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Jardiance vs Janumet
Introduction
For patients diagnosed with type 2 diabetes, certain medications that alter the absorption and usage of glucose in the body can help manage blood sugar levels. Jardiance and Janumet are two such drugs prescribed for this condition. They each impact different processes in the body, but both are effective in controlling high blood sugar levels. Jardiance is a sodium-glucose co-transporter 2 (SGLT2) inhibitor which inhibits reabsorption of glucose by kidneys thereby promoting its excretion through urine. On the other hand, Janumet is a combination of two drugs: metformin and sitagliptin. Metformin decreases hepatic glucose production as well as intestinal absorption while improving insulin sensitivity by increasing peripheral glucose uptake and utilization; Sitagliptin works to regulate insulin production after meals by inhibiting DPP-4 enzyme which slows down digestion thus making you feel full longer.
Jardiance vs Janumet Side By Side
| Attribute | Jardiance | Janumet |
|---|---|---|
| Brand Name | Jardiance | Janumet |
| Contraindications | Should not be taken with drugs that stimulate insulin production such as glipizide or glyburide. Not recommended for patients with kidney disease or on dialysis. | Should not be taken with drugs that stimulate insulin production such as glipizide or glyburide. Regular monitoring by a doctor due to potential impact on kidney function. |
| Cost | $540 for 30 tablets of 10 mg | $480 for 60 tablets of 50 mg/1000mg |
| Generic Name | Empagliflozin | Sitagliptin/Metformin |
| Most Serious Side Effect | Diabetic ketoacidosis, dehydration symptoms like dizziness, faintness or lightheadedness due to low blood pressure | Pancreatitis, lactic acidosis |
| Severe Drug Interactions | Dangerous interactions with drugs that stimulate insulin production requiring a 48-hour clearance period. | Dangerous interactions with drugs that stimulate insulin production requiring a 48-hour clearance period. |
| Typical Dose | Starts at 10 mg/day, may be increased to 25 mg/day | 500 mg/50 mg twice daily, not to exceed 2000 mg/100mg per day |
What is Jardiance?
Empagliflozin (the generic name for Jardiance) is a drug from the SGLT2 inhibitors class of antidiabetic medications, which was an important advancement over earlier classes of diabetes medications. Empagliflozin was first approved by the FDA in 2014. It works by blocking a protein in the kidneys called SGLT2, effectively trapping glucose in the urine and preventing it from being reabsorbed into the bloodstream. This leads to lower blood sugar levels and can be used to treat type 2 diabetes mellitus.
On the other hand, Janumet combines two active ingredients: sitagliptin (a DPP-4 inhibitor) and metformin (a biguanide). These ingredients work together to control high blood sugar level in people with type 2 diabetes. Sitagliptin helps increase levels of insulin produced after meals and decreases amount of sugar made by your body while Metformin lowers glucose production and improves body's response to insulin.
Jardiance specifically targets renal absorption of glucose whereas Janumet has more systemic effects including on pancreas function as well as hepatic processes leading to its potential side effects.
What conditions is Jardiance approved to treat?
Jardiance has been approved to treat the following medical conditions:
- Type 2 diabetes as an adjunct to diet and exercise to improve glycemic control
- Reducing the risk of cardiovascular death in patients with type 2 diabetes and established cardiovascular disease.
In contrast, Janumet is used for:
- The management of blood sugar levels in adults with type 2 diabetes mellitus along with diet and physical activity.
It's important to understand that these medications work differently. Jardiance works by helping the kidneys get rid of glucose from your bloodstream, while Janumet combines two drugs - sitagliptin and metformin - which work together to lower blood sugar levels.
How does Jardiance help with these illnesses?
Jardiance helps to manage type 2 diabetes by enhancing the elimination of glucose from the body via urine. It does this by blocking a protein in the kidneys, sodium-glucose co-transporter 2 (SGLT2), which is responsible for reabsorbing most of the glucose filtered out of blood by the kidneys. By inhibiting SGLT2, Jardiance reduces reabsorption and promotes excretion of excess glucose through urine. This process lowers blood sugar levels without causing weight gain - common with some other diabetes medications. On top of that, it has been shown to reduce cardiovascular deaths in those with type 2 diabetes.
