Janumet (Sitagliptin/Metformin)

Name: Janumet
Brand: Merck
SKU: 6632
Availability: InStock

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Janumet Tablet

Manufacturer: Merck

Country: Canada

Dosage: 50 mg/1000 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: Merck

Country: Canada

Dosage: 50 mg/500 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: MSD

Country: Canada

Dosage: 50 mg/850 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: MSD

Country: Turkey

Dosage: 50 mg/1000 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: MSD

Country: Turkey

Dosage: 50 mg/500 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: MSD

Country: Australia

Dosage: 50 mg/1000 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: MSD

Country: Australia

Dosage: 50 mg/500 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: MSD

Country: Australia

Dosage: 50 mg/850 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet

Manufacturer: MSD

Country: Turkey

Dosage: 50 mg/850 mg

Qty-Price (USD):

Type:

Product: Janumet Tablet (ON BACKORDER)

Manufacturer: MSD

Country: India

Dosage: 50 mg/1000 mg

Qty-Price (USD):

Generic Equivalent of Janumet

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Sitagliptin/Metformin Tablet

Manufacturer: Generic

Country: Canada

Dosage: 50 mg/1000 mg

Qty-Price (USD):

Type:

Product: Sitagliptin/Metformin Tablet

Manufacturer: Generic

Country: Canada

Dosage: 50 mg/500 mg

Qty-Price (USD):

Type:

Product: Sitagliptin/Metformin Tablet

Manufacturer: Generic

Country: Canada

Dosage: 50 mg/850 mg

Qty-Price (USD):

Type:

Product: Sitagliptin/Metformin Tablet

Manufacturer: Generic

Country: India

Dosage: 50 mg/500 mg

Qty-Price (USD):

Type:

Product: Sitagliptin/Metformin Tablet (Istamet-Sun Pharma)

Manufacturer: Generic

Country: India

Dosage: 50 mg/1000 mg

Qty-Price (USD):

Janumet Information

medically reviewed by Dr. HaVy Ngo, Pharmacist on April 30, 2025.

Janumet and Sitagliptin/Metformin at CanadaPharmacyOnline.com

Brand Janumet is manufactured by Merck, also known as Merck Sharp & Dohme (MSD) in regions such as Canada, Turkey, India, and Australia.

Generic sitagliptin/metformin is sourced from manufacturers meeting applicable local regulatory standards. The specific manufacturer of dispensed medication may vary.

Important Information about Generic Sitagliptin/Metformin:

Generic sitagliptin/metformin contains the same active ingredient as brand-name Janumet and is required to meet the same safety, effectiveness, and quality standards. This means it is designed to work in the same way as Janumet. Studies have demonstrated bioequivalence between generic and brand-name sitagliptin/metformin, meaning they have comparable absorption rates and overall effects. However, individual responses to any medication can vary. Talk to your doctor or pharmacist, if you have any questions about using generic sitagliptin/metformin.

For more information about generic drug approval and bioequivalence, you can visit the FDA website: https://www.fda.gov/drugs/buying-using-medicine-safely/generic-drugs

Dosage:

Brand Janumet and generic sitagliptin/metformin are commonly available in 50 mg/500 mg, 50 mg/850 mg, and 50 mg/1000 mg oral tablets (at this pharmacy).

Your doctor will determine the appropriate dose based on your individual needs and medical conditions.

Usage:

Janumet (sitagliptin/metformin) is a prescription medication used to help lower blood sugar levels in adults with type 2 diabetes. It is used with diet and exercise to improve blood sugar control throughout the day in patients who are treated with both sitagliptin and metformin as separate medications or whose blood sugar is not adequately controlled on metformin alone. It may be used alone or with other diabetes medications like sulfonylureas, insulin, or pioglitazone. (source: the product labeling information)

Janumet is not for people with type 1 diabetes. (source: Merck’s official Janumet website)

Mechanism of Action:
Sitagliptin is an oral dipeptidyl peptidase-4 (DPP-4) inhibitor. It works by preventing the breakdown of incretin hormones (GLP-1 and GIP), which increases insulin release (when blood sugar is high) and decreases glucagon secretion. This helps lower both post-meal and fasting blood glucose with a lower risk of hypoglycemia.

