Janumet is a prescription medication used in the management of type 2 diabetes, in addition to diet and exercise. Janumet is composed of two medications: sitagliptin and metformin, and is used when an individual's diabetes is not adequately controlled on either medication alone. The patient should speak with a physician if he has any concerns regarding therapy with this drug.
Nausea, Vomiting, Diarrhea
Janumet may cause many gastrointestinal side effects, particularly from the metformin in this medication. While sitagliptin may produce nausea in about 2 percent of users, metformin produces nausea and vomiting in up to 26 percent of patients, reports the "Drug Information Handbook." Metformin may also cause diarrhea in 10 to 53 percent of users. The patient should follow a healthy diet as directed by her physician to control blood glucose levels; eating healthily may help prevent the onset of these side effects. Usually these side effects occur when the drug is started and decrease with time. However, if they become persistent, the patient may require a switch to another medication.
Inflammation and Infection
Janumet may increase the risk of developing inflammation and upper respiratory tract infection. About 5 percent of users develop nasopharyngitis, which is inflammation of the nasal passages and upper throat, while an upper respiratory tract infection is seen in up to 10 percent of users. If a patient develops any symptoms of inflammation or infection, such as runny nose, sore throat, coughing, and sneezing, she should inform her physician.
Vitamin B12 Deficiency
Metformin appears to reduce the absorption of vitamin B12 in the body. According to "Basic and Clinical Pharmacology," this occurs during long-term metformin therapy and annual screening of vitamin B12 levels should be performed. This side effect may be present in about 7 percent of users. If a patient has low levels of vitamin B12, he may require vitamin B12 injections. The patient should keep all doctor appointments and be tested appropriately.
Headache, Dizziness, Weakness
Headache is commonly seen in about 6 percent of users of Janumet. Dizziness and lightheadedness may also occur and may hinder the ability to drive or perform activities that require strict attention. About 9 percent of users may experience general weakness or fatigue. If these side effects do not go away or worsen, the patient should contact a health care professional.
Hypoglycemia
Hypoglycemia, which is a low blood sugar level, may occur in patients taking Janumet. Signs and symptoms of low blood sugar are headache, dizziness, nervousness, irritability, increased sweating and hunger. Patient should carry something that contains a direct source of sugar, such as hard candy or fruit juice, to help bring their sugar levels up. Patients who are more at risk of developing hypoglycemia include those who skip meals or exercise rigorously, explains "Pharmacotherapy: A Pathophysiologic Approach." Patients who take another medication that lowers blood sugar, such as insulin, glyburide, glipizide or glimepiride, are also at a higher risk of developing this adverse reaction. The patient should follow his physician's instructions exactly to minimize the effect.
References
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- "Basic and Clinical Pharmacology"; Bertram G. Katzung; 2007
- "Pharmacotherapy: A Pathophysiologic Approach"; Josep T. Dipiro, Robert L. Talbert, et al.; 2008
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