Janumet 50/1000mg Tablet 15'S

Introduction About JANUMET 50/1GM TABLET

Janumet 50/1000mg Tablet is a prescription medicine used to manage type 2 diabetes. It combines Sitagliptin and Metformin to help control high blood sugar levels, especially when diet and exercise alone are not enough.

Janumet 50/1000mg tablet may be prescribed on its own or in combination with other diabetes medications. It is most effective when paired with a healthy diet and regular physical activity. Your prescribed dose will depend on your condition, blood sugar levels, and any other medications you are using. Taking it with meals can help minimize the risk of an upset stomach.

To get the maximum benefit, take the medication consistently at the same time each day, and only stop if your doctor advises it. Following the diet and exercise plan prescribed by your doctor is crucial while using this medication, as your lifestyle plays a significant role in managing diabetes.

Common side effect of this medication includes nausea, upset stomach, headache, dizziness, upper respiratory tract infection, vomiting and diarrhea. Hypoglycemia, or low blood sugar, can be a potential side effect if you are also taking other diabetes medications such as insulin or sulfonylureas. Therefore, it is important to understand how to identify and manage it.

This medication may not be appropriate for everyone. Before taking it, inform your doctor if you have a history of kidney, liver, or heart disease, any issues with your pancreas, or if you consume alcohol frequently. Pregnant or breastfeeding women should also consult with their doctor before taking this medicine. Additionally, certain other medications may interact with Janumet 50/1000mg tablet, so make sure to tell your doctor about all other medications you are currently taking. It is advisable to avoid alcohol, as it can lower blood glucose levels. Your doctor will monitor your kidney function and blood sugar levels before and during management.

Uses Of JANUMET 50/1GM TABLET

• Type 2 diabetes mellitus

Benefits of JANUMET 50/1GM TABLET

1. Helps lower blood sugar levels in type 2 diabetes: Janumet effectively lowers blood sugar levels, which is crucial in managing type 2 diabetes.
2. Combines two effective ingredients: Sitagliptin and Metformin: The medication contains two active ingredients: Sitagliptin and Metformin. Sitagliptin works by increasing insulin production and lowering glucose production in the liver, while Metformin helps the body use insulin more efficiently and reduces glucose production in the liver.
3. Reduces the risk of diabetes-related complications: By controlling blood sugar, Janumet helps reduce the long-term risks of diabetes-related complications like heart disease, kidney problems, and nerve damage.
4. Supports better blood sugar control when combined with lifestyle changes: When used alongside dietary adjustments, exercise, and other lifestyle changes, Janumet provides better overall blood sugar control.
5. Convenient dual-action oral medication: Instead of taking multiple medications, Janumet offers the convenience of a single pill that combines both Sitagliptin and Metformin, making it easier for patients to manage their diabetes.

How JANUMET 50/1GM TABLET Works

Janumet 50/1000mg tablet is a combination medication used to manage type 2 diabetes. It contains two active ingredients: sitagliptin (50mg) and metformin (1000mg). Sitagliptin works by inhibiting the enzyme DPP-4, which increases the levels of incretin hormones, leading to improved insulin secretion and reduced glucose production in the liver. Metformin helps lower blood sugar by reducing the amount of glucose produced by the liver and improving insulin sensitivity in the body’s cells. Together, these actions help control blood sugar levels, especially after meals, and reduce the risk of complications associated with diabetes.

How to use JANUMET 50/1GM TABLET

Follow your doctor's instructions regarding the exact dosage. Do not exceed the recommended daily dosage.

How to Take Janumet 50/1000mg Tablet?

• Take one tablet daily with meal to reduce the chance of gastrointestinal side effects
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication.
• For best results, take the tablet at the same time each day.

What if I forgot to take JANUMET 50/1GM TABLET

• If you forget to take your dose, take it as soon as you remember.
• Do not take two doses to make up for a missed dose. This could increase your risk of side effects.
• If it is almost time for your next dose, skip the missed dose and take your regular dose at the usual time.

