Janumet alternatives: What can I take instead of Janumet?

Compare Janumet alternatives | Jardiance | Rybelsus | Glipizide | Xigduo XR | Steglujan | Natural alternatives | How to switch meds

Effectively treating Type 2 diabetes mellitus often requires multiple medications, and Janumet (sitagliptin/metformin) is a combination product that can reduce your pill and copay burden. The convenience comes with some negative trade offs though, that may have you looking for a different approach. Janumet contains sitagliptin, a pricey dipeptidyl peptidase-4 (DPP-4) inhibitor that has no available generic, and a metformin, a biguanide that is notorious for causing diarrhea. If you are experiencing either an adverse effect on your bowel or your wallet, you should read on to discover what other options exist.

RELATED: Janumet side effects and how to avoid them

What can I take in place of Janumet?

Metformin is typically the first agent chosen to treat Type 2 diabetes mellitus. The potential to slow the progression of diabetes and avoid weight gain and hypoglycemia (low blood sugar) makes a strong argument for its use in most cases. Extended or slow-release metformin products can help to avoid the diarrhea side effect that afflicts many users.

Unfortunately, metformin’s effectiveness may not be enough to meet your goals for glucose control, and at that point, a host of options exists to add to it. The DPP-4 inhibitor Januvia (sitagliptin) may be chosen based on the low risk of hypoglycemia and low incidence of side effects in general. By bringing metformin and sitagliptin together in one pill, Janumet offers you a cost and convenience advantage. Your insurance formulary may favor a different DPP-4 inhibitor, such as Tradjenta, Onglyza, or Nesina, all of which are also available in combination tablets with metformin (Jentadueto, Kombiglyze XR, and Kazano, respectively).

Treatment options for Type 2 diabetes abound, so if DPP-4 inhibitors are not meeting your needs, you have plenty of other drug classes to choose from. Glucagon-like peptide-1 (GLP-1) agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors are relatively new categories that are often favored due to strong efficacy and additional benefits. Mounjaro is a novel agent that acts as an agonist to both the GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. Older and cheaper categories of diabetes medications include the sulfonylurea, alpha-glucosidase inhibitor, and thiazolidinedione classes, each still having a role in certain circumstances. Finally, the many forms of insulin can be a reliable choice, albeit one that is usually selected when others have failed. You will certainly want to know more specifics when comparing your options.

Other alternatives to Janumet

• Byetta (exenatide)
• Bydureon Bcise (exenatide)
• Adlyxin (lixisenatide)
• Qtern (dapagliflozin/saxagliptin)
• Invokamet (canagliflozin/metformin)
• Invokamet ER (canagliflozin/metformin ER)
• Synjardy (empagliflozin/metformin)
• Synjardy XR (empagliflozin/metformin ER)
• Glyxambi (empagliflozin/linagliptin)
• Trijardy XR (empagliflozin/linagliptin/metformin ER)
• Steglatro (ertugliflozin)
• Amaryl (glimepiride)
• Glucotrol XR (glipizide extended release)
• Glipizide/metformin
• Glyburide
• Glyburide/metformin
• Repaglinide
• Repaglinide/metformin
• Metformin ER
• Tradjenta (linagliptan)
• Nesina (alogliptan)
• Kazano (alogliptin/metformin)
• Oseni (alogliptin/pioglitazone)
• Onglyza (saxagliptan)
• Nateglinide
• Symlin (pramlintide)
• Precose (acarbose)
• Jentadueto (linagliptin/metformin)
• Jentadueto XR (linagliptin/metformin ER)
• Actos (pioglitazone)
• Actoplus Met (pioglitazone/metformin)
• Duetact (pioglitazone/glimepiride)
• Kombiglyze XR (saxagliptin/metformin ER)
• Miglitol
• Basaglar Kwikpen (insulin glargine)
• Soliqua (insulin glargine/lixisenatide)
• Levemir Flextouch (insulin detemir)
• Tresiba (insulin degludec)
• Xultophy (insulin degludec/liraglutide)
• Humalog Kwikpen (insulin lispro)
• Humalog Mix 50/50 (insulin lispro protamine/insulin lispro)
• Humalog Mix 75/25 (insulin lispro protamine/insulin lispro)
• Novolog Flexpen (insulin aspart)
• Novolog Mix 70/30 Flexpen (insulin aspart protamine/insulin aspart)
• Novolin N (insulin NPH)
• Novolin R (insulin regular)
• Novolin 70/30 (insulin NPH/insulin regular)
• Humulin N (insulin NPH)
• Humulin R (insulin regular)
• Humulin 70/30 (insulin NPH/insulin regular)

Top 5 Janumet alternatives

The following are some of the most common alternatives to Janumet.