On the other hand, Janumet combines two active ingredients: sitagliptin and metformin. Sitagliptin works on increasing levels of natural substances called incretins which help to control blood sugar while Metformin decreases production and absorption of glucose in your liver and intestines respectively along with making your body more responsive towards insulin produced naturally.
Therefore when comparing both drugs one should consider their mode of action, potential side effects as well as individual health circumstances.
What is Janumet?
Janumet is a brand name for a combination of two drugs, sitagliptin and metformin. It works by both inhibiting the enzyme dipeptidyl peptidase 4 (DPP-4) and reducing hepatic glucose production while increasing insulin sensitivity. This dual mechanism makes it effective in controlling blood sugar levels in patients with Type 2 diabetes. Approved by the FDA in 2007, Janumet does not work like SGLT2 inhibitors such as Jardiance because it does not cause an increased excretion of glucose through urine.
The unique action on DPP-4 means its side-effect profile differs from that of SGLT2 inhibitors; notably, it doesn't increase the risk for urinary tract infections or genital mycotic infections which are common with medications like Jardiance. However, potential side effects can include gastrointestinal issues like diarrhea and nausea due to Metformin's influence on gut motility.
Its combined effect on DPP-4 inhibition and improved insulin sensitivity can be beneficial for managing type 2 diabetes, especially in patients who do not respond well to typical SGLT2 inhibitor medication such as Jardiance.
What conditions is Janumet approved to treat?
Janumet is approved for the treatment of:
- Type 2 diabetes mellitus. It's used alongside diet and exercise to improve blood sugar control in adults with type 2 diabetes.
Please note, Janumet contains two active ingredients - sitagliptin and metformin, which work together to lower glucose (sugar) levels in patients whose condition cannot be managed by diet and exercise alone.
How does Janumet help with these illnesses?
Janumet, like Jardiance, is a medication used to manage type 2 diabetes but it works differently within the body. Janumet is a combination drug that includes metformin and sitagliptin. Metformin reduces glucose production in the liver and enhances insulin sensitivity, thereby lowering blood sugar levels. Sitagliptin acts on incretin hormones which regulate glucose metabolism by increasing insulin secretion when blood sugar levels are high and reducing glucagon release from the liver.
The combined action of these two mechanisms helps manage blood sugar throughout the day, including after meals when spikes often occur. This dual approach may be beneficial for patients who struggle with their diet or have erratic meal patterns which can lead to unstable blood sugars.
In contrast to Jardiance's primary mode of action – promoting excretion of excess glucose through urine – Janumet focuses more on regulating how your body uses insulin and processes glucose internally; this could make it a suitable choice where kidney function might be compromised or fluid balance issues exist.
How effective are both Jardiance and Janumet?
Both empagliflozin (Jardiance) and sitagliptin/metformin (Janumet) are effective in the management of type 2 diabetes, but they work by different mechanisms and may be preferred under different scenarios. Empagliflozin is a sodium-glucose co-transporter 2 inhibitor that reduces glucose reabsorption in the kidneys, leading to increased glucose excretion through urine. On the other hand, Janumet combines two drugs: sitagliptin, which increases insulin production and decreases glucagon release; and metformin which decreases hepatic glucose production.
In clinical trials comparing both medications, it was shown that they have similar efficacy in reducing HbA1c levels – an indicator of long-term blood sugar control. However, empagliflozin has been associated with weight loss due to its mechanism of action while Janumet does not typically influence weight.
Moreover, a large-scale trial conducted on patients with cardiovascular disease revealed that empagliflozin reduced cardiovascular mortality rates significantly compared to placebo in addition to standard care for heart conditions - this could make Jardiance more suitable for diabetic patients who also suffer from heart conditions. Nonetheless, Janumet might still be preferred under certain circumstances such as when cost is a major consideration since it's less expensive than Jardiance or when there's renal impairment present considering its safety profile remains stable whereas Jardiance should not be started if GFR falls below 45 ml/min/1.73 m².
