Side effects of januvia with metformin

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Side Effects of Januvia with Metformin

Introduction to Januvia and Metformin Combination

Januvia (sitagliptin) and metformin are commonly prescribed together to manage type 2 diabetes. Januvia is a dipeptidyl peptidase-4 (DPP-4) inhibitor that enhances insulin secretion and reduces glucagon levels, while metformin decreases hepatic glucose production and improves insulin sensitivity. This combination aims to improve blood glucose control without causing significant hypoglycemia or weight gain .

Common Side Effects

Digestive Issues

One of the most frequently reported side effects of the Januvia and metformin combination is digestive discomfort. This includes symptoms such as nausea, diarrhea, and abdominal pain. These side effects are primarily attributed to metformin .

Risk of Lactic Acidosis

Metformin carries a risk of lactic acidosis, a rare but serious condition characterized by the buildup of lactic acid in the blood. This risk is particularly heightened in patients with renal insufficiency. Therefore, careful monitoring of kidney function is essential when using this combination therapy .

Less Common but Notable Side Effects

Bladder Infections

Patients using the combination of Januvia and metformin may experience an increased risk of bladder infections. This is a significant concern as bladder infections are already common among diabetes patients, and the combination therapy may exacerbate this issue .

Photosensitivity

Although not widely reported, there have been concerns about photosensitivity reactions with sitagliptin (Januvia). However, this side effect has not been officially included in the list of adverse reactions by regulatory agencies .

Monitoring and Management

Regular Monitoring

Patients on Januvia and metformin should undergo regular monitoring to manage potential side effects effectively. This includes periodic checks of kidney function to prevent lactic acidosis and monitoring for signs of bladder infections 13.

Adjustments in Therapy

In some cases, adjustments in therapy may be necessary. For instance, if a patient experiences significant digestive issues or shows signs of renal impairment, healthcare providers may need to modify the dosage or consider alternative treatments .

Conclusion

The combination of Januvia and metformin is effective in managing type 2 diabetes but comes with a range of potential side effects. Common issues include digestive discomfort and the risk of lactic acidosis, while less common concerns involve bladder infections and possible photosensitivity. Regular monitoring and appropriate management strategies are crucial to mitigate these risks and ensure patient safety.

Sources and full results

Most relevant research papers on this topic

SGLT2 inhibitors enter crowded diabetes space

SGLT2 inhibitors are a new class of diabetes drugs that target the enzyme SGLT2 in the pancreas, potentially reducing the risk of kidney damage and lowering blood sugar levels.

2013·

13citations

·A. Bouchie

Photosafety of the antidiabetic drug sitagliptin

Photosensitivity is not included in the adverse reactions for the antidiabetic drug sitagliptin, but it has been reported in a study of patients with type 2 diabetes mellitus.

2019·

1citation

·A. Dubón et al.

[Medication of the month. Sitagliptin-metformin fixed combination (Janumet)].

Janumet improves glucose control in type 2 diabetes patients without causing hypoglycemia or weight gain, with a good tolerance profile and side effects attributable to metformin.

2010·

2citations

·A. Scheen

Sitagliptin

Sitagliptin is a well-tolerated and effective treatment option for type 2 diabetes, with oral administration, a generally weight-neutral effect, and low risk of hypoglycemia.

Highly Cited

2010·

116citations

·Sohita Dhillon

Sitagliptin: A Review of Its Use in Patients with Type 2 Diabetes Mellitus

Sitagliptin is an effective and generally well-tolerated treatment option for patients with type 2 diabetes, improving glycemic control and reducing the risk of hypoglycemia.

Literature ReviewHighly Cited

2014·

96citations

·G. Plosker

Dipeptidyl-peptidase-4 inhibitors for treatment of type 2 diabetes.

Sitagliptin (Januvia) decreases A1C levels by 0.7 percent in type 2 diabetes patients, but long-term safety and patient-oriented outcomes are inconclusive.

2009·

11citations

·C. Kripke

Sitagliptin/Metformin (janumet) as combination therapy in the treatment of type-2 diabetes mellitus.

Sitagliptin and metformin show potential in improving glycemic levels in type-2 diabetes patients, but their cost and need for more data may limit their use.

2012·

28citations

·Erin St. Onge et al.

A straightforward case of diabetic amyotrophy?

1 European Medicines Agency. European Public Assessment Report. Januvia Scientific Discussion. 2007. Available at http://www. ema.europa.eu/humandocs/PDFs/EPAR/januvia/H-722-en6.pdf Last accessed 28 February 2010. 2 Williams-Herman D, Johnson J, Teng R, Luo E, Davies MJ, Kaufman KD et al. Efficacy and safety of initial combination therapy with sitagliptin and metformin in patients with Type 2 diabetes: a 54-week study. Curr Med Res Opin 2009; 25: 569–583. 3 Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239–245. 4 Cugno M, Nussberger J, Cicardi M, Agostoni A. Bradykinin and the pathophysiology of angioedema. Int Immunopharmacol. 2003; 3: 311–317. 5 Byrd JB, Touzin K, Sile S, Gainer JV, Yu C, Nadeau J et al. Dipeptidyl peptidase IV in angiotensin-converting enzyme inhibitorassociated angioedema. Hypertension 2008; 51: 141–147. 6 Grossman E, Messerli FH, Neutel JM. Angiotensin II receptor blockers: equal or preferred substitutes for ACE inhibitors? Arch Intern Med 2000; 160: 1905–1911. 7 Byrd JB, Shreevatsa A, Putlur P, Foretia D, McAlexander L, Sinha T et al. Dipeptidyl peptidase IV deficiency increases susceptibility to angiotensin-converting enzyme inhibitor-induced peritracheal edema. J Allergy Clin Immunol 2007; 120: 403–408.

Case ReportRigorous Journal

2010·

0citations

·R. Kumar et al.

Evaluation of the anti-osteoporotic effects of metformin and sitagliptin in postmenopausal diabetic women

Metformin has no anti-osteoporotic effect, while sitagliptin may positively regulate bone metabolism in postmenopausal diabetic women.

RCTHighly Cited

2015·

75citations

·S. Hegazy

Janumet™: a combination product suitable for use in patients with Type 2 diabetes

The combination tablet of sitagliptin (Januvia) and metformin HCl (Glucophage) is effective for patients with Type 2 diabetes who are not adequately controlled by either drug alone.

2008·

17citations

·Jonathan K. Reynolds et al.

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