Janumet (Sitagliptin Metformin HCL) Drug Information: Description, User Reviews, Drug Side Effects, Interactions

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February 9, 2012

Janumet

Diabetes Prevention »

Introduction to diabetes prevention

I'm pretty lucky in my office practice. I have friendly patients who are usually already fairly well informed about their disease. They are also generally willing to have discussions about therapies and options.

What I have noticed (much to my delight) is that there are a growing number of patients coming to me for evaluation BEFORE they actually have developed diabetes, wanting to know how to prevent it. Most of them have seen family members with diabetes go through the process of diagnosis and management. As our attitude towards disease changes, and we learn to focus on prevention, I have more and more to discuss with these patients. Ultimately, I hope to see a paradigm shift where our focus is primarily on prevention of chronic diseases such as diabetes. For now, I hope this review provides some information to those of you wanting to make healthy lifestyle changes, and that it encourages you to open up a...

Read the Diabetes Prevention article »

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JANUMET®
(sitagliptin/metformin HCl) tablets

WARNING

LACTIC ACIDOSIS

Lactic acidosis is a rare, but serious complication that can occur due to metformin accumulation. The risk increases with conditions such as sepsis, dehydration, excess alcohol intake, hepatic insufficiency, renal impairment, and acute congestive heart failure.

The onset is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, increasing somnolence, and nonspecific abdominal distress.

Laboratory abnormalities include low pH, increased anion gap and elevated blood lactate.

If acidosis is suspected, JANUMET should be discontinued and the patient hospitalized immediately. [See WARNINGS AND PRECAUTIONS.]

DRUG DESCRIPTION

JANUMET (sitagliptin/metformin HCl) tablets contain two oral antihyperglycemic drugs used in the management of type 2 diabetes: sitagliptin and metformin hydrochloride.

Sitagliptin

Sitagliptin is an orally-active inhibitor of the dipeptidyl peptidase-4 (DPP-4) enzyme. Sitagliptin is present in JANUMET tablets in the form of sitagliptin phosphate monohydrate. Sitagliptin phosphate monohydrate is described chemically as 7-[(3R)-3-amino-1-oxo-4-(2,4,5-trifluorophenyl)butyl]-5,6,7,8-tetrahydro-3-(trifluoromethyl)-1,2,4-triazolo[4,3-a]pyrazine phosphate (1:1) monohydrate with an empirical formula of C₁₆H₁₅F₆N₅O•H₃PO₄•H₂O and a molecular weight of 523.32. The structural formula is:

Sitagliptin phosphate monohydrate is a white to off-white, crystalline, non-hygroscopic powder. It is soluble in water and N,N-dimethyl formamide; slightly soluble in methanol; very slightly soluble in ethanol, acetone, and acetonitrile; and insoluble in isopropanol and isopropyl acetate.

Metformin hydrochloride

Metformin hydrochloride (N,N-dimethylimidodicarbonimidic diamide hydrochloride) is not chemically or pharmacologically related to any other classes of oral antihyperglycemic agents. Metformin hydrochloride is a white to off-white crystalline compound with a molecular formula of C₄H₁₁N•HCl and a molecular weight of 165.63. Metformin hydrochloride is freely soluble in water and is practically insoluble in acetone, ether, and chloroform. The pKa of metformin is 12.4. The pH of a 1% aqueous solution of metformin hydrochloride is 6.68. The structural formula is as shown:

Metformin HCl Structural Formula Illustration

JANUMET

JANUMET is available for oral administration as tablets containing 64.25 mg sitagliptin phosphate monohydrate and metformin hydrochloride equivalent to: 50 mg sitagliptin as free base and 500 mg metformin hydrochloride (JANUMET 50 mg/500 mg) or 1000 mg metformin hydrochloride (JANUMET 50 mg/1000 mg). Each film-coated tablet of JANUMET contains the following inactive ingredients: microcrystalline cellulose, polyvinylpyrrolidone, sodium lauryl sulfate, and sodium stearyl fumarate. In addition, the film coating contains the following inactive ingredients: polyvinyl alcohol, polyethylene glycol, talc, titanium dioxide, red iron oxide, and black iron oxide.

What are the possible side effects of metformin and sitagliptin (Janumet)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

pancreatitis - severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, fast heart rate;
feeling short of breath, even with mild exertion;
swelling or rapid weight gain;
fever, chills, body aches, flu symptoms;...

Read All Potential Side Effects and See Pictures of Janumet »