- Type 2 Diabetes: Learn the Warning Signs
- Diabetes Friendly Dining
- Type 2 Diabetes: Test Your Medical IQ
- What's the difference between metformin vs. Januvia?
- What is metformin? What is Januvia?
- What are the side effects of metformin and Januvia?
- What is the dosage of metformin vs. Januvia?
- What are the drugs that interact with metformin vs. Januvia?
- Are metformin and Januvia safe to take while pregnant or breastfeeding?
What's the difference between metformin vs. Januvia?
- Metformin and Januvia (sitagliptin) are oral medications that lower blood glucose (sugar) and are used to treat type 2 diabetes.
- Metformin is also used to treat polycystic ovaries and weight gain due to medications used for treating psychoses.
- Brand names of metformin include Glumetza, Glucophage, and Fortamet.
- Side effects of metformin and Januvia that are similar include nausea and diarrhea.
- Side effects of metformin that are different from Januvia include vomiting, gas, bloating, and loss of appetite.
- Side effects of Januvia that are different from metformin include upper respiratory tract infection, headache, and abdominal pain.
What is metformin? What is Januvia?
Metformin is an oral medication that lowers blood glucose (sugar) and is used for treating type 2 diabetes. Metformin increases the sensitivity of liver, muscle, fat, and other tissues to the uptake and effects of insulin, which lowers the sugar levels in the blood. Metformin does not increase the concentration of insulin in the blood and does not cause excessively low blood glucose levels (hypoglycemia) when used alone. Metformin can reduce complications of diabetes such as heart disease, blindness, and kidney disease. Metformin is also used to treat polycystic ovaries and weight gain due to medications used for treating psychoses.
Januvia (sitagliptin) is an oral drug that reduces blood sugar (glucose) levels in patients with type 2 diabetes. Januvia is a DPP-4 inhibitor. Other drugs in this class include saxagliptin (Onglyza) and linagliptin (Tradjenta). Januvia works to reduce blood glucose levels by inhibiting the DPP-4 enzyme and increasing the levels of the hormones GLP-1 and GIP.
What are the side effects of metformin and Januvia?
The most common side effects with metformin are
These symptoms occur in one out of every three patients. These side effects may be severe enough to cause therapy to be discontinued in one out of every 20 patients. These side effects are related to the dose of the medication and may decrease if the dose is reduced.
Metformin may also cause:
- weakness or lack of energy
- respiratory tract infections,
- low levels of vitamin B-12,
- low blood glucose (hyperglycemia)
- indigestion, muscle pain,
- heartburn, and
A serious but rare side effect of metformin is lactic acidosis. Lactic acidosis occurs in one out of every 30,000 patients and is fatal in 50% of cases. The symptoms of lactic acidosis are
- 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
The most common side effects of sitagliptin are:
Other important side effects of sitagliptin include:
There have been reports of fatal and non-fatal pancreatitis following use of sitagliptin. Acute kidney failure and severe hypersensitivity reactions have also been reported during treatment with sitagliptin.
What is the dosage of metformin vs. Januvia?
- For treating type 2 diabetes in adults, metformin (immediate release) usually is begun at a dose of 500 mg twice a day or 850 mg once daily. The dose is gradually increased by 500 mg weekly or 850 mg every two weeks as tolerated and based on the response of the levels of glucose in the blood. The maximum daily dose is 2550 mg given in three divided doses.
- If extended tablets are used, the starting dose is 500 mg or 1000 mg daily with the evening meal. The dose can be increased by 500 mg weekly up to a maximum dose of 2000 mg except for Fortamet (2500 mg of Fortamet, once daily or in two divided doses). Glumetza tablets (500 -1000mg formulations are given once daily (either 1000 to 2000mg). Fortamet and Glumetza are modified release formulations of metformin. Metformin should be taken with meals.
- For pediatric patients 10-16 years of age, the starting dose is 500 mg twice a day. The dose can be increased by 500 mg weekly up to a maximum dose of 2000 mg in divided doses.
- Children older than 17 years of age may receive 500 mg of extended release tablets daily up to a maximum dose of 2000 mg daily. Extended release tablets are not approved for children younger than 17 years of age.
- Metformin-containing drugs may be safely used in patients with mild to moderate renal impairment. Renal function should be assessed before starting treatment and at least yearly.
- Metformin should not be used by patients with an estimated glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m2 and starting metformin in patients with an eGFR between 30-45 mL/minute/1.73 m2 is not recommended.
- Metformin should be stopped at the time of or before administering iodinated contrast in patients with an eGFR between 30 and 60 mL/minute/1.73 m2; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Kidney function should be evaluated 48 hours after receiving contrast and metformin may be restarted if kidney function is stable.
- Sitagliptin may be taken with or without food. The recommended dose is 100 mg once daily. Renal function should be assessed prior to starting sitagliptin and periodically during treatment. The dose of sitagliptin should be modified based on renal function.
