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Diabetes
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Janumet (Sitagliptin + Metformin)
SELECT REF DESCRIPTION MANUFACTURER PACK SIZE STRENGTH OUR PRICE
P1263 Janumet (Sitagliptin + Metformin) MSD 14 tabs 50 mg+500 mg $27.05
P1264 Janumet (Sitagliptin + Metformin) MSD 14 tabs 50 mg+1000 mg $27.05
P1226 Amaryl M 1 mg (Glimepride+Metformin) Sanofi-Aventis 10 tabs 1 mg+500 mg $5.45
P1227 Amaryl M 2 mg (Glemepride+Metformin) Sanofi-Aventis 10 tabs 2 mg+500 mg $8.91
P1228 Azulix Forte (Glimepride + Metformin) Torrent 10 tabs 1 mg+1000 mg $5.30
P1229 Azulix Forte (Glimepride + Metformin) Torrent 10 tabs 2 mg+1000 mg $5.99
P1231 Carbophage 1000 SR (Metformin) Merck 10 tabs 1000 mg $3.91
P1230 Carbophage 500SR (Metformin) Merck 10 tabs 500 mg $3.00
J153 Glucophage (Metformin Hcl) Generic 10 tabs 500 mg $1.61
J154 Glucophage (Metformin Hcl) Generic 10 tabs 850 mg $3.29
J155 Glucophage (Metformin Hcl) Generic 10 tabs 1000 mg $3.54
J421 Glyburide/ Metformin Generic 10 tabs 5/500 mg $2.59
P1232 Glyciphage (Metformin) Franco Indian 10 tabs 250 mg $1.16
P1233 Glyciphage (Metformin) Franco Indian 10 tabs 500 mg $2.80
P1234 Glyciphage (Metformin) Franco Indian 10 tabs 850 mg $1.68
P1238 Pioglit 15MF (Pioglitazone + Metformin) Sun Pharma 10 tabs 15 mg+500 mg $5.35
P1239 Pioglit 30MF (Pioglitazone + Metformin) Sun Pharma 10 tabs 30 mg+500 mg $7.51
P1237 Pioglit 7.5 MF (Pioglitazone + Metformin) Sun Pharma 10 tabs 7.5 mg+500 mg $3.91
Out Of Stock P1242 Rezult M (Rosiglitazone + Metformin) Sun Pharma 10 tabs 2 mg+500 mg $4.20
Out Of Stock P1243 Rezult M 4 (Rosiglitazone + Metformin) Sun Pharma 10 tabs 4 mg+500 mg $5.08
J443 Metformin Generic 10 tabs 850 mg $1.82
J485 Metformin Generic 10 tabs 500 mg $2.10
P1260 Januvia (Sitagliptin) MSD 7 tabs 25 mg $19.93
P1261 Januvia (Sitagliptin) MSD 7 tabs 50 mg $22.45
P1262 Januvia (Sitagliptin) MSD 7 tabs 100 mg $25.47
Price is per pack & not per tab.. eg: if pack size is 10 tabs & price is $2.75 then for 100 tabs the price would be $27.50
What is metformin and sitagliptin?
Metformin and sitagliptin are oral diabetes medicines that help control blood sugar levels.

Metformin works by decreasing glucose (sugar) production in the liver and decreasing absorption of glucose by the intestines.

Sitagliptin works by regulating the levels of insulin your body produces after eating.

The combination of metformin and sitagliptin is for people with type 2 diabetes who do not use daily insulin injections. This medication is not for treating type 1 diabetes.

Metformin and sitagliptin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about metformin and sitagliptin?
Do not use this medication if you are allergic to metformin or sitagliptin, if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Before taking metformin and sitagliptin, tell your doctor if you have liver or kidney disease, a history of heart disease, or if you are over 80 years old and have not recently had your kidney function checked.

Some people have developed a life-threatening condition called lactic acidosis while taking metformin. Get emergency medical help if you have any of these symptoms of lactic acidosis: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired. Avoid drinking alcohol while taking metformin and sitagliptin.

If you need to have any type of x-ray or CT scan using a dye that is injected into a vein, you may need to temporarily stop taking metformin and sitagliptin.

What should I discuss with my health care provider before taking metformin and sitagliptin?
Some people have developed a life-threatening condition called lactic acidosis while taking metformin. Get emergency medical help if you have any of these symptoms of lactic acidosis: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired.

You may be more likely to develop lactic acidosis if you have liver disease, kidney disease, congestive heart failure, a stroke or heart attack, a serious infection, if you are dehydrated, or if you drink large amounts of alcohol. Talk with your doctor about your individual risk.

Do not use this medication if you are allergic to metformin (Actoplus Met, Avandamet, Fortamet, Glucophage, Riomet) or sitagliptin (Januvia), if you have kidney disease, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

If you need to have any type of x-ray or CT scan using a dye that is injected into a vein, you will need to temporarily stop taking metformin and sitagliptin. Be sure the doctor knows ahead of time that you are using this medication.

