Dosing







Dosage forms and strengths1*
The dose of antihyperglycaemic therapy with Janumet should be individualised on the basis of the patient’s current regimen, effectiveness, and tolerability while not exceeding the maximum recommended daily dose of 100 mg sitagliptin. 		Janumet logo
JANUMET 50 mg/1000 mgOne tablet, twice daily50 mg sitagliptin 1000 mg metformin HCI
JANUMET 50 mg/850 mg
One tablet, twice daily50 mg sitagliptin 850 mg metformin HCI
*Please see Janumet SPC for Renal Impairment Dosing1







Dosage forms and strengths2*
When used in combination with metformin and/or a PPARγagonist, the dose of metformin and/or PPARγ agonist should be maintained, and Januvia administered concomitantly.
When Januvia is used in combination with a sulphonylurea or with insulin, a lower dose of the sulphonylurea or insulin may be considered to reduce the risk of hypoglycaemia.
If a dose of Januvia is missed, it should be taken as soon as the patient remembers. A double dose should not be taken on the same day.		Januvia logo
JANUVIA 100 mgOne tablet, once dailyNo dose adjustment is required
for patients with GFR ≥ 45
JANUVIA 50 mgOne tablet, once dailyGFR ≥ 30 to < 45 ml/min
JANUVIA 25 mgOne tablet, once dailyGFR <30 ml/min including End Stage Renal Disease
*Please see Januvia SPC for Renal Impairment Dosing 2
  • Januvia and Janumet should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.
  • Use of DPP-4 inhibitors has been associated with a risk of developing acute pancreatitis. If pancreatitis is suspected, Januvia or Janumet should be discontinued; if confirmed, Januvia or Janumet should not be restarted. Caution should be exercised in patients with a history of pancreatitis. Resolution of pancreatitis has been observed after discontinuation of sitagliptin, but very rare cases of necrotising or haemorrhagic pancreatitis and/or death have been reported.
  • Hypoglycaemia has been observed when sitagliptin was used in combination with insulin or a sulphonylurea. Therefore, to reduce the risk of hypoglycaemia, a lower dose of sulphonylurea or insulin may be considered.
  • For Januvia only – Renal Impairment: Lower dosages are recommended in patients with GFR < 45 mL/min, as well as in ESRD patients requiring haemodialysis or peritoneal dialysis.
  • Janumet is contraindicated in patients with GFR < 30mL/min and should be temporarily discontinued during conditions with the potential to alter renal function.
  1. Summary of Product Characteristics, Janumet
    Janumet https://www.medicines.ie/medicines/list/all/ page-1/per-page-25?query=janumet. 
    Date of Revision of Text: September 2021.
  2. Summary of Product Characteristics, Januvia
    Januvia https://www.medicines.ie/medicines/list/all/ page-1/per-page-25?query=januvia.
    Date of Revision of Text: September 2021.