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Janumet alternatives: What can I take instead of Janumet?

Janumet doesn't work for everyone. Jardiance, Rybelsus, Glipizide, Xigduo XR, and Steglujan are some Janumet alternatives. Get the full list here.
Rx pill bottles: What can I take instead of Janumet?

Key takeaways

  • Janumet alternatives include Jardiance, Rybelsus, Glipizide, Xigduo XR, and Steglujan, among others, for the treatment of Type 2 diabetes mellitus, offering different mechanisms of action and potential benefits.

  • Metformin is often the first choice in treating Type 2 diabetes due to its effectiveness in glucose control without causing weight gain or hypoglycemia, with extended-release versions available to minimize gastrointestinal side effects.

  • GLP-1 agonists (e.g., Rybelsus) and SGLT2 inhibitors (e.g., Jardiance) are newer drug classes favored for their efficacy and additional health benefits, though they may come at a higher cost and risk of side effects such as genital yeast infections.

  • Natural alternatives for managing Type 2 diabetes include lifestyle changes like a low carbohydrate diet, regular exercise, weight loss, and possibly dietary supplements, but these should be discussed with a healthcare provider to ensure safety and efficacy.

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 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 their 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.

Compare Janumet alternatives

Drug name Uses Dosage Coupons
Janumet (sitagliptin/metformin) Type 2 diabetes mellitus 50 mg/500 mg to 50 mg/1000 mg twice daily Janumet coupons
Janumet XR (sitagliptin/metformin extended-release) Type 2 diabetes mellitus 100 mg/1000 mg once daily to 50 mg/1000 mg twice daily Janumet XR coupons
Metformin Type 2 diabetes mellitus, polycystic ovarian syndrome (off-label) 500-1000 mg twice daily Metformin coupons
Januvia (sitagliptin) Type 2 diabetes mellitus 100 mg once daily Januvia coupons
Steglujan (ertugliflozin/sitagliptin) Type 2 diabetes mellitus 5 mg/100 mg to 15 mg/100 mg once daily Steglujan coupons
Xigduo XR (dapagliflozin/metformin extended-release [ER]) Type 2 diabetes mellitus 1-2 tablets every morning (2.5-10 mg of dapagliflozin with 500-1000 mg of extended-release metformin per tablet) Xigduo XR coupons
Trulicity (dulaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease or multiple risk factors 0.75-4.5 mg subcutaneous (under the skin) injection once weekly Trulicity coupons
Ozempic (semaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease 0.5-1 mg subcutaneous injection once weekly Ozempic coupons
Rybelsus (semaglutide) Type 2 diabetes mellitus 7-14 mg once daily Rybelsus coupons
Victoza (liraglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease 1.2-1.8 mg subcutaneous injection once daily Victoza coupons
Mounjaro (tirzepatide) Type 2 diabetes mellitus 5-15 mg subcutaneous injection once weekly Mounjaro coupons
Farxiga (dapagliflozin) Type 2 diabetes mellitus, heart failure risk reduction in Type 2 diabetes mellitus with heart disease or multiple cardiovascular risk factors, heart failure risk reduction in those with reduced cardiac ejection fractions, heart failure and kidney disease progression risk reduction in those with chronic renal disease 5-10 mg once daily Farxiga coupons
Jardiance (empagliflozin) Type 2 diabetes mellitus, cardiovascular event risk reduction in Type 2 diabetes mellitus, heart failure risk reduction in those with reduced cardiac ejection fractions 10-25 mg once daily Jardiance coupons
Invokana (canagliflozin) Type 2 diabetes mellitus, cardiovascular event risk reduction in Type 2 diabetes mellitus with cardiovascular disease, kidney disease progression risk reduction and cardiovascular event risk reduction in those with Type 2 diabetes mellitus and nephropathy and albuminuria >300 mg/day 100-300 mg once daily Invokana coupons
Glipizide Type 2 diabetes mellitus 2.5-20 mg twice daily Glipizide coupons
Lantus Solostar (insulin glargine) Type 2 diabetes mellitus, Type 1 diabetes mellitus Individualized dose injected subcutaneously once daily Lantus Solostar coupons

Other alternatives to Janumet

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 congestive 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:  Janumet vs. JardianceJardiance 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 result 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 an 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, an 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.