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At what dose is Jardiance typically prescribed?
Oral dosages of Jardiance typically start at 10 mg/day, but may be increased to 25 mg/day for treating type-2 diabetes in adults. It is not recommended for use in children or adolescents under the age of 18. On the other hand, Janumet dosage starts with one tablet twice a day along with meals (which can either be the 50mg/500mg or the 50mg/1000mg formulation), and should also only be used by adults over 18 years old. Depending on your response and tolerance to the medication, your doctor might increase your dose up until a maximum daily dose of two tablets of Janumet XR 100mg/1000mg per day. In both cases, follow-up adjustments should only be done based on efficacy and tolerability as determined by regular blood glucose level monitoring.
At what dose is Janumet typically prescribed?
Janumet treatment is typically initiated at a dosage of 500 mg/50 mg twice daily, taken with meals to reduce the risk of an upset stomach. The dose can then be increased as needed, based on blood glucose control. However, it should not exceed more than 2000 mg/100mg in total per day divided into two doses and spaced approximately 12 hours apart. This maximum dosage may be considered if there's no adequate response to lower dosages after several weeks. The patient's kidney function should also be assessed before starting Janumet and periodically thereafter.
What are the most common side effects for Jardiance?
Common side effects of Jardiance may include:
- Urinary tract infections
- Yeast infections in females and males
- Thirst due to increased urination
- Constipation, nausea, and stomach discomfort
- Increased cholesterol levels
On the other hand, Janumet can cause side effects like:
- Nausea, vomiting or diarrhea,
- Upper respiratory tract infection
- Weakness or physical weakness (asthenia)
- Gas (flatulence), indigestion
- Headache
It's important to remember that these medications work differently and therefore have different side effect profiles. Always discuss potential side effects with your healthcare provider before starting a new medication.
Are there any potential serious side effects for Jardiance?
While Jardiance and Janumet are both prescribed for the management of type 2 diabetes, they may have different side effects.
For example, a small percentage of people taking Jardiance may experience significant side effects such as:
- Dehydration symptoms like dizziness, faintness or lightheadedness due to low blood pressure
- Yeast infections in both men and women
- Urinary tract infections
- Increased cholesterol levels
In very rare cases, it can cause diabetic ketoacidosis (a condition that happens when your body doesn't produce enough insulin), which presents with symptoms like nausea, vomiting, stomach pain or tiredness.
On the other hand, users of Janumet could potentially face serious complications such as:
- Pancreatitis with symptoms ranging from severe stomach pain spreading to your back along with nausea and vomiting.
- Heart failure especially if you've had heart problems before.
Remember that lactic acidosis is also a rare but serious complication associated with Janumet use. It might result in weakness, slow heart rate, cold feeling in your extremities along with muscle pain.
Anytime these signs occur while on either medication immediately seek medical attention.
What are the most common side effects for Janumet?
Janumet, a combination medication used to control high blood sugar in patients with type 2 diabetes, can cause the following side effects:
-
Upset stomach or nausea
-
Diarrhea or constipation
-
Headache or weakness
-
Mild rash
-
Gas and bloating
-
Metallic taste in mouth In severe cases, it could also lead to:
-
Fast heart rate,
-
Lightheadedness,
-
Muscle pain or weakness,
-
Sleep problems. Remember that while Janumet is effective for controlling blood glucose levels, managing side-effects is part of the treatment process. Always report any concerns to your healthcare provider promptly.
Are there any potential serious side effects for Janumet?
Janumet, while generally well-tolerated, can in rare cases cause serious side effects. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Unusual muscle pain that is significant and persistent
- Feeling very weak or tired
- Trouble breathing
- Stomach pain with nausea and vomiting
- Slow or irregular heart rate
- A feeling similar to being extremely dizzy or about to pass out
If you notice any signs of these symptoms it's important to stop taking Janumet and contact your healthcare provider immediately. It's also critical to note that the use of Janumet needs regular monitoring by a doctor due its potential impact on kidney function.
