From the Guidelines
Yes, Janumet (sitagliptin/metformin) and Jardiance (empagliflozin) can be taken together for diabetes management, as they work through different mechanisms and can provide complementary effects on glycemic control. This combination therapy is sometimes prescribed when a patient's blood glucose remains inadequately controlled on either medication alone. Janumet works by increasing insulin production and decreasing glucose production in the liver, while Jardiance works by helping the kidneys remove glucose from the bloodstream through urine. The typical dosage for Janumet is 50/500 mg or 50/1000 mg twice daily, while Jardiance is usually taken as a 10 mg or 25 mg tablet once daily 1.
When taking these medications together, it's essential to monitor for side effects such as low blood sugar, urinary tract infections, genital yeast infections, and dehydration. Patients should maintain adequate hydration and follow their healthcare provider's instructions regarding timing of doses, meal planning, and blood glucose monitoring. The American Diabetes Association recommends a patient-centered approach to choosing pharmacologic treatment, considering factors such as efficacy, comorbidities, hypoglycemia risk, effects on body weight, side effects, cost, and patient preferences 1.
Key considerations for this combination therapy include:
- Monitoring renal function, as both medications can affect kidney function
- Adjusting dosages based on individual response and kidney function
- Providing patient education on recognizing and managing potential side effects, such as diabetic ketoacidosis and acute kidney injury
- Regularly monitoring vitamin B12 levels, as metformin may lower serum vitamin B12 concentration 1.
Overall, the combination of Janumet and Jardiance can be an effective treatment strategy for patients with type 2 diabetes, but it requires careful monitoring and individualized care to minimize potential risks and optimize benefits.
From the Research
Combination Therapy for Type 2 Diabetes
- The combination of Janumet (sitagliptin and metformin) and Jardiance (empagliflozin) for the treatment of type 2 diabetes has been studied in various clinical trials 2, 3, 4.
- Janumet is a combination product suitable for use in patients with type 2 diabetes, and it has been shown to be safe and effective in improving glycemic control 2.
- Empagliflozin, on the other hand, is a sodium glucose cotransporter 2 (SGLT2) inhibitor that has been shown to be effective in reducing HbA1c, fasting plasma glucose, and body weight in patients with type 2 diabetes 4.
- The combination of empagliflozin and metformin has been studied, and it has been shown to be well tolerated and effective in reducing HbA1c, fasting plasma glucose, and body weight in patients with type 2 diabetes inadequately controlled on metformin monotherapy 4.
Safety and Efficacy
- The safety and efficacy of the combination of Janumet and Jardiance have not been directly studied in clinical trials.
- However, the individual components of the combination have been studied, and they have been shown to be safe and effective in improving glycemic control in patients with type 2 diabetes 5, 6, 2, 3, 4.
- The most common adverse events associated with empagliflozin are urinary tract infections, pollakiuria, and genital infections 5, 6, 4.
- The most common adverse events associated with sitagliptin and metformin are gastrointestinal symptoms, such as diarrhea, nausea, and vomiting 2, 3.
Clinical Use
- The combination of Janumet and Jardiance may be considered for use in patients with type 2 diabetes who are not adequately controlled on metformin or sitagliptin alone 2, 3, 4.
- However, the decision to use this combination should be based on individual patient needs and medical history, and it should be made under the guidance of a healthcare professional 5, 6, 2, 3, 4.