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In this Article

• What is metformin and sitagliptin (Janumet)?
• What are the possible side effects of metformin and sitagliptin (Janumet)?
• What is the most important information I should know about metformin and sitagliptin (Janumet)?
• What should I discuss with my health care provider before taking metformin and sitagliptin (Janumet)?
• How should I take metformin and sitagliptin (Janumet)?
• What happens if I miss a dose (Janumet)?
• What happens if I overdose (Janumet)?
• What should I avoid while taking metformin and sitagliptin (Janumet)?
• What other drugs will affect metformin and sitagliptin (Janumet)?
• Where can I get more information?

What should I discuss with my health care provider before taking metformin and sitagliptin (Janumet)?

Some people have developed a life-threatening condition called lactic acidosis while taking metformin. Get emergency medical help if you have any of these symptoms of lactic acidosis: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired.

You may be more likely to develop lactic acidosis if you have liver disease, kidney disease, congestive heart failure, a stroke or heart attack, a serious infection, if you are dehydrated, or if you drink large amounts of alcohol. Talk with your doctor about your individual risk.

Do not use this medication if you are allergic to metformin (Actoplus Met, Avandamet, Fortamet, Glucophage, Riomet) or sitagliptin (Januvia), if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

If you need to have any type of x-ray or CT scan using a dye that is injected into a vein, you will need to temporarily stop taking metformin and sitagliptin. Be sure the doctor knows ahead of time that you are using this medication.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take metformin and sitagliptin:

• liver disease;
• kidney disease;
• a history of pancreatitis;
• a history of heart disease; or
• if you are over 80 years old and have not recently had your kidney function checked.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Your name may need to be listed on a Janumet pregnancy registry if you become pregnant while you are taking this medication. The purpose of this registry is to track the outcome of the pregnancy and delivery to evaluate whether metformin and sitagliptin had any effect on the baby.

It is not known whether metformin and sitagliptin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Metformin and sitagliptin should not be given to a child younger than 18 years old without a doctor's advice.

How should I take metformin and sitagliptin (Janumet)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Metformin and sitagliptin is usually taken twice daily with meals. Follow your doctor's instructions.

Metformin and sitagliptin is only part of a complete program of treatment that also includes diet, exercise, weight control, and possibly other medications. It is important to use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your kidney function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.

Your medication needs may change if you become sick or injured, if you have a serious infection, or if you have any type of surgery. Your doctor may want you to stop taking metformin and sitagliptin for a short time if any of these situations affect you.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them:

• hunger, headache, confusion, irritability;
• drowsiness, weakness, dizziness, tremors;
• sweating, fast heartbeat;
• seizure (convulsions); or
• fainting, coma (severe hypoglycemia can be fatal).

Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

Your doctor may have you take extra vitamin B12 while you are taking metformin and sitagliptin. Take only the amount of vitamin B12 that your doctor has prescribed.

Store metformin and sitagliptin at room temperature away from moisture, heat, and light.