What Janumet is and what it is used for<\/h2>\n\n\n\n
Janumet contains two active substances called sitagliptin and metformin .<\/p>\n\n\n\n
sitagliptin belongs to a group of medicines called DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors)<\/li>
metformin belongs to a group of medicines called biguanides.<\/li><\/ul>\n\n\n\n
Both of these substances help regulate blood sugar levels in adult patients with a type of diabetes called type 2 diabetes mellitus . This drug helps to increase the levels of insulin produced after a meal and reduces the amount of sugar that is formed in the body.<\/p>\n\n\n\n
Along with diet and exercise, this drug is used to help lower your blood sugar. This medicine can be taken alone or with certain other medicines used to treat diabetes ( insulin , sulphonylureas or glitazones).<\/p>\n\n\n\n
What is type 2 diabetes ?<\/p>\n\n\n\n
Type 2 diabetes is a condition that means that your body does not produce enough insulin and that the insulin that the body produces does not work as well as it should. Your body can also produce too much sugar. When this happens, sugar ( glucose ) accumulates in the blood. This can lead to serious medical problems such as heart disease, kidney disease, blindness and amputation.<\/p>\n\n\n\n
What you need to know before taking Janumet<\/h2>\n\n\n\n
Do not take Janumet<\/h2>\n\n\n\n
if you are allergic to sitagliptin, metformin or any of the other ingredients of this medicine (listed in section 6)<\/li>
if you have severe renal impairment<\/li>
if you have uncontrolled diabetes with, for example, severe hyperglycaemia (high blood sugar), nausea, vomiting, diarrhea, rapid weight loss, lactic acidosis (see “Risk of lactic acidosis” below) or ketoacidosis . Ketoacidosis is a condition in which substances called ketone bodies accumulate in the blood, which can lead to diabetic precoma. Symptoms include stomach pain, rapid and deep breathing, drowsiness or that your breath gets a different, fruity smell<\/li>
if you have a severe infection or if you are dehydrated<\/li>
if you are going to have a contrast X-ray with an injection of a dye. You will need to take a treatment break with Janumet for 2 or more days after the procedure according to the doctor’s instructions, depending on how your kidneys work.<\/li>
if you have recently had a heart attack or have severe problems with your blood circulation or difficulty breathing<\/li>
if you have liver problems<\/li>
if you drink too much alcohol (either you do it every day or only periodically)<\/li>
if you are breast-feeding.<\/li><\/ul>\n\n\n\n
Do not take Janumet if any of the above apply to you and talk to your doctor about other ways to manage your diabetes . If you are not sure, talk to your doctor, pharmacist or nurse before taking Janumet.<\/p>\n\n\n\n
Warnings and cautions<\/h2>\n\n\n\n
Cases of inflammation of the pancreas ( pancreatitis ) have been reported in patients receiving Janumet (see section 4).<\/p>\n\n\n\n
If you get blisters on your skin, it could be a sign of a condition called bullous pemphigoid . Your doctor may tell you to stop taking Janumet.<\/p>\n\n\n\n
Risk of lactic acidosis<\/u><\/strong><\/p>\n\n\n\n
Janumet may cause a very rare, but very serious side effect a lactic acidosis , particularly if your kidneys are not working properly. The risk of developing lactic acidosis is also increased in uncontrolled diabetes , severe infections , prolonged fasting or alcohol intake, dehydration (see more information below), liver problems and conditions where part of the body has reduced oxygen supply (including acute severe heart disease).<\/p>\n\n\n\n
If any of the above apply to you, talk to your doctor for further information.<\/p>\n\n\n\n
Stop taking Janumet for a short time if you have a condition that may be associated with dehydration,<\/strong> such as severe vomiting, diarrhea, fever, exposure to heat or if you drink less fluid than normal. Talk to a doctor for further instructions.<\/p>\n\n\n\n
Stop taking Janumet and contact your doctor or nearest hospital immediately if you get any of the symptoms of lactic acidosis<\/strong> as the condition may lead to coma .<\/p>\n\n\n\n
The symptoms of lactic acidosis include:<\/p>\n\n\n\n
vomiting<\/li>
abdominal pain (stomach pain)<\/li>
muscle cramps<\/li>
a general feeling of not feeling well and pronounced fatigue<\/li>
hard to breathe<\/li>
lowered body temperature and heart rate .<\/li><\/ul>\n\n\n\n
Lactic acidosis is an acute medical condition that must be treated in a hospital.<\/p>\n\n\n\n
Talk to your doctor or pharmacist before taking Janumet:<\/p>\n\n\n\n
if you have or have had a disease of the pancreas (eg pancreatitis )<\/li>
if you have or have had gallstones , alcohol dependence or very high levels of triglycerides (a type of fat) in your blood. These medical conditions may increase the risk of developing pancreatitis (see section 4).<\/li>
if you have type 1 diabetes . This is also called insulin-dependent diabetes .<\/li>
if you have or have had an allergic reaction to sitagliptin, metformin or Janumet (see section 4).<\/li>
if you are taking a sulphonylurea or insulin , medicines for diabetes , together with Janumet, as you may experience low blood sugar levels ( hypoglycemia ). Your doctor may reduce the dose of one of your sulphonylureas or your insulin .<\/li>
if you are going to have a major operation, you must stop taking Janumet during the operation and for a certain period of time after it. Your doctor will decide when to stop taking Janumet and when to start taking it again.<\/li><\/ul>\n\n\n\n
If you are not sure if any of the above applies to you, contact your doctor or pharmacist before taking Janumet.<\/p>\n\n\n\n
During treatment with Janumet, your doctor will check your kidney function at least once a year or more often if you are older and \/ or if your kidney function is deteriorating.<\/p>\n\n\n\n
Children and young people<\/h2>\n\n\n\n
Children and adolescents under 18 years of age should not use this medicine. It is not effective in children and adolescents between 10 and 17 years of age. It is not known if this medicine is safe and effective when used in children and adolescents under 10 years of age.<\/p>\n\n\n\n
Other medicines and Janumet<\/h2>\n\n\n\n
If you need to get an injection in the blood with contrast media that contains iodine, for example in connection with X-rays or computed tomography , you must stop taking Janumet before or at the time of injection . Your doctor will decide when to stop taking Janumet and when to start taking it again.<\/p>\n\n\n\n
Tell your doctor if you are taking, have recently taken or might take any other medicines.<\/p>\n\n\n\n
You may need to do more blood sugar and kidney function tests, or your doctor may need to adjust the dose of Janumet. It is especially important that you mention the following:<\/p>\n\n\n\n
medicines (taken by mouth, inhalation or injection ) used to treat inflammation such as asthma and arthritis ( glucocorticoids )<\/li>
drugs that increase urine production ( diuretics )<\/li>
drugs used to treat pain and inflammation ( NSAIDs and COX-2 inhibitors, such as ibuprofen and celecoxib)<\/li>
certain medicines for high blood pressure (ACE inhibitors and angiotensin II receptor antagonists)<\/li>
specific drugs used to treat respiratory problems (beta-2 agonists )<\/li>
iodinated contrast media or drugs containing alcohol<\/li>
certain medicines used to treat stomach problems, such as cimetidine<\/li>