From the Research
Janumet can potentially cause hyperkalemia, which is an elevated level of potassium in the blood, particularly in patients with underlying kidney issues or those taking medications that increase potassium levels, as supported by the most recent study on hyperkalemia management 1.
Causes and Risk Factors
Janumet is a combination medication containing sitagliptin (a DPP-4 inhibitor) and metformin (a biguanide) used to treat type 2 diabetes. The metformin component of Janumet is primarily responsible for this side effect. Metformin can affect kidney function in some patients, particularly those with underlying kidney issues, which may lead to reduced potassium excretion and subsequent hyperkalemia. This risk is higher in patients with renal impairment, those taking medications that increase potassium levels (like ACE inhibitors, ARBs, or potassium-sparing diuretics), and elderly patients.
Symptoms and Monitoring
Symptoms of hyperkalemia include muscle weakness, numbness, irregular heartbeat, and in severe cases, potentially life-threatening cardiac arrhythmias. Regular monitoring of potassium levels and kidney function is recommended for patients taking Janumet, especially those with risk factors for hyperkalemia. If you experience symptoms of hyperkalemia while taking Janumet, seek medical attention promptly. According to a study on the management of chronic hyperkalemia, monitoring and prevention are key elements for reducing the number of hospital admissions, morbidity, and mortality related to drug-induced hyperkalemia 1.
Treatment and Management
Treatment options for hyperkalemia have evolved, with new potassium binders, such as Patiromer Sorbitex Calcium and Sodium Zirconium Cyclosilicate, demonstrating clinical efficacy in reducing serum potassium with a good safety profile 1, 2. These newer agents may allow for the continuation and optimization of RAASi therapy in patients with hyperkalemia, maintaining the cardio-renal protective effect in patients with CKD and cardiovascular disease. However, further research is needed to address questions related to potassium disorders, including the definition of chronic hyperkalemia, monitoring strategies, and prediction scores for hyperkalemia 1.