Contraindications for Jardiance and Janumet?
Both Jardiance and Janumet, like most other diabetes medications, may cause potential side effects in some people. If you notice a significant increase in thirst or urination, unexplained weight loss, or persistent nausea/vomiting, please seek immediate medical attention.
Neither Jardiance nor Janumet should be taken if you are using drugs that stimulate insulin production such as glipizide or glyburide. Always tell your physician which medications you are taking; these diabetic medicines will require a period of about 48 hours to clear from the system to prevent dangerous interactions with Jardiance and Janumet.
In particular, if you have kidney disease or are on dialysis it is critical that your doctor knows before prescribing these therapies. Furthermore, both these drugs can lead to dehydration so make sure to consume adequate fluids while under medication.
How much do Jardiance and Janumet cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Jardiance (10 mg) averages around $540, which works out to roughly $18/day.
- The price for 60 tablets of Janumet (50 mg/1000mg) is about $480, working out to approximately $8/day.
Thus, if you are in the standard dosage range for Jardiance (i.e., 10 or 25 mg per day), then brand-name Janumet is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
It's important to mention that there are no generic alternatives available currently for either Jardiance or Janumet and therefore their costs can't be compared with those related to generics as we did with Wellbutrin and Prozac above:
- Bupropion (generic version of Wellbutrin; an antidepressant medication)
- Fluoxetine (generic version of Prozac; another type of antidepressant).
Again, your medical professional will determine the best drug option based upon your specific health situation rather than only considering costs.
Popularity of Jardiance and Janumet
Empagliflozin, commercially known as Jardiance, was prescribed to approximately 1.5 million people in the United States in 2020. This drug accounted for about 8% of prescriptions among SGLT2 inhibitors, a class of medications that lower blood sugar levels in patients with type 2 diabetes. The prevalence of empagliflozin has been generally increasing since its approval by the FDA in 2014.
On the other hand, Janumet—a combination of sitagliptin and metformin—was prescribed to around 3 million people in the US during the same period. In terms of overall antidiabetic prescriptions within the country, Janumet accounts for just under 10%. Despite newer classes of drugs entering into this therapeutic area (such as SGLT2 inhibitors like Jardiance), the use rate for Janumet has remained fairly consistent over recent years due to its proven effectiveness and safety profile.
Conclusion
Both Jardiance (empagliflozin) and Janumet (sitagliptin/metformin) are utilized in the management of type 2 diabetes, with extensive clinical trials showing their efficacy over placebo treatments. While these two medications can be used concomitantly, this should only be done under careful monitoring by a healthcare professional due to potential interactions. The difference in mechanisms of action between Jardiance, which works by blocking glucose reabsorption in the kidneys thereby promoting its excretion through urine, and Janumet, which combines sitagliptin's DPP-4 inhibitory effects that increase insulin secretion and decrease glucagon release with metformin's ability to suppress liver glucose production makes them suitable for different treatment scenarios.
Jardiance is often prescribed when diet and exercise alone do not provide adequate blood sugar control or as an adjunct therapy to other antidiabetic drugs including metformin. On the other hand, Janumet is typically considered when monotherapy with either sitagliptin or metformin does not achieve desired glycemic control.
Both medications have generic versions available offering cost benefits especially for patients paying out-of-pocket. Their therapeutic effects may take some time before becoming noticeable necessitating patience from patients during initial stages of treatment.
In terms of side effects profile, both Jardiance and Janumet are generally well-tolerated but carry distinct risks associated with their usage; while genital yeast infections are more common with Jardiance use due to increased urinary glucose levels creating favorable conditions for fungal growths; gastrointestinal issues like diarrhea can occur more frequently on starting Janumet because of the presence of Metformin. As always it is crucial that patients monitor their symptoms closely after initiation or adjustment of these medications' doses and seek immediate medical intervention if any adverse reactions develop.
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Refrences
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