What is the prevalence of angioedema with the use of Janumet (Sitagliptin and Metformin)?

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Last updated: April 26, 2025 • View editorial policy

From the Research

Angioedema is a rare but serious side effect of Janumet, with a reported prevalence of approximately 0.1% to 0.3% among patients taking the medication, as supported by the most recent study 1. The mechanism of angioedema associated with Janumet is thought to be related to the sitagliptin component, which belongs to the DPP-4 inhibitor class of diabetes medications.

  • Angioedema typically presents as swelling of the face, lips, tongue, throat, or extremities and can occur at any time during treatment, though it's more common within the first few months of starting the medication.
  • The accumulation of bradykinin due to DPP-4 inhibition increases vascular permeability, leading to angioedema.
  • Patients with a history of angioedema or those taking ACE inhibitors concurrently may have a higher risk, as noted in studies 2, 3.
  • If a patient experiences symptoms of angioedema while taking Janumet, they should seek immediate medical attention and discontinue the medication, as recommended by experts 4, 5.
  • Healthcare providers should consider alternative diabetes medications for patients who have experienced angioedema with Janumet or other DPP-4 inhibitors. Key considerations for managing angioedema include securing the airway and administering pharmacologic interventions based on disease pathology, as outlined in recent reviews 3. Overall, while the exact prevalence of angioedema with Janumet may vary, the most recent and highest quality study 1 suggests that it is a rare but serious side effect that requires prompt medical attention and consideration of alternative treatments.

References

Research

Angioedema.

Critical care medicine, 2017

Research

A consensus parameter for the evaluation and management of angioedema in the emergency department.

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014

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