Are you also being treated for Type 2 Diabetes ? If so, your doctor may have prescribed you a pill that combines two drugs, Sitagliptin and Metformin. You may know this by the brand name Janumet XR. It works by controlling your blood sugar levels. So today, let's talk about this important drug, what it does, what to be careful about while using it, and all the side effects.
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What really happens with this medicine?
Simply put, this pill helps control your blood sugar (glucose) levels in two ways.
1. Metformin: This mainly controls the unnecessary production of sugar by your liver. It also helps your body's cells respond better to insulin .
2. Sitagliptin: This helps increase the amount of insulin your body naturally produces after you eat and reduce the production of sugar by the liver.
But remember this. This is not a magic pill. To get the most out of this medicine, it is absolutely important to have a good diet and exercise as recommended by your doctor .
Things you need to tell your doctor before taking medicine
Before giving you this medication, it is very important that your doctor knows your complete health history . Be sure to tell them about any of the conditions listed below.
| Disease or condition | Why should you inform? |
|---|---|
| Kidney or liver disease | The drug is eliminated from the body mainly through the kidneys. If there are problems with these organs, the dose of the drug may need to be changed or not given at all. |
| Heart disease or heart failure | The use of this medication may be risky in some heart conditions. |
| If you have had pancreatitis | Because this medication can rarely cause pancreatitis, prior history is important. |
| If you drink alcohol regularly | Combining alcohol and Metformin increases the risk of a dangerous condition called lactic acidosis. |
| Vitamin B12 deficiency or anemia | Long-term use of metformin can cause vitamin B12 levels to decrease. |
| If you are pregnant, trying to get pregnant, or are a breastfeeding mother | This medicine is not suitable in these cases, and your doctor will provide you with a safer alternative. |
| If you have allergies to other medications, foods, or substances | It is important to inform about any allergies. |
How exactly do you use this medicine?
- Take the prescribed dose as prescribed by the doctor. Do not take more or less than that.
- This pill is usually taken once a day, with dinner .
- Swallow the tablet whole with a glass of water.
- Very important: This pill is an Extended-Release (XR) pill. This means that the medicine is released into the body over a 24-hour period. Therefore , never break, crush, or chew the pill. Doing so can cause the medicine to be released into the body all at once, causing dangerous side effects.
- If you miss a dose, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take two doses at once.
- If you think you have taken too much medicine, do not waste time and immediately call the National Poisons Information Centre at the Colombo National Hospital. Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Be careful about these things when taking medication.
- Regular checkups: Your doctor will check you regularly, especially with a blood test called HbA1C (A1C) every 3 to 6 months. This will look at how well your blood sugar has been controlled over the past 2-3 months.
- Know your blood sugar levels: Learn how to check your blood sugar levels at home. Be aware of the symptoms of low blood sugar (Hypoglycemia) and high blood sugar (Hyperglycemia).
- Keep some sugar nearby: Always keep something like some sugar, a piece of toffee, or a glucose tablet nearby in case you suddenly run out of sugar.
Important: If someone has low blood sugar and is having seizures or is unconscious, do not put anything in their mouth. It could become a choking hazard. Seek immediate medical attention.
- Surgery and scans: If you are going to have surgery, an MRI, or a CT scan, be sure to tell your doctor that you are taking this medicine. You may need to stop taking the medicine for a few days.
- Other medications: Tell your doctor about all other medications you are taking (including vitamins and herbal remedies). Some medications may interact with this one.
What are the possible side effects?
Like any medicine, this one can cause side effects in some people. Some of them are dangerous, some of them are normal.
| Classification of side effects | |
|---|---|
Serious side effects that require immediate medical attention | |
| Allergic Reaction | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Pancreatitis | Severe stomach pain (this may spread to the back), pain that worsens after eating, fever, nausea, vomiting. |
| Lactic Acidosis | Muscle cramps or pain, stomach pain, difficulty breathing, extreme fatigue, feeling weak. (This is a very serious emergency). |
| Heart Failure | Difficulty breathing, swelling of the ankles, feet, or hands, sudden weight gain, unusual fatigue. |
| Severe joint pain | Unbearable pain in the joints. |
Side effects that are usually not dangerous, but should be reported to the doctor if they persist | |
| Digestive system problems | Stomach pain, diarrhea, gas, nausea. |
| Other | Symptoms such as headache, sore throat, and cold. |
💡 Take-Home Message
- Sitagliptin and Metformin are very important medications that help control type 2 diabetes . But this should be done in conjunction with diet and exercise.
- Never break, crush, or chew an Extended-Release (XR) tablet. Swallow it whole.
- It is imperative to inform your doctor about all other medications you are taking and any other medical conditions you may have.
- Be aware of the symptoms of low blood sugar (hypoglycemia) and always keep something with sugar nearby.
- Seek immediate medical attention if you experience severe stomach pain, difficulty breathing, or severe allergic symptoms.
- Avoid stopping medication or changing the dosage on your own. Always talk to your doctor.
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