What are the drugs that interact with metformin vs. Januvia?
- Cimetidine (Tagamet), by decreasing the elimination of metformin from the body, can increase the amount of metformin in the blood by 40%. This may increase the frequency of side effects from metformin.
- Ioversol (Optiray) and other iodinated contrast media may reduce kidney function, which reduces elimination of metformin, leading to increased concentrations of metformin in the blood. Metformin should be stopped 48 hours before and after use of contrast media.
- Thiazide diuretics, steroids, estrogens, and oral contraceptives may increase blood glucose and reduce the effect of metformin. When these drugs are stopped, patients should be closely observed for signs of low blood glucose.
- Alcohol consumption increases the effect of metformin on lactate production, increasing the risk of lactic acidosis.
- Sitagliptin may slightly increase the concentration of digoxin (Lanoxin) in the body when both drugs are being taken. Digoxin concentrations should be monitored appropriately. The occurrence of low blood glucose increases when sitagliptin is combined with a sulfonylurea (for example, glyburide [Micronase, Diabeta, Glynase, Prestab]) or insulin. The dose of insulin or sulfonylurea should be reduced.
Are metformin and Januvia safe to take while pregnant or breastfeeding?
- There are no adequate studies in pregnant women. Most experts agree that insulin is the best treatment for pregnant women with diabetes.
- Metformin is excreted into breast milk and can, therefore, be transferred to the nursing infant. Nursing mothers should not use metformin.
- There are no adequate studies of sitagliptin in pregnant women.
- It is unknown whether sitagliptin is secreted in human breast milk.
Metformin and Januvia (sitagliptin) are oral medications that lower blood glucose (sugar) and are used to treat type 2 diabetes. Metformin is also used to treat polycystic ovaries and weight gain due to medications used for treating psychoses.
Multimedia: Slideshows, Images & Quizzes
Type 2 Diabetes Diagnosis, Treatment, Medication
Learn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Read how diet and exercise can help manage...
Diabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Discover the best and worst meals for diabetes-savvy dining. See how to avoid carbs and control your blood sugar with healthier...
Type 2 Diabetes: Test Your Medical IQ
What causes type 2 diabetes? Can it be prevented? Take this online quiz and challenge your knowledge of this common condition....
Diabetes Quiz: Test Your Medical IQ
Take the Diabetes Quiz and learn the causes, signs, symptoms, and types of this growing epidemic. What does diabetes have to do...
Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels
Learn to better control your glucose levels by preventing blood sugar swings. Beware of caffeine, sugary foods, spices, exercise,...
Diabetes Diet: 11 Low-Sugar Drink Ideas
Searching for low-sugar drink ideas? This pictures slideshow has eleven beverages ideal for people with diabetes and those...
Diabetes Management Tips and Preventing Complications
Learn 10 simple ways to better manage your diabetes. See tips for controlling blood sugar, diet and exercise and other helpful...
Related Disease Conditions
Diabetes Diet for Type 2 Diabetes, List of Foods
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to...
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are...
Diabetes Treatment (Type 1 and Type 2 Medications and Diet)
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar....
Type 1 vs Type 2 Diabetes (Similarities and Differences)
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million...
Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body....
Second Source article from Government...
Diabetes and Foot Problems (Treatment)
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves,...
Type 2 Diabetes Medications (Side Effects, Differences)
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and...
Diabetes and Kidney Disease
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose...
Diabetes and Eye Problems
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems...
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the...
Diabetes - Safe Drugs for Colds and the Flu
If you have diabetes and catch a cold or the flu, can be more difficult to recover from infections and their complications, for...
Treatment & Diagnosis
- Diabetes: Your Treatment Options
- Diabetes: Maintaining Control with Nutrition
- Diabetes Alert Day
- Diabetes: Scientific Research for Type I Diabetes
- Diabetes: The Doctor is In: Discussing Diabetes -- Brunilda Nazario, MD -- 03/18/03
- Diabetes: Your Guide to Life With Diabetes
- Diabetes and Diet: What Do I Eat?
- Diabetes FAQs
- Type 2 Diabetes FAQs
- Diabetes Type I...Insulin Therapy
- Exercise Therapy in Type 2 Diabetes - Part 1
- Exercise Therapy in Diabetes - Part 2
- Can You Get Diabetes from Stress?
- Can oral diabetes medications cause impotence?
- Can You Have Type 1 Diabetes Without Symptoms?
- 6 Frequently Asked Diabetes Question
- Can Diabetes Cause Muscle Pain?
- 11 Diabetes Diet Tips for the Holidays
- Diabetes: Eating Well with Type 2 Diabetes
- Diabetes: What Can I Eat?
Medications & Supplements
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
FDA Prescribing Information