Sitagliptin-Metformin (Janumet): Uses, Side Effects, Differences

According to the World Health Organization (WHO), roughly 422 million people worldwide have diabetes. 

Diabetes is a chronic condition that affects blood glucose levels. 

Lifestyle changes, such as good nutrition and exercise, are the first line of action to manage the condition. 

However, there might be times when you need extra help. 

Anti-diabetic medication, such as sitagliptin and metformin, can play a role in managing blood glucose levels. 

And in some cases, you might find yourself taking not only one medication but a combination of both. 

Janumet is an anti-diabetic medication that combines metformin and sitagliptin to help you control your sugar levels and prevent the negative effects of diabetes. 

In this article, we’ll go over everything you need to know about Janumet. You’ll learn what sitagliptin-metformin is used for, how to take it, possible side effects, benefits, similarities, differences, and the pricing of the medication. 

What Are ​​Sitagliptin-Metformin Tablets Used For?

First, it’s important to understand what each medication does in the body. Both medications, found under the name of Janumet, work to help reduce blood glucose levels. 

When left unhandled, diabetes can increase the risk of heart disease, nerve damage, kidney issues, mental health problems, and trouble in the skin, eyes, and hearing. 


Metformin is typically the first line of medication prescribed to treat diabetes. It works by decreasing the amount of sugar secreted in the liver and reduces glucose absorption in the stomach. 

Metformin can be found under several names, such as Axpinet, Diagemet, Glucient, Glucophage, and Metabet. 

You can normally find metformin in two doses: 500 mg or 850 mg. If you are a beginner, the doctor might prescribe the medication once daily, but it can be taken up to three times daily. 


On the other hand, sitagliptin works by increasing incretins. Incretins help increase insulin, which is a hormone produced in the pancreas that helps move glucose found in the blood into the cells. It also tells the liver to stop producing glucose if too much is available.  

When taken on its own, sitagliptin is often found under the name of Januvia. It comes in doses of 25 mg, 50, and 100 mg, typically taken once a day. 

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How Should I Take Sitagliptin-Metformin?

It’s best to take sitagliptin-metformin with a meal to prevent any digestive issues, such as upset stomach. 

Make sure you never crush, break, or chew the tablets. They should be swallowed with water. 

Ideally, take the extended-release tablets in the evening to have better glucose control throughout the night. But, if the doctor recommends taking it another time, make sure you follow your doctor’s orders. 

Don’t increase the dosage or the frequency of the medication since it can increase the risk of hypoglycemia. 

What Are The Side Effects of Janumet?

Even though Janumet is safe to take, you can still experience certain side effects. Here is a list of the possible side effects of sitagliptin-metformin: 

  • Nausea
  • Vomiting 
  • Upset stomach
  • Headache
  • Diarrhea
  • Weakness
  • Metallic aftertaste 

It’s very uncommon for this medication to produce hypoglycemia (low sugar levels) unless it’s taken with another anti-diabetic medication. Still, knowing the symptoms of low sugar levels is a good idea. 

Here are the symptoms you need to be on the lookout for when experiencing low sugar levels:

  • Fast heartbeat
  • Sweating
  • Shaking
  • Anxiety
  • Dizziness
  • Hunger 
  • Weakness 

If you are experiencing any previous symptoms, talk to your doctor to determine if this medication is right for you or need changes in the dosage. 

Benefits of Taking Sitagliptin-Metformin

The biggest benefit of taking sitagliptin-metformin is a reduction in blood glucose levels. 

According to studies, the combination of both medications can help reduce HbA1c levels, decrease body weight, and improve beta cell function (pancreatic cells in charge of producing insulin). 

Another benefit of taking sitagliptin and metformin is it might improve symptoms of PCOS. Polycystic ovary syndrome is a condition that affects 8-13% of women. It causes irregular periods, increased androgen levels, and polycystic ovaries. 

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Similarities Between Metformin and Sitagliptin

  • Both are only suitable to treat type 2 diabetes since insulin must be released from the pancreas. 
  • Both work by having a direct effect on insulin. 
  • You take both of them orally. 
  • They have similar side effects and risks. 

Differences Between Metformin vs Sitagliptin

  • Sitagliptin is used to release more insulin to help control blood sugar levels, whereas metformin helps the insulin already produced work better (improve insulin sensitivity). 
  • When taken alone, sitagliptin tends to be more expensive than metformin. While it depends on where you buy it (and if you have insurance), one tablet of sitagliptin costs around $5.00, and metformin costs $0.80 per tablet. 
  • If you combine sitagliptin with insulin, it might lead to hypoglycemia. On the other hand, metformin and insulin rarely produce hypoglycemia. 

