| Diabetes Mellitus, Non-Insulin-Dependent
Janumet vs Segluromet
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Janumet vs Segluromet 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 signalsSegluromet has a higher rate of injection site reactions vs Janumet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Segluromet but not Janumet, including UnitedHealthcare
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Category
Janumet
Segluromet
At A Glance
Oral
Twice daily
DPP-4 inhibitor / biguanide combination
Oral
Twice daily
SGLT2 