Metformin is a biguanide. Its main actions are reducing glucose production by the liver and increasing the body's sensitivity to insulin. It may also slightly decrease glucose absorption in the gut. Metformin typically doesn't cause low blood sugar and can be weight-neutral or cause slight weight loss. Janumet lowers blood glucose levels through these complementary mechanisms: sitagliptin enhances the effects of incretins, while metformin reduces liver glucose production and improves insulin sensitivity. This combined action provides a more effective way to manage type 2 diabetes when diet and exercise alone are not enough.

Take Janumet exactly as your doctor prescribes, following the instructions in the patient information leaflet accompanying the medication. Consult your doctor for personalized guidance and safe use.

The information below summarizes some, but not all, potential side effects, risks, and interactions. Before taking Janumet, it is essential to discuss all possible side effects, risks, and interactions with your doctor or pharmacist.

Side Effects:

The information below outlines potential side effects associated with Janumet (sitagliptin/metformin). It is not an exhaustive list, and individual reactions can vary. This information is for educational purposes and should not replace professional medical advice. Before starting Janumet, it is crucial to discuss possible side effects and risks with your doctor or pharmacist.

Common side effects - These are some common side effects of Janumet, but others are possible. Contact your doctor promptly if any side effects are persistent, worsening, or concerning or if you experience any other concerning symptoms.

The frequency of these side effects is based on data from clinical trials as reported on the Official Website for Janumet, https://www.janumetxr.com/.

Very Common (affecting more than 1 in 10 people):
• Abdominal pain (gastrointestinal side effects, including abdominal pain, may be very common, particularly when starting treatment);
• Diarrhea
• Loss of appetite
• Nausea
• Vomiting

Common (affecting between 1 in 10 and 1 in 100 people):
• Flatulence (gas)
• Headache
• Hypoglycemia (low blood sugar) (the risk is higher when Janumet is used in combination with other medications that can lower blood sugar, such as sulfonylureas or insulin. It is less frequent when Janumet is used alone, but it can still occur. Monitor blood glucose levels regularly and be aware of the symptoms of hypoglycemia);
• Indigestion
• Mild to moderate Joint pain
• Metallic taste
• Runny or stuffy nose
• Sore throat
• Stomach upset
• Upper respiratory tract infection (like a cold)
• Weakness

Less Common (affecting between 1 in 100 and 1 in 1,000 people):
• Constipation
• Dizziness
• Dry mouth
• Sleepiness

Serious or rare side effects- Seek immediate medical attention or call emergency services if you experience any of the following:
• Allergic reactions including rash, itching, hives, swelling of the face, lips, tongue, or throat, difficulty breathing;
• Bullous pemphigoid (a rare skin condition with blisters);
• Heart failure (symptoms may include increasing shortness of breath, swelling in the feet, ankles, or legs, and rapid weight gain);
• Kidney problems (including kidney failure, sometimes requiring dialysis);
• Lactic acidosis - a rare but serious condition due to metformin buildup (lactic acidosis is a medical emergency requiring immediate discontinuation of the drug and medical intervention);
• Low vitamin B12 levels (long-term use of metformin can decrease vitamin B12 absorption, leading to anemia and neurological issues. Your doctor may need to monitor your B12 levels);
• Pancreatitis (inflammation of the pancreas, can be severe and cause severe abdominal pain, nausea, and vomiting);
• Severe hypoglycemia (low blood sugar - particularly if severe or accompanied by loss of consciousness, seizures, or inability to treat effectively. More likely when Janumet is combined with other medications that can lower blood sugar, such as sulfonylureas or insulin);
• Severe joint pain (a serious but rare side effect linked to sitagliptin that may occur in some individuals taking Janumet, as sitagliptin belongs to a class of medications called DPP-4 inhibitors)

Contraindications:

The following is not an exhaustive list of contraindications. Before starting Janumet, it is crucial to discuss all your medical conditions, past and present, and all medications you are taking with your doctor or pharmacist.

