JANUMET® XR (Sitagliptin / Metformin Hydrochloride) Modified-Release Tablets

What Is JANUMET® XR?

JANUMET® XR combines two well-established glucose-lowering agents with complementary mechanisms of action. Sitagliptin is a DPP-4 inhibitor that enhances the body’s incretin hormones, while metformin reduces hepatic glucose production and improves insulin sensitivity. This dual-action approach supports more consistent glycaemic control.

According to the NICE guideline on Type 2 diabetes in adults, combination therapy may be recommended when blood glucose targets are not achieved with lifestyle measures and monotherapy alone.

Available Strengths and Formulations

Standard JANUMET® Tablets

• 50 mg sitagliptin / 500 mg metformin hydrochloride
• 50 mg sitagliptin / 850 mg metformin hydrochloride
• 50 mg sitagliptin / 1000 mg metformin hydrochloride

JANUMET® XR (Modified-Release) Tablets

• 50 mg sitagliptin / 500 mg metformin hydrochloride
• 50 mg sitagliptin / 1000 mg metformin hydrochloride
• 100 mg sitagliptin / 1000 mg metformin hydrochloride

How JANUMET® XR Works

Sitagliptin increases incretin hormone levels, stimulating insulin release in response to meals and reducing glucagon secretion. Metformin decreases hepatic glucose output and enhances peripheral glucose uptake. Together, these actions lower both fasting and post-prandial blood glucose levels.

The modified-release formulation enables once-daily dosing, helping maintain stable plasma concentrations and improving adherence.

Dosage and Administration

Route of administration: Oral.

Standard JANUMET® Tablets

Typically taken twice daily with meals to minimise gastrointestinal side effects.

JANUMET® XR Tablets

Taken once daily with the evening meal. Tablets must be swallowed whole and must not be crushed, broken or chewed.

Common Side Effects

• Gastrointestinal symptoms (nausea, diarrhoea, vomiting, abdominal discomfort)
• Hypoglycaemia (particularly when combined with insulin or sulfonylureas)
• Upper respiratory tract infections
• Headache
• Altered or metallic taste

Serious but Rare Adverse Effects

• Lactic acidosis: A rare but serious complication associated with metformin accumulation. Symptoms include muscle pain, breathing difficulties, abdominal pain, dizziness, and feeling cold.
• Pancreatitis: Severe abdominal pain with nausea and vomiting may indicate inflammation of the pancreas.

Seek urgent medical advice if symptoms suggestive of these conditions occur.

Drug Interactions and Precautions

• Insulin or sulfonylureas: Increased risk of hypoglycaemia.
• Diuretics: May influence renal function.
• Cationic medicines (e.g., cimetidine): May increase metformin exposure.
• Alcohol: Raises the risk of lactic acidosis.
• Iodinated contrast agents: Used in imaging procedures; may temporarily affect kidney function.

Kidney function should be assessed before starting therapy and monitored periodically. The MHRA provides further safety guidance on metformin-containing medicines.

Important Considerations

• Not indicated for type 1 diabetes or diabetic ketoacidosis.
• Caution in renal impairment.
• Limit alcohol intake during treatment.

Purchasing JANUMET® XR Online

JANUMET® XR is a prescription-only medicine. When purchasing online, ensure the pharmacy is appropriately regulated and requires a valid prescription.

You may review our shipping policy and visit the JANUMET® XR product page for further ordering information.

Cost-Saving Tips

• Compare pricing across reputable pharmacies.
• Check for manufacturer or pharmacy discount schemes.
• Sign up for newsletters for promotional offers.
• Ask your healthcare professional about available patient assistance programmes.

Further Information

For detailed prescribing information, consult the official JANUMET® Product Monograph.