1. Jardiance

Jardiance is a SGLT2 inhibitor, in the same class as Farxiga, Steglatro, and Invokana. Their mechanism of action sets them up for additional benefits, besides just lowering blood sugar levels. By inhibiting SGLT2 in the kidney, these drugs cause sugar and water to be eliminated from the body. This diuretic action can help to lower blood pressure and assist in the management of congestion heart failure. Jardiance can even reduce the risk of cardiovascular morbidity and mortality in individuals with Type 2 diabetes and a high cardiovascular risk. Likewise, Farxiga has an additional indication from the Food and Drug Administration (FDA) for reducing the risk of kidney disease progression in chronic renal disease. The advantages of SGLT2 inhibitors come at a premium price and with a risk of genital yeast infections and urinary tract infections. These factors might have you looking elsewhere

RELATED: Jardiance side effects and how to avoid them

2. Rybelsus

A GLP-1 agonist could be an intriguing option for you. GLP-1 action results in the release of more insulin and less glucagon hormone after meals, both of which results in lower blood sugar. It even slows your stomach down, allowing you to feel full after eating less. As a result, GLP-1 agonists produce more profound glucose lowering than DPP-4 inhibitors and yet still have a low risk of hypoglycemia. GLP-1 agonists can often assist with weight loss, a nice feature considering that obesity is associated with Type 2 diabetes. Trulicity, Victoza, and Ozempic are class members with FDA approval for use in reducing the rate of cardiovascular events, like heart attack and stroke, for those with both Type 2 diabetes and cardiovascular disease or multiple risk factors for cardiovascular disease. Although Rybelsus does not have that particular FDA indication, it has a different advantage over the other GLP-1 agonists. It is the only one available as a once-daily oral pill, rather than a daily or weekly injection. Nonetheless, all members of the class carry a significant expense, which could be enough of a concern to pass on them.

3. Glipizide

Cost concerns with brand-name diabetic drugs are a primary reason why inexpensive sulfonylureas like glipizide still have an important role in treating Type 2 diabetes mellitus. Like its fellow sulfonylurea agents glimepiride and glyburide, glipizide stimulates the pancreas to make more insulin. The higher insulin levels lower blood glucose levels effectively but with significant risk of hypoglycemia. Sulfonylureas can also contribute to weight gain. The lack of additional cardiac indications may also dissuade you from glipizide. If cost is the primary motivation in looking for an alternative to Janumet, present a SingleCare discount card at your local pharmacy to see how you can save money on your diabetic prescriptions.

RELATED: Glipizide side effects and how to avoid them

4. Xigduo XR

One option for saving on the expense of your medications is to ask about combination drugs. This may be why you ended up on Janumet. You can still get the convenience of a combo pill but with the unique advantages of an SGLT2 inhibitor. Xigduo XR brings together dapagliflozin, the active ingredient in Farxiga, with extended-release metformin. It provides the renal, cardiac, and blood pressure advantages of a SGLT2 inhibitor, along with the potential urinary adverse effects. Although you may be paying one copay for the combination product Xigduo XR instead of two copays for the separate components, it may still be a steep one.

5. Steglujan

Metformin could be the source of your concern with Janumet. The diarrhea and stomach upset can be intolerable, even when using Janumet XR with extended-release metformin. If this is the case, you have the option of sticking with sitagliptin, ditching the metformin, and still having the convenience of a once-daily pill. Steglujan combines ertuglifozin, a SGT2 inhibitor, with sitagliptin, the DPP-4 inhibitor in Janumet. You probably won’t save money compared to Janumet, but you will avoid metformin’s side effects.

Natural alternatives to Janumet

The realization that every treatment option has particular disadvantages can be discouraging. No wonder there is substantial interest in natural alternatives. To start with, a low carbohydrate diet, regular exercise, and weight loss can put you well along toward meeting your diabetic treatment goals. Dietary supplements could play a supporting role too. Cinnamon and dietary fiber have proven efficacy in Type 2 diabetes. Berberine is a plant-based compound used for diabetes with the backing of small studies. Turmeric’s key component curcumin has shown promise in animal studies but awaits quality clinical trials in humans. Before trying any of these measures, you should present your ideas to your healthcare provider to see if they would be safe and discuss whether natural alternatives should add to rather than substitute for your prescription medicines.

RELATED: What’s the best diabetes diet?

How to switch to a Janumet alternative

At this point, having gathered information on options if you were to change from Janumet, it is typically best to set up an appointment with the prescribing healthcare professional. You are now prepared to go over the list of alternatives that make the most sense to you and then hear the medical advice of your provider. In addition, the two of you can review your medical history and current over-the-counter and prescription drugs to see if any contraindications or drug interactions might factor into the decision. Making a well-informed decision is a great goal for the meeting.