Janumet should not be used if:
• You are allergic to sitagliptin, metformin, or any of the inactive ingredients in Janumet.
• You have severe renal impairment (eGFR below 30 mL/min/1.73 m²). Janumet is contraindicated in this population. For patients with an eGFR between 30 and less than 45 mL/min/1.73 m², Janumet is generally not recommended or may require significant dosage adjustments based on your doctor's assessment;
• You have acute or chronic metabolic acidosis, including diabetic ketoacidosis.
• You have diabetic ketoacidosis (Janumet should not be used for the treatment of this condition).
• You have conditions that cause tissue hypoxia (e.g., severe heart or respiratory failure, recent myocardial infarction, shock)

Tell your doctor about all of your medical conditions, past and present, before starting Janumet. This is crucial because certain conditions can affect whether Janumet is right for you. These conditions may include, but are not limited to:
• Dehydration (dehydration increases the risk of metformin-associated lactic acidosis);
• Heart problems (especially severe heart failure (due to risk of tissue hypoxia);
• History of pancreatitis (other risk factors for pancreatitis should be discussed with your doctor, as sitagliptin has been associated with pancreatitis);
• Heavy alcohol use (increases the risk of lactic acidosis associated with metformin and can impact liver function);
• Kidney problems (past or present, crucial for dosage adjustments and contraindications based on eGFR);
• Liver problems (can impair lactate clearance, increasing lactic acidosis risk with metformin);
• Lung problems (severe lung disease can lead to tissue hypoxia, increasing lactic acidosis risk);
• Metabolic acidosis (past or present), including diabetic ketoacidosis (current metabolic acidosis is a contraindication; past history is important to discuss);
• Pancreatitis (past) (history increases the risk of recurrence with sitagliptin.
• Serious infections (can lead to dehydration and tissue hypoxia, increasing lactic acidosis risk);
• Scheduled surgery or medical procedures (especially those involving restricted oral intake or iodinated contrast, which can affect kidney function);
• Vitamin B12 deficiency or risk factors (metformin can interfere with vitamin B12 absorption)

Drug Interactions:

Before taking Janumet, it is essential to discuss all potential risks and interactions with your doctor or pharmacist. For complete and up-to-date information, refer to the product monograph in Canada: https://pdf.hres.ca/dpd_pm/00038451.PDF

Provide your doctor with a completelist of all your medications, including prescriptions, over-the-counter (OTC) drugs, vitamins, and herbal supplements. It is also important to inform your doctor about any herbal teas, recreational drugs, or significant dietary changes you are making, as these could potentially interact with Janumet. Janumet may interact with other medicines but is not limited to:

• Drugs that may increase the risk of hypoglycemia when taken with Janumet (e.g., glipizide, glyburide, rapid-acting insulin analogs);
• Drugs that may increase the risk of Hyperglycemia when taken with Janumet (corticosteroids, thiazide diuretics, loop diuretics, beta-blockers, phenothiazines, thyroid medications, certain hormonal medications (e.g., some oral contraceptives, hormone replacement therapy) may affect blood glucose control and should be discussed with your doctor), seizure medications, asthma, cold, and allergy medications (some contain decongestants like pseudoephedrine and phenylephrine that can raise blood sugar);
• Drugs that may increase the risk of lactic acidosis (e.g., acetazolamide);
• Certain medications that affect kidney function (e.g., ibuprofen, naproxen);
• Cimetidine (can increase metformin levels in the blood);
• Ranolazine (may increase metformin levels);
• Dolutegravir (an antiviral medication that can reduce the elimination of metformin);
• Iodinated contrast media (used for some X-ray procedures - can temporarily affect kidney function and may require stopping Janumet before the procedure);
• Digoxin (sitagliptin may increase digoxin levels in the blood - the doctor may monitor your digoxin levels if you are taking both medications);
• Certain medications that affect metformin elimination through various renal tubular transport mechanisms;
• Vitamin B12 (long-term metformin use can decrease vitamin B12 absorption);
• Herbal supplements (some herbal supplements may interact with Janumet or affect blood glucose levels. For example, supplements like garlic and chromium have been suggested to lower blood sugar, guar gum might affect metformin absorption, and Ginkgo biloba has been reported to potentially worsen glucose tolerance. It is crucial to discuss all herbal supplements with your doctor or pharmacist)

