|Type of medicine||Antidiabetic medicine|
|Used for||Type 2 diabetes mellitus|
Janumet® (sitagliptin with metformin)
Insulin is a hormone which is made naturally in your body, in the pancreas. It helps to control the levels of sugar in your blood. If your body does not make enough insulin to meet its needs, or if it does not use the insulin it makes effectively, this results in the condition called diabetes mellitus (sugar diabetes).
People with diabetes need treatment to control the amount of glucose (sugar) in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat, but for other people, medicines like sitagliptin are given alongside changes in diet.
Sitagliptin works in part by increasing the amount of insulin produced by your body, which then controls the level of sugar in your blood. It also reduces the amount of a substance called glucagon being produced by your pancreas. Glucagon causes your liver to produce more sugar, so by reducing the amount of glucagon in your body, this also helps to reduce the levels of sugar in your blood.
Sitagliptin can be given alone or alongside other antidiabetic medicines.
Before taking sitagliptin
Before taking sitagliptin make sure your doctor or pharmacist knows:
- If you are under 18 or over 75 years of age.
- If you are pregnant, trying for a baby or breast-feeding.
- If you have kidney or liver problems.
- If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
- If you have ever had an allergic reaction to this or to any other medicine.
How to take sitagliptin
- Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
- Take sitagliptin tablets exactly as your doctor has told you. They are taken once a day.
- You can take the tablets before, during or after meals.
- You can take sitagliptin tablets at any time of the day; however, it is best to try take your doses at the same time each day to help you avoid missing any doses.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
- If you have been given Janumet® (sitagliptin combined with metformin) you should take these tablets twice daily with meals.
Getting the most from your treatment
- It is important that you keep your regular doctor's and clinic appointments. This is so your progress can be monitored. You are likely to need regular check-ups with an eye clinic and a foot clinic as well as with your doctor and diabetes clinic.
- Your doctor may recommend that you test for sugar in your blood or urine regularly to check that your diabetes is being controlled. Your doctor or diabetes nurse will show you how to do this.
- If you have been given advice by your doctor about changes to your diet, stopping smoking or taking regular exercise, it is important for you to follow the advice you have been given.
- Check with your doctor before taking up any new physical exercise, as this will have an effect on your blood sugar levels and you may need to check your blood or urine levels more regularly.
- Taking sitagliptin and alcohol may affect the control of your blood sugar. Keep to the recommended alcohol limits.
- If you are due to have an operation or dental treatment, you should tell the person carrying out the treatment that you are diabetic and taking sitagliptin.
- If you get unusually thirsty, pass urine more frequently, and feel very tired, then let your doctor know. Your dose of sitagliptin may need adjusting.
- If you are a driver you should take special care, as your ability to concentrate may be affected if your diabetes is not well-controlled. Make sure you know what it feels like if your blood sugar is low. This is known as hypoglycaemia or a 'hypo'. The first signs of hypoglycaemia are: feeling shaky or anxious, sweating, looking pale, feeling hungry, having palpitations (a feeling that your heart is pounding), and feeling dizzy. If these happen you should eat or drink something containing sugar or have a snack straightaway. It is advisable to check your blood or urine glucose levels before you travel on long journeys, and have a snack with you.
Can sitagliptin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common sitagliptin side-effects - these affect less than 1 in 10 people who take this medicine||What can I do if I experience this?|
|Infection of the upper airways, aches and pains, cold and flu-like symptoms, headache, sore throat||Ask your pharmacist to recommend a suitable remedy. Let your doctor know if any of these become severe or troublesome|
|Symptoms of hypoglycaemia: feeling shaky or anxious, sweating, looking pale, feeling hungry, feeling that your heart is pounding, feeling dizzy||Eat something containing sugar such as a biscuit or a sugary drink (not diet) and follow this up with a snack such as a sandwich. Tell your doctor if you notice these symptoms|
|Feeling dizzy||If this happens, do not drive or use tools or machines|
|Stomach upset, feeling sick, indigestion||Stick to simple foods|
Important: if you get any of the following rare but serious symptoms, speak with your doctor immediately or go to your local accident and emergency department straightaway:
- Any swelling of your mouth or face, or any difficulty breathing or swallowing.
- Severe abdominal pain.
- Severe skin rash.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store sitagliptin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Manufacturer's PIL, Januvia® 100 mg film-coated tablets; Manufacturer's PIL, Januvia® 100 mg film-coated tablets, Merck Sharp & Dohme Limited, electronic Medicines Compendium. Dated August 2011.
- Manufacturer's PIL, Janumet® 50 mg/1000 mg film-coated tablets; Manufacturer's PIL, Janumet® 50 mg/1000 mg film-coated tablets, Merck Sharp & Dohme Limited, electronic Medicines Compendium. Dated August 2011.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Helen Huins