Side Effects Of JANUMET 50/1GM TABLET

Like all medicines, Janumet 50/1000mg tablet may cause certain side effects in some individuals, although not everybody gets them.

The most common side effects of taking Janumet 50/1000mg tablet are:

• nausea
• upset stomach
• headache
• dizziness
• upper respiratory tract infection
• vomiting
• diarrhea

When to consult your doctor?

• Lactic Acidosis symptoms such as weakness or tiredness, unusual muscle pain or discomfort, difficulty breathing, cold feeling, dizziness, lightheadedness, or fainting, slow or irregular heartbeat
• Severe Allergic Reactions symptoms such as rash, itching, or swelling (especially of the face/tongue/throat), severe dizziness or trouble breathing
• Pancreatitis symptoms such as severe stomach/abdominal pain (especially upper abdomen), nausea/vomiting
• Kidney Problems symptoms such as swelling in the ankles/feet, unusual tiredness, changes in urine output
• Hypoglycemia symptoms such as sweating, shaking, confusion, dizziness, or fast heart rate 

How To Manage Side Effects

Diarrhea

• Drink Fluids: Drink clear fluids such as water, broths, and oral rehydration solutions (ORS).
• Electrolytes: If you are losing a lot of fluids (for example, from frequent diarrhea), consider drinking an electrolyte solution to help replenish lost minerals like potassium and sodium.
• BRAT Diet: Try to take Bananas, Rice (white rice), Apple sauce and Toast (plain, without butter) to control diarrhoea management.
• Avoid Certain Foods: While recovering avoid the following food items such as fatty, greasy, or fried foods, spicy foods, dairy products (especially if you have a temporary lactose intolerance), caffeinated drinks and alcohol and artificial sweeteners like sorbitol.
• Over-the-Counter Medications: You can take over-the-counter anti-diarrheal medications such as loperamide, Bismuth subsalicylate if appropriate for you. Follow the recommended dosage.

Dizziness Or Drowsiness

• Sit or Lie Down: If you feel dizzy, sit down, or lie down immediately to prevent falling. Keep your head still and close your eyes if needed.
• Hydrate: Dehydration can cause dizziness, so drink water or electrolyte-replenishing drinks like sports drinks.
• Avoid Sudden Movements: When standing or sitting, do so slowly to avoid triggering dizziness. Take your time when getting up.
• Eat Small, Regular Meals: Low blood sugar can cause dizziness, so eat small meals throughout the day and avoid skipping meals.
• Fresh Air: Sometimes dizziness can be alleviated by taking slow, deep breaths in a well-ventilated area.

Nausea And Vomiting

• Eat Small, Frequent Meals: Avoid heavy or greasy foods. Opt for bland foods like crackers, toast, or bananas.
• Stay Hydrated: Sip on clear fluids like water, ginger tea, or electrolyte drinks, Avoid caffeinated and carbonated beverages.
• Ginger: Ginger is a natural remedy for nausea. Try ginger tea, ginger candies, or ginger ale (ensure it contains real ginger).
• Avoid Strong Odors: Minimize exposure to smells that might trigger nausea, such as perfumes or cooking odors.

Warning & Precautions

Pregnancy

Contraindicated

Janumet 50/1000mg Tablet is not recommended for use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. It is important to consult your doctor before taking this medication.

Breastfeeding

Contraindicated

Janumet 50/1000mg Tablet is not recommended for use during breastfeeding. Data suggests that the drug may cause toxicity to the baby. It is important to consult your doctor before taking this medication.

Driving and Using Machines

Use with Caution

Do not drive or operate machines if you experience dizziness after taking it.

Alcohol

Consult your doctor

Alcohol can raise the risk of lactic acidosis and hypoglycemia, so it is recommended to avoid alcohol consumption while taking Janumet 50/1000mg Tablet.

