Janmet 500

Presentation:Each film-coated tablet contains Sitagliptin Phosphate Monohydrate equivalent to 50 mg of Sitagliptin and Metformin Hydrochloride BP 500 mg.

Indications:Janmet is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellituswhen treatment with both sitagliptin and metforminis appropriate.This includes:

• Patients not adequately controlled on metformin alone.
• Patients already treated with sitagliptin and metformin as separate tablets.
• Treatment-naïve patients with high initial glucose levels as initial therapy.

Dosage and Administration:The usual starting dose is one tablet twice daily with meals.Dosage should be individualized based on the patient's current regimen, effectiveness, and tolerability, while not exceeding the maximum daily dose of 100 mg sitagliptin and 2000 mg metforminhydrochloride.

• Patients not controlled on metformin alone: Initiate with one tablet twice daily.
• Patients switching from separate sitagliptin and metformin:Initiate with the same daily dose of sitagliptin and metformin already being taken.  
• Treatment-naïve patients:Initiate with one tablet twice daily.  

Gradual dose escalation is recommended to reduce gastrointestinal side effects associated with metformin.Tablets should be swallowed whole and not crushed or chewed.Renal function should be assessed prior to initiation and periodically thereafter.

Side Effects:

• Common:Diarrhea, nausea, vomiting, flatulence, abdominal discomfort, and headache.  
• Uncommon: Hypoglycemia (when used in combination with sulfonylureas or insulin), constipation, and dizziness.
• Rare: Lactic acidosis (potentially serious, requiring immediate medical attention), pancreatitis, angioedema, rash, and urticaria.

Precautions:

Janmet is contraindicated in patients with:

• Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis.  
• Known hypersensitivity to sitagliptin or metformin.

Caution should be exercised in patients with:

• Moderate renal impairment (eGFR 30 to < 45 mL/min/1.73 m²).
• Heart failure.
• History of pancreatitis.
• Excessive alcohol intake.
• Conditions predisposing to dehydration.

Temporary discontinuation of Janmet may be necessary for surgical procedures or iodinated contrast imaging.Monitor renal function regularly. Educate patients on the symptoms of lactic acidosis and pancreatitis.

Storage: Store below 30°C, protected from light and moisture. Keep out of reach of children.

Important Note: This information is for general knowledge and informational purposes only, and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication. They can assess your individual medical condition and provide the most appropriate advice.