Is Sitagliptin Better Than Metformin?

One is not better than the other. Since they have different mechanisms of action, they are going to help control blood glucose levels in different ways. That is why they are typically used together. 

However, to determine if one is better for you depending on your condition, a health professional can guide you on the best anti-diabetic medication based on your health and other meditations you might be taking. 

Why Is Janumet So Expensive?

Currently, there is no generic version for Janumet (sitagliptin and metformin). For that reason, it normally sells at a high price. 

While it might depend on where you purchase it, 60 tablets might cost between $500 and $600 (between $8 and $10 per tablet). 

Now, there might be some insurance companies that cover the cost of Janumet, making it more affordable. 

If your insurance company doesn’t cover the cost and is out of your budget, talk to your doctor about other anti-diabetic medications more suitable for your case. 

Important Lifestyle Changes To Make While On Sitagliptin-Metformin

Medication is only one factor that plays a role in helping reduce glucose levels. Nutrition, exercise, and mood are essential to have adequate glucose levels. 

Here are some tips to help you manage your condition in conjunction with ​​sitagliptin-metformin:

Choose simple over complex carbohydratesSimple carbs (pastries, white bread, white pasta, cookies, and sugars) are easier to digest. As a result, they have a high glycemic index, meaning they spike blood sugar levels. So, switch your simple carbs with complex carbs (whole grains, legumes, and vegetables). 
ExerciseDoing regular physical activity can help increase insulin sensitivity. Make sure you are doing at least 150 minutes of light to moderate exercise and do a variety of workouts (cardio, strength training, and flexibility). 
Manage stressHigh stress levels can make sugar levels increase. Pay attention to your mood, and make sure you have good coping mechanisms (yoga, walking, journaling, and meditation) to help you reduce stress. 
Be careful with your alcohol intakeThe problem with alcohol is that it can make your sugar levels too high or too low. The fact that it’s difficult to predict its tendency means you should be aware when drinking alcohol. Stay to the recommended guidelines of men having no more than two drinks per day and women only one.
Get regular checkupsIf you are taking medications, it’s always important to constantly monitor your blood glucose levels. It is recommended to check your glucose levels at least once per day (or how often the doctor recommends) and your Hb1Ac levels at least every 3-4 months.


Managing your diabetes is crucial to help prevent health complications, such as heart and kidney problems. 

Anti-diabetic medication, such as sitagliptin and metformin, can be a great way to help you control your blood sugar levels (always with the right nutrition and exercise). 

Metformin is a medication that works by improving insulin sensitivity, while sitagliptin works by helping the pancreas produce more insulin. 

While you can take both medications separately, you can take them together in the form of Janumet. 

While they have different mechanisms of action, they are similar in the positive effects they have in helping you handle your condition. 

Always remember to talk with your doctor if you are experiencing any side effects when taking the medication.

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  3. St Onge EL, Miller S, Clements E. Sitagliptin/Metformin (janumet) as combination therapy in the treatment of type-2 diabetes mellitus. P T. 2012 Dec;37(12):699-708. PMID: 23319848; PMCID: PMC3541863.
  4. Du Q, Wu B, Wang YJ, Yang S, Zhao YY, Liang YY. Comparative effects of sitagliptin and metformin in patients with type 2 diabetes mellitus: a meta-analysis. Curr Med Res Opin. 2013 Nov;29(11):1487-94. doi: 10.1185/03007995.2013.833090. Epub 2013 Sep 5. PMID: 23927568.
  5. Palma, J.C. & Byhen, E. & Ibáñez, L. & Macedo, L. & Palma, C. & Ramírez, C.R.. Comparative treatment between sitagliptin vs. metformin, alone or in combination, in patients with polycystic ovary syndrome. A clinical entity at high risk for developing diabetes mellitus and gestational diabetes: A pilot study. Revista Médica del Hospital General de México. 81. 2017.
  6. Modarres SZ, Daneshjou D, Mehranjani MS, Ali Shariatzadeh SM. Comparative evaluation of metformin & sitaformin in classic PCOS patients undergoing intracytoplasmic sperm injection: A randomized controlled pilot study. Indian J Med Res. 2023 Jan;157(1):66-73. doi: 10.4103/ijmr.IJMR_2139_20. PMID: 37040229; PMCID: PMC10284353.
  7. World Health Organization. Polycystic ovary syndrome.

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