Kidney

Contraindicated

Janumet 50/1000mg Tablet is not recommended for use in patients with severely reduced kidney functions. Please consult your doctor before taking it.

Liver

Consult your doctor

Janumet 50/1000mg Tablet is not recommended for use in patients with severe liver problems and should be used with caution in patients with gallstones. Please consult your doctor before taking it.

Allergy

Contraindicated

Do not take this medication if you are allergic to Metformin or Sitagliptin or any other ingredients of this medicine.

Heart Disease

Contraindicated

Janumet 50/1000mg Tablet is not recommended for use in patients with severe heart problems (such as acute heart failure or a recent heart attack).  Please consult your doctor before taking it.

Use In Pediatrics

Contraindicated

Janumet 50/1000mg Tablet is not recommended for use in children and adolescents (under 18 years of age). Consult your pediatrician before giving it.

Use In Geriatrics

Use with Caution

Janumet 50/1000mg Tablet should be used with caution in elderly patients (aged 65 years or above). Please consult your doctor before taking it.

Other Warnings for JANUMET 50/1GM TABLET

Before taking Janumet 50/1000mg Tablet inform your doctor if you:

• have or ever had pancreatitis (inflammation of the pancreas)
• have high blood lipid levels
• have type I diabetes mellitus (insulin-dependent diabetes)
• are about to have a major surgery
• are fasting
• are malnourished, starved, on an irregular diet, or feeling weak
• perform extreme muscle exercises
• have a vitamin B12 deficiency

Who should not take [GBNKEYWORD

Janumet 50/1000mg Tablet is not recommended for use, if you have:

• have severe, uncontrollable diabetes
• have nausea, vomiting, diarrhea, or rapid weight loss
• have lactic acidosis or ketoacidosis (a buildup of lactic acid or ketones in the body)
• are dehydrated
• have any severe systemic infection
• have shock or problems in blood circulation
• are scheduled for any X-rays in the upcoming days

Safety Advice

• Follow your doctor's instructions regarding the exact dosage.
• Do not exceed the recommended daily dosage.
• Take one tablet daily with meal to reduce the chance of stomach upset.
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication.
• For best results, take the tablet at the same time each day.
• Follow the prescribed diet and exercise plan along with taking this medication for best results.
• Monitor your blood sugar levels regularly while taking this medicine.
• Alcohol can raise the risk of lactic acidosis and hypoglycemia, so it is recommended to limit or avoid alcohol consumption while taking Janumet 50/1000mg tablet.
• Let your doctor know if you have kidney problems or liver problems.
• Let your doctor know If you are pregnant or planning to become pregnant or breastfeeding women.
• Do not suddenly stop taking the medication without consulting your doctor, as this can lead to uncontrolled blood sugar levels.
• Store Janumet 50/1000mg tablet at room temperature, away from moisture and heat, in a dry place, and out of reach of children.
• Make sure to keep regular follow-up appointments with your doctor to track your progress and adjust your medication as needed.
• If you are planning to have surgery or a medical procedure that requires the use of contrast dye, be sure to inform your doctor. You might need to temporarily stop taking Janumet prior to the procedure.

Diet and Lifestyle Advice

Dietary Recommendations:

Exercise Guidelines

Drug - Drug interaction

Inform your physician if you are taking any of the following medicine before taking Janumet 50/1000mg Tablet:

1. Insulin and Other Oral Hypoglycemics

• Interaction: Combining Janumet with insulin or other oral hypoglycemics (such as sulfonylureas) may increase the risk of hypoglycemia (low blood sugar). This occurs due to enhanced insulin secretion and glucose uptake.
• Effect: The risk of severe hypoglycemia is increased, leading to symptoms such as dizziness, sweating, confusion, shakiness, and, in severe cases, loss of consciousness or coma.
• Management:
  • Close monitoring of blood glucose levels is essential.
  • Adjustments to the doses of insulin or other oral hypoglycemics may be required, especially during physical activity or fasting.
  • Educate patients to recognize the early signs of hypoglycemia and teach them how to treat it (e.g., consuming quick-acting carbohydrates such as glucose tablets).