Before taking metformin and sitagliptin, tell your doctor if you are allergic to any drugs, or if you have:

liver disease;

kidney disease;

a history of heart disease; or

if you are over 80 years old and have not recently had your kidney function checked.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
Your name may need to be listed on a Janumet pregnancy registry if you become pregnant while you are taking this medication. The purpose of this registry is to track the outcome of the pregnancy and delivery to evaluate whether metformin and sitagliptin had any effect on the baby.

It is not known whether metformin and sitagliptin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Metformin and sitagliptin should not be given to a child younger than 18 years old without a doctor's advice.

How should I take metformin and sitagliptin?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Metformin and sitagliptin is usually taken twice daily with meals. Follow your doctor's instructions.

Metformin and sitagliptin is only part of a complete program of treatment that also includes diet, exercise, weight control, and possibly other medications. It is important to use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your kidney function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.

Your medication needs may change if you become sick or injured, if you have a serious infection, or if you have any type of surgery. Your doctor may want you to stop taking metformin and sitagliptin for a short time if any of these situations affect you.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them:

hunger, headache, confusion, irritability;

drowsiness, weakness, dizziness, tremors;

sweating, fast heartbeat;

seizure (convulsions); or

fainting, coma (severe hypoglycemia can be fatal).

Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

Your doctor may have you take extra vitamin B12 while you are taking metformin and sitagliptin. Take only the amount of vitamin B12 that your doctor has prescribed.

Store metformin and sitagliptin at room temperature away from moisture, heat, and light.

What happens if I miss a dose?
Take the missed dose as soon as you remember (be sure to take the medicine with food if your doctor has instructed you to). If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. You may have signs of low blood sugar, such as hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma.

What should I avoid while taking metformin and sitagliptin?
Avoid drinking large amounts of alcohol while taking metformin and sitagliptin. Alcohol may increase the risk of lactic acidosis while you are taking this medicine.

Metformin and sitagliptin side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

feeling short of breath, even with mild exertion;

swelling or rapid weight gain;

fever, chills, body aches, flu symptoms; or

a severe blistering, peeling, and red skin rash.

Less serious side effects may include:

runny or stuffy nose, sore throat;

headache, weakness; or

mild nausea, vomiting, diarrhea, gas, stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Metformin and sitagliptin Dosing Information
Usual Adult Dose for Diabetes Mellitus Type II:

The starting dose of metformin-sitagliptin should be individualized based on the patient's current regimen.

For patients not adequately controlled on metformin alone, the usual starting dose of metformin-sitagliptin should be equal to 100 mg total daily dose (50 mg twice daily) of sitagliptin plus the dose of metformin already being taken. For patients taking metformin 850 mg twice daily, the recommended starting dose of metformin-sitagliptin is 50 mg sitagliptin/1000 mg metformin hydrochloride twice daily.

For patients not adequately controlled on sitagliptin alone, the usual starting dose of metformin-sitagliptin is 50 mg sitagliptin/500 mg metformin hydrochloride twice daily. Patients may be titrated up to 50 mg sitagliptin/1000 mg metformin hydrochloride twice daily. Patients taking sitagliptin monotherapy with the dose adjusted for renal insufficiency should not be switched to metformin-sitagliptin.

For patients switching from sitagliptin administrated with metformin, metformin-sitagliptin may be initiated at the dose of sitagliptin and metformin already being taken.

Metformin-sitagliptin should be given twice daily with meals, with gradual dose escalation, to reduce the gastrointestinal (GI) side effects due to metformin.

What other drugs will affect metformin and sitagliptin?
You may be more likely to have hyperglycemia (high blood sugar) if you are taking metformin and sitagliptin with other drugs that raise blood sugar. Drugs that can raise blood sugar include:

isoniazid;

diuretics (water pills);

steroids (prednisone and others);

phenothiazines (Compazine and others);

thyroid medicine (Synthroid and others);

birth control pills and other hormones;

seizure medicines (Dilantin and others); and

diet pills, or medicines to treat asthma, colds or allergies.

You may be more likely to have hypoglycemia (low blood sugar) if you are taking metformin and sitagliptin with other drugs that lower blood sugar. Drugs that can lower blood sugar include:

some nonsteroidal anti-inflammatory drugs (NSAIDs);

aspirin or other salicylates (including Pepto-Bismol);

sulfa drugs (Bactrim and others);

a monoamine oxidase inhibitor (MAOI);

beta-blockers (Tenormin and others); or
probenecid (Benemid).

Some medications may interact with metformin and sitagliptin. Tell your doctor if you are using any of the following drugs:

amiloride (Midamor) or triamterene (Dyrenium);

cimetidine (Tagamet) or ranitidine (Zantac);

digoxin (Lanoxin);

furosemide (Lasix);

morphine (MS Contin, Kadian, Oramorph);

nifedipine (Adalat, Procardia);

procainamide (Procan, Pronestyl, Procanbid);

quinidine (Cardioquin, Quinidex, Quinaglute);

trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra); or

vancomycin (Vancocin, Lyphocin).

This list is not complete and there may be other drugs that can interact with metformin and sitagliptin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?
Your pharmacist can provide more information about metformin and sitagliptin.

 

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