Janumet XR® Extended-Release Tablets for Type 2 Diabetes Control

What Janumet XR® Is and How It Works

Janumet XR® combines sitagliptin, a DPP-4 inhibitor, with extended-release metformin. It is used with diet and exercise to improve blood sugar control in adults with type 2 diabetes. The sitagliptin component boosts incretin hormones, which increase insulin release and lower glucagon when glucose is high. Metformin decreases liver glucose production and improves insulin sensitivity. Together, they lower A1C and fasting and post-meal glucose with a low risk of hypoglycemia when used without insulin or sulfonylureas. Many patients choose Janumet XR to simplify therapy and manage costs compared with separate tablets.

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Janumet XR is an oral, once-daily extended-release tablet. Common strengths include 50/500 mg, 50/1000 mg, 100/500 mg, and 100/1000 mg (sitagliptin/metformin ER). Dosing is individualized based on current treatment, kidney function, and glycemic goals.

Dosage and Usage

• Take once daily with a meal to reduce stomach upset. Many patients take the dose with the evening meal.
• Swallow tablets whole. Do not split, crush, or chew extended-release tablets.
• Typical target provides sitagliptin 100 mg daily and metformin ER up to 2000 mg daily, as tolerated.
• If switching from metformin alone, match your current metformin ER dose and add sitagliptin up to 100 mg daily as prescribed.
• If switching from immediate-release Janumet, the XR version may allow once-daily dosing with the same total daily amounts.
• If you miss a dose, take it when remembered unless it is near the next dose. Skip the missed dose if close to the next dose and resume the regular schedule.
• Do not take two doses at the same time.
• You may notice an inert tablet shell in the stool. The medicine has already been released.

• Store at 20–25°C (68–77°F). Excursions 15–30°C (59–86°F) are acceptable.
• Keep tablets in the original, tightly closed container to protect from moisture.
• Do not store in a bathroom. Avoid heat, freezing, and direct sunlight.
• For travel, carry in your hand luggage with the pharmacy label. Keep dry and at room temperature.
• Use a pill organizer for short trips if needed, and carry a photo of the labeled bottle.

Benefits and Savings

Janumet XR can reduce A1C by about 1–2% from baseline when diet and exercise are maintained. The combination targets both fasting and post-meal glucose. Many people find gastrointestinal tolerability improves with extended-release metformin compared with immediate-release forms. Weight effects are generally neutral. The once-daily schedule can simplify therapy versus separate tablets.

Buying from a Canadian pharmacy can offer meaningful savings. Many customers save 60–80% versus typical US retail prices, especially on multi-month supplies. Ordering larger quantities may lower the per-month cost, and you can set gentle reminders to reorder before you run out.

For current offers, see our Janumet XR coupon page.

Side Effects and Safety

• Diarrhea, nausea, stomach upset, or gas
• Headache
• Upper respiratory symptoms (stuffy nose, sore throat)
• Reduced vitamin B12 levels with long-term metformin
• Metallic taste
• Mild hypoglycemia when used with insulin or sulfonylureas

Serious but rare risks include lactic acidosis (higher risk with significant kidney disease, dehydration, heavy alcohol use, or acute illness), pancreatitis, severe joint pain, allergic reactions including angioedema, and bullous pemphigoid. Stop the medication and seek urgent care for symptoms of lactic acidosis (fast breathing, severe fatigue, muscle pain), severe abdominal pain, or signs of a severe allergic reaction. Hypoglycemia risk increases when combined with insulin or sulfonylureas; dose adjustments of those agents may be needed.

Onset Time

Metformin’s glucose-lowering effect begins within a few days. Many people see improvements in fasting and post-meal readings within 1–2 weeks as the dose is titrated. A1C reflects an average over about three months, so the full effect is usually seen after 8–12 weeks on a stable regimen. Gastrointestinal side effects, if present, often lessen after the first 1–2 weeks as the body adjusts.

Compare With Alternatives

Immediate-release Janumet uses the same active ingredients but is typically taken twice daily with meals. Some patients prefer the XR version for once-daily convenience and smoother gastrointestinal tolerability.

Januvia® (sitagliptin alone) may suit those already controlled on metformin or who cannot take metformin. It offers modest A1C reduction and is weight neutral, with a low hypoglycemia risk when used without insulin or sulfonylureas.

Invokana® (canagliflozin) is an SGLT2 inhibitor that lowers glucose by increasing urinary glucose excretion. It can aid weight loss and offers cardiovascular and renal benefits in specific patients. It is often used with metformin and may be combined with DPP-4 inhibitors in select cases.

Combination Therapy

• With basal insulin: consider reducing insulin dose if glucose levels improve to lower hypoglycemia risk.
• With sulfonylureas: a lower sulfonylurea dose may be needed to avoid low blood sugar.
• With SGLT2 inhibitors: complementary mechanisms can improve A1C; monitor kidney function and volume status.
• With statins and antihypertensives: common for cardiovascular risk management in diabetes.

Patient Suitability and Cost-Saving Tips

Janumet XR is intended for adults with type 2 diabetes who need dual therapy with sitagliptin and metformin. It is not for type 1 diabetes or diabetic ketoacidosis. It is generally not recommended in severe kidney impairment (eGFR below 30 mL/min/1.73 m²) or in people with a history of lactic acidosis. Use caution with significant liver disease or heavy alcohol use. Report a history of pancreatitis or severe skin reactions.

Metformin may be paused around iodinated contrast procedures or certain surgeries and restarted when kidney function is stable. Periodic kidney function and B12 checks are often part of ongoing care. Discuss pregnancy or breastfeeding plans with a clinician.

To save more, consider a 90-day supply when appropriate, as multi-month orders may reduce the monthly price. You can enable friendly reorder reminders so you have time to renew your prescription and place your next order before running low.

Authoritative Sources

DailyMed search: Janumet XR prescribing information

Health Canada Drug Product Database

Merck (manufacturer) product information portal

Order Janumet XR® from YouDrugstore: add to cart, upload your prescription, and we ship with prompt, express delivery.

This page is for educational purposes and does not replace advice from your healthcare professional. Always follow your prescriber’s guidance and the dispensing pharmacist’s directions.