Alcohol:
Avoid or minimize alcohol consumption while taking Janumet. Excessive alcohol consumption can potentiate the effect of metformin on lactate metabolism, increasing the risk of lactic acidosis. Alcohol can increase the risk of hypoglycemia when consumed on an empty stomach or after exercise. Alcohol may worsen the side effects of metformin, such as gastrointestinal issues like diarrhea and nausea.

Pregnancy and Breastfeeding:

Janumet is generally contraindicated during pregnancy due to potential risks to the developing fetus. While it is unknown if sitagliptin passes into breast milk, metformin does in small amounts, and the potential risks to a nursing infant should be discussed with a doctor. Adequate blood sugar control is crucial during pregnancy.

Frequently Asked Questions about Janumet at Canada Pharmacy Online:

Why is Janumet more affordable in Canada than in the United States?

Prescription drug prices, including Janumet, are generally lower in Canada than in the US due to a combination of factors, primarily government price regulations, differing market dynamics, and other economic considerations. In Canada, provincial and federal governments negotiate drug prices with pharmaceutical companies, which often results in lower costs compared to the U.S., where market forces play a more significant role. For more information, see the FAQs on Prescription Drug Importation from the Kaiser Family Foundation (KFF): https://www.kff.org/health-costs/issue-brief/faqs-on-prescription-drug-importation/

What is the difference between Janumet 50 mg/500 mg and 50 mg/1000 mg?

The difference in dosage represents the amount of active ingredient(s) present in the drug.

How much is the shipping?

Our shipping fee is a flat rate of $10.00 per order. Our pharmacy focuses on offering you the lowest prices on high-quality products.

How do I order from your pharmacy?

Ordering from us is very simple. You can purchase online or call Customer Service at 1866.920.3784; for more information or to learn about the ordering process, visit our How to Order page.

Is there a limit on how many tablets I am allowed to order at one time?

CanadaPharmacyOnline.com can only dispense a maximum of a three-month supply of Janumet at once, per your doctor's prescription.

Can I buy over the counter from you?

No, Janumet requires a valid prescription from your doctor. We do not sell this product without a valid prescription.

Do you ship to the United States?

Yes, we do. It usually takes 7 and 18 business days to receive your order from our pharmacy.

Is there a generic for Janumet?

Yes, there is a generic alternative for this product called sitagliptin/metformin.

Can the Janumet pill be split or crushed?

Do not crush, chew, or split Janumet tablets. Swallow the tablet whole with water. Crushing, chewing, or splitting the tablets may affect how the medication is released and absorbed in the body. Consult your doctor or pharmacist if you have difficulty swallowing the tablet.

What is the difference between Janumet and Janumet XR?

Both Janumet and Janumet XR contain sitagliptin and metformin. Janumet is an immediate-release tablet taken twice daily with meals. Janumet XR is an extended-release tablet taken once daily, preferably with the evening meal.

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The generic alternative is not manufactured by the company that makes the brand product.

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The information on this page is sourced from independent third parties contracted by CanadaPharmacyOnline. While we cannot guarantee its medical accuracy, we strongly recommend consulting a healthcare professional for personalized advice regarding medications or medical conditions.

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