2. Alcohol

• Interaction: Alcohol may enhance the blood sugar-lowering effects of metformin, increasing the risk of lactic acidosis (a rare but serious side effect). Alcohol can also cause unpredictable changes in blood glucose levels.
• Effect: Lactic acidosis is a potentially life-threatening condition characterized by symptoms such as muscle pain, weakness, difficulty breathing, dizziness, and cold skin.
• Management:
  • Advise patients to limit alcohol intake while taking Janumet.
  • Instruct patients on recognizing symptoms of lactic acidosis and seek immediate medical attention if symptoms occur.
  • Periodic kidney function tests should be performed to monitor for lactic acidosis, especially in patients who consume alcohol heavily.

3. Cimetidine (and Other H2 Receptor Antagonists)

• Interaction: Cimetidine (a medication used for heartburn and ulcers) may increase the plasma concentration of metformin, potentially increasing the risk of side effects such as gastrointestinal disturbances or lactic acidosis.
• Effect: Elevated metformin levels can increase the risk of side effects like nausea, vomiting, abdominal discomfort, and in rare cases, lactic acidosis.
• Management:
  • Avoid using cimetidine with Janumet if possible.
  • If co-administration is necessary, consider dose adjustments for metformin and monitor renal function closely.

4. Drugs That Affect Kidney Function (e.g., Diuretics, ACE Inhibitors)

• Interaction: Medications that impair kidney function (such as diuretics and ACE inhibitors) may increase the concentration of metformin in the blood, raising the risk of lactic acidosis.
• Effect: Decreased renal clearance of metformin can increase its plasma concentration, leading to side effects such as lactic acidosis.
• Management:
  • Monitor renal function regularly when combining Janumet with drugs that affect kidney function.
  • Adjust the dosage of Janumet based on renal function and avoid the combination in patients with severe renal impairment (e.g., eGFR < 30 mL/min/1.73 m²).
  • Ensure hydration and proper electrolyte balance in patients taking diuretics or ACE inhibitors.

5. Corticosteroids

• Interaction: Corticosteroids (e.g., prednisone) may reduce the effectiveness of Janumet in lowering blood glucose, as they can induce hyperglycemia (elevated blood sugar levels).
• Effect: Increased blood glucose levels, potentially leading to difficulty in managing diabetes.
• Management:
  • Blood glucose should be monitored more frequently when corticosteroids are started or discontinued.
  • Temporary adjustments in the dose of Janumet or additional blood glucose-lowering medications may be necessary.
  • Counsel patients on maintaining a healthy diet and exercise routine during corticosteroid therapy.

6. Medications That Can Increase the Risk of Lactic Acidosis (e.g., Contrast Agents, Carbonic Anhydrase Inhibitors)

• Interaction: Certain medications, such as iodinated contrast agents used in imaging studies and carbonic anhydrase inhibitors (e.g., acetazolamide), can increase the risk of lactic acidosis in patients taking metformin.
• Effect: The use of these medications alongside Janumet may reduce renal function, increasing the risk of lactic acidosis.
• Management:
  • Temporarily discontinue Janumet before or at the time of imaging studies that require the use of iodinated contrast agents.
  • Ensure normal renal function before resuming Janumet after the procedure.
  • Monitor for signs of lactic acidosis and adjust treatment accordingly.

7. Beta-Blockers

• Interaction: Beta-blockers (e.g., atenolol, metoprolol) can mask the symptoms of hypoglycemia, such as tachycardia (rapid heartbeat), making it harder for patients to recognize low blood sugar.
• Effect: Beta-blockers may also enhance the blood sugar-lowering effects of metformin, leading to an increased risk of hypoglycemia, especially in combination with other glucose-lowering agents.
• Management:
  • Monitor blood glucose levels regularly.
  • Patients should be educated about the possibility of masked hypoglycemia symptoms.
  • Consider using a non-selective beta-blocker or other classes of antihypertensives if managing hypertension in diabetic patients.

