| Diabetes Mellitus, Non-Insulin-Dependent
Cycloset vs Janumet XR
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Cycloset vs Janumet with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsJanumet has a higher rate of injection site reactions vs Cycloset based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Janumet but not Cycloset, including UnitedHealthcare
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Category
Cycloset
Janumet
At A Glance
Oral
Daily
Dopamine D2 receptor agonist
Oral
Once daily
DPP-4 inhibitor / biguanide
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Diabetes Mellitus, Non-Insulin-Dependent 1.6 mg to 4.8 mg once daily within 2 hours after waking in the morning with food; initiate at 0.8 mg, increase by one tablet per week to maximal tolerated dose; limit to 1.6 mg daily with moderate CYP3A4 inhibitors; avoid with strong CYP3A4 inhibitors.
Diabetes Mellitus, Non-Insulin-Dependent Take once daily with a meal; recommended starting dose is 100 mg sitagliptin and 1000 mg metformin HCl extended-release once daily; maximum daily dose is 100 mg sitagliptin and 2000 mg metformin HCl; dose of sitagliptin component limited to 50 mg once daily if eGFR falls below 45 mL/min/1.73 m2; do not split, crush, or chew tablets.
Contraindications
- Known hypersensitivity to bromocriptine, ergot-related drugs, or any excipient in CYCLOSET
- Syncopal migraine
- Postpartum patients
- Lactating patients
- Severe renal impairment (eGFR below 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- History of a serious hypersensitivity reaction to JANUMET XR, sitagliptin, or metformin, such as anaphylaxis or angioedema
Adverse Reactions
Most common (>=5%) Nausea, fatigue, vomiting, headache, dizziness, rhinitis, constipation, sinusitis, diarrhea, asthenia, somnolence, dyspepsia, amblyopia, anorexia
Serious Hypotension, psychotic disorders, somnolence, syncope, fibrotic-related complications, cardiovascular events (myocardial infarction, stroke)
Postmarketing Hallucinations, retroperitoneal fibrosis, pulmonary fibrosis, pleural effusion, pericarditis, pericardial effusions, cardiac valvulopathy, psychotic and psychiatric disorders, impulse control/compulsive behaviors, neuroleptic-like malignant syndrome
Most common (>=5%) Diarrhea, upper respiratory tract infection, headache (from sitagliptin and metformin coadministration studies); nasopharyngitis (sitagliptin monotherapy); hypoglycemia, diarrhea, nausea (extended-release metformin added to glyburide)
Serious Lactic acidosis, pancreatitis, heart failure, acute renal failure, vitamin B12 deficiency, hypoglycemia with insulin or insulin secretagogues, hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid
Postmarketing Anaphylaxis, angioedema, rash, urticaria, cutaneous vasculitis, Stevens-Johnson syndrome, hepatic enzyme elevations, fatal and non-fatal hemorrhagic and necrotizing pancreatitis, worsening renal function including acute renal failure, tubulointerstitial nephritis, severe and disabling arthralgia, bullous pemphigoid, constipation, vomiting, myalgia, rhabdomyolysis, cholestatic and hepatocellular liver injury
Pharmacology
CYCLOSET (bromocriptine mesylate) is a sympatholytic dopamine D2 receptor agonist; timed morning administration in type 2 diabetes is associated with increased insulin sensitivity and glucose disposal and reduced fasting and postprandial hyperglycemia without raising plasma insulin levels.
JANUMET XR combines sitagliptin, a selective DPP-4 inhibitor that slows inactivation of incretin hormones (GLP-1 and GIP) to increase insulin release and decrease glucagon in a glucose-dependent manner, and metformin, a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity without altering insulin secretion.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Cycloset
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (2/12) · Qty limit (6/12)
Janumet
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Cycloset
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Janumet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Cycloset
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (2/3) · Qty limit (2/3)
Janumet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Cycloset.
No savings programs available for Janumet.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.