| Diabetes Mellitus, Non-Insulin-Dependent

Janumet XR vs Xultophy

Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.
Deep comparison between: Janumet vs Xultophy 100/3.6 with Prescriber.AI
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Safety signalsXultophy 100/3.6 has a higher rate of injection site reactions vs Janumet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xultophy 100/3.6 but not Janumet, including UnitedHealthcare
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Janumet
Xultophy 100/3.6
At A Glance
Oral
Once daily
DPP-4 inhibitor / biguanide
SC injection
Once daily
Basal insulin/GLP-1 receptor agonist combination
Indications
  • Diabetes Mellitus, Non-Insulin-Dependent
  • Diabetes Mellitus, Non-Insulin-Dependent
Dosing
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.
Diabetes Mellitus, Non-Insulin-Dependent Patients naive to basal insulin or GLP-1 receptor agonist: start 10 units SC once-daily; patients currently on basal insulin or GLP-1 receptor agonist: start 16 units SC once-daily (discontinue prior therapy first); titrate by 2 units once or twice weekly based on fasting plasma glucose; maximum 50 units/day.
Contraindications
  • 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
  • Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Episodes of hypoglycemia
  • Hypersensitivity to insulin degludec, liraglutide, or any excipient in Xultophy 100/3.6
Adverse Reactions
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
Most common (>=5%) Nasopharyngitis, headache, nausea, diarrhea, increased lipase, upper respiratory tract infection, hypoglycemia
Serious Thyroid C-cell tumors, acute pancreatitis, hypoglycemia, acute kidney injury, severe gastrointestinal reactions, hypersensitivity reactions including anaphylaxis, acute gallbladder disease, hypokalemia, pulmonary aspiration
Postmarketing Localized cutaneous amyloidosis, acute and necrotizing pancreatitis, hepatitis, cholecystitis, angioedema, anaphylactic reactions, medullary thyroid carcinoma, acute renal failure, alopecia
Pharmacology
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.
Xultophy 100/3.6 combines insulin degludec, a long-acting basal insulin analog that lowers blood glucose by stimulating peripheral glucose uptake and inhibiting hepatic glucose production, with liraglutide, a GLP-1 receptor agonist that increases glucose-dependent insulin release, decreases glucagon secretion, and slows gastric emptying.
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Most Common Insurance
Anthem BCBS
Janumet
  • Covered on 5 commercial plans
  • PA (0/12) · Step Therapy (9/12) · Qty limit (11/12)
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Xultophy 100/3.6
  • Covered on 5 commercial plans
  • PA (5/12) · Step Therapy (7/12) · Qty limit (9/12)
View full coverage details ›
UnitedHealthcare
Janumet
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
View full coverage details ›
Xultophy 100/3.6
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
View full coverage details ›
Humana
Janumet
  • Covered on 0 commercial plans
  • PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
View full coverage details ›
Xultophy 100/3.6
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Janumet.
No savings programs available for Xultophy 100/3.6.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.