metformin and sitagliptin (Janumet)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Type 2 Diabetes Warning Signs

Sitagliptin is an oral drug that reduces blood glucose levels in patients with type 2 diabetes. Following a meal, incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are released from the intestine, and their levels increase in the blood. GLP-1 and GIP reduce blood glucose by increasing the production and release of insulin from the pancreas. GLP-1 also reduces blood glucose by reducing the secretion by the pancreas of glucagon, a hormone that increases the production of glucose by the liver and raises the level of glucose in the blood. The net effect of increased release of GLP-1 and GIP is to reduce blood glucose levels. In addition, sitagliptin inhibits the enzyme, dipeptidyl peptidase-4 (DPP-4) that destroys GLP-1 and GIP and thereby increases the levels and activity of both hormones and thereby the release of insulin. As a result, blood glucose levels fall.

PRESCRIBED FOR: Janumet is combined with diet and exercise to improve blood glucose levels in patients with type 2 diabetes. It is not be used for treating type 1 diabetes.

SIDE EFFECTS AND PRECAUTIONS: The most common side effects of Janumet are:

Lactic acidosis is a serious side effect of metformin that occurs in one out of every 30,000 patients and is fatal in 50% of cases. The symptoms of lactic acidosis are weakness, trouble breathing, abnormal heartbeats, unusual muscle pain, stomach discomfort, light-headedness and feeling cold. Patients at risk for lactic acidosis include those with reduced function of the kidneys or liver, congestive heart failure, severe acute illnesses, and dehydration. Janumet should be discontinued immediately if lactic acidosis is suspected.

Medically Reviewed by a Doctor on 12/19/2014

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