
  • Levobunolol
  • Levomefolate
  • Levonorgestrel
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Linezolid
  • Liothyronine
  • Lisdexamfetamine
  • Lisinopril
  • Lithium
  • Lomefloxacin
  • Lomitapide
  • Lopinavir; Ritonavir
  • Loratadine; Pseudoephedrine
  • Lorcaserin
  • Losartan
  • Lovastatin; Niacin
  • Mecasermin rinfabate
  • Mecasermin, Recombinant, rh-IGF-1
  • Medroxyprogesterone
  • Meglitinides
  • Memantine
  • Mepivacaine; Levonordefrin
  • Mestranol; Norethindrone
  • Metformin; Repaglinide
  • Methamphetamine
  • Methazolamide
  • Methyclothiazide
  • Methylphenidate
  • Methylprednisolone
  • Methyltestosterone
  • Metolazone
  • Metoprolol
  • Metyrapone
  • Midodrine
  • Moexipril
  • Mometasone
  • Monoamine oxidase inhibitors
  • Nadolol
  • Nandrolone Decanoate
  • Naproxen; Pseudoephedrine
  • Nateglinide
  • Nebivolol
  • Nebivolol; Valsartan
  • Nelfinavir
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nicotine
  • Nifedipine
  • Non-Ionic Contrast Media
  • Norepinephrine
  • Norethindrone
  • Norgestrel
  • Octreotide
  • Olmesartan
  • Ombitasvir; Paritaprevir; Ritonavir
  • Orlistat
  • Oxandrolone
  • Oxymetholone
  • Pasireotide
  • Pegvisomant
  • Pemoline
  • Penbutolol
  • Pentamidine
  • Pentoxifylline
  • Perindopril
  • Perindopril; Amlodipine
  • Phendimetrazine
  • Phenothiazines
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pindolol
  • Ponatinib
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Prednisolone
  • Prednisone
  • Prilocaine; Epinephrine
  • Progesterone
  • Progestins
  • Propantheline
  • Propoxyphene
  • Propranolol
  • Protease inhibitors
  • Pseudoephedrine
  • Pyrimethamine; Sulfadoxine
  • Quinapril
  • Quinolones
  • Racepinephrine
  • Ramipril
  • Ranolazine
  • Regular Insulin
  • Regular Insulin; Isophane Insulin (NPH)
  • Repaglinide
  • Reserpine
  • Ritodrine
  • Ritonavir
  • Sacubitril; Valsartan
  • Salicylates
  • Saquinavir
  • Segesterone Acetate; Ethinyl Estradiol
  • Sofosbuvir
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Somatropin, rh-GH
  • Sotalol
  • Sparfloxacin
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Sulfonylureas
  • Sympathomimetics
  • Tacrolimus
  • Tafenoquine
  • Tegaserod
  • Telmisartan
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Testolactone
  • Testosterone
  • Thiazide diuretics
  • Thyroid hormones
  • Timolol
  • Tipranavir
  • tobacco
  • Tolazamide
  • Tolbutamide
  • Topiramate
  • Torsemide
  • Trandolapril
  • Trandolapril; Verapamil
  • Triamcinolone
  • Triamterene
  • Trospium
  • Trovafloxacin, Alatrofloxacin
  • Ultralente Insulin
  • Valsartan
  • Vandetanib
  • Zonisamide
You cannot copy content of this page