| Diabetes Mellitus, Non-Insulin-Dependent

Janumet vs Lyumjev

Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.

Deep comparison between: Janumet vs Lyumjev with Prescriber.AI

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Safety signalsLyumjev has a higher rate of injection site reactions vs Janumet based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Lyumjev but not Janumet, including UnitedHealthcare

Category

Janumet

Lyumjev

At A Glance

RouteOral

FrequencyTwice daily

ClassDPP-4 inhibitor / biguanide combination

RouteSC injection

FrequencyWith each meal

ClassRapid-acting insulin analog

Indications

Diabetes Mellitus, Non-Insulin-Dependent

Diabetes Mellitus, Non-Insulin-Dependent

Dosing

Diabetes Mellitus, Non-Insulin-Dependent 50 mg sitagliptin/500 mg metformin HCl twice daily with meals as starting dose for patients not on metformin; for patients on metformin HCl 850 mg twice daily, start at 50 mg sitagliptin/1000 mg metformin HCl twice daily; max 100 mg sitagliptin/2000 mg metformin HCl daily; do not split or divide tablets.

Diabetes Mellitus, Non-Insulin-Dependent Administer U-100 or U-200 SC at meal start or within 20 minutes after starting a meal into abdomen, upper arm, thigh, or buttocks; U-100 also available via CSII insulin pump or IV infusion (under medical supervision, diluted to 1 unit/mL); individualize dose based on metabolic needs and glucose monitoring.

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, sitagliptin, or metformin, such as anaphylaxis or angioedema

Episodes of hypoglycemia
Hypersensitivity to insulin lispro-aabc or any excipient in LYUMJEV

Drug Interactions

2382View drug interactions

375View drug interactions

Adverse Reactions

Most common (>=5%) Diarrhea, upper respiratory tract infection, headache, nasopharyngitis, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia

Serious Lactic acidosis, pancreatitis, heart failure, acute renal failure, hypoglycemia (with sulfonylurea or insulin), 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, acute renal failure, tubulointerstitial nephritis, rhabdomyolysis, constipation, myalgia, back pain, pruritus, mouth ulceration, cholestatic and hepatocellular liver injury

Most common (>=5%) Nasopharyngitis, upper respiratory tract infection, infusion site reaction, infusion site pain

Serious Hypoglycemia (including severe), severe hypersensitivity reactions (anaphylaxis, angioedema, bronchospasm, hypotension, shock)

Postmarketing Localized cutaneous amyloidosis at injection site, hyperglycemia or hypoglycemia associated with injection into areas of localized cutaneous amyloidosis

Pharmacology

Sitagliptin is a DPP-4 inhibitor that slows inactivation of incretin hormones GLP-1 and GIP, increasing insulin release and decreasing glucagon in a glucose-dependent manner; metformin is a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity by increasing glucose uptake and utilization.

Rapid-acting human insulin analog that binds insulin receptors to stimulate peripheral glucose uptake in skeletal muscle and fat and inhibit hepatic glucose production, while also inhibiting lipolysis and proteolysis and enhancing protein synthesis.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Janumet