8. Thiazolidinediones (TZDs)

• Interaction: Combining Janumet with thiazolidinediones (e.g., pioglitazone) may increase the risk of fluid retention, heart failure, and weight gain, as both drugs can cause fluid retention.
• Effect: Edema, weight gain, and in severe cases, exacerbation of heart failure.
• Management:
  • Close monitoring of weight and symptoms of fluid retention, such as swelling of the ankles or shortness of breath.
  • Adjust doses and discontinue either medication if signs of heart failure develop.

9. Diuretics (Loop or Thiazide)

• Interaction: Diuretics (such as furosemide or hydrochlorothiazide) can increase blood glucose levels and impair the action of Janumet in controlling blood sugar.
• Effect: Elevated blood glucose levels may lead to difficulty managing diabetes, and in some cases, hyperglycemia.
• Management:
  • Monitor blood glucose levels more frequently.
  • Adjust the dosage of Janumet as needed, especially when starting or stopping diuretics.
  • Encourage patients to follow a healthy diet and exercise plan.

Synopsis

More Information

1.Product Comparison

a) Janumet vs Glucophage, why janumet is considered a standout management for type 2 diabetes?

Why Janumet Stands Out:

• Dual Action: It combines metformin and sitagliptin, offering dual mechanisms of action that can provide more comprehensive blood sugar control compared to metformin alone.
• Convenience: For patients who need both drugs, Janumet simplifies therapy into one pill, reducing the need for multiple medications.
• Suitable for Certain Patients: It is specifically beneficial for individuals who are not adequately controlled on metformin alone and require the additional benefit of a DPP-4 inhibitor like sitagliptin.

FAQs About JANUMET 50/1GM TABLET

References

1. KD. Tripathi. Insulin, Oral Hypoglycaemic Drugs and Glucagon. Essentials of medical pharmacology. Seventh edition. 2013. Page-274 & 275.

2. Erin L. St. Onge, Shannon Miller and Elizabeth Clements. Sitagliptin/Metformin (Janumet) as Combination Therapy in the Treatment of Type-2 Diabetes Mellitus. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. December 2012. [Accessed on 24th April 2025] 

3. Chitrabhanu Ballav and Stephen C.L. Gough. Safety and Efficacy of Sitagliptin-Metformin in Fixed Combination for the Treatment of Type 2 Diabetes Mellitus. Libertas Academica. 2013. [Accessed on 24th April 2025] 

4. Merck Sharp & Dohme (UK) Limited. Electronic Medicines Compendium (EMC) [Revised in February 2022] [Accessed on 24th April 2025] 

5. Merck & Co., Inc. JANUMET® (sitagliptin and metformin hydrochloride) tablets, for oral use. [Revised in July 2022] [Accessed on 24th April 2025] 

6. Milpharm Limited. Electronic Medicines Compendium (EMC). [Revised in June 2020] [Accessed on 24th April 2025] 

7. Rx Farma Limited. Electronic Medicines Compendium (EMC). [Revised in September 2019] [Accessed on 24th April 2025] 

8. Organon Pharma (UK) Limited. Electronic Medicines Compendium (EMC). [Revised in November 2021] [Accessed on 24th April 2025] 

User Feedback

Useful Diagnostic Tests

• Random Blood Sugar (RBS)
• Fasting Blood Sugar (FBS)
• Post Prandial Blood Sugar (PPBS)
• Sugar Risk Package
• HbA1C, Also known as Glycated Hemoglobin, Glycosylated Hemoglobin

Author Details

Written By Dr. Karthikeyan Rajagopal - M.Pharm (Pharmacology)

Reviewed For Accuracy By Dr. Jaya Prabakaran - MBBS, MD (Diabetology and Family Medicine)

Last updated on 24 Apr 2025 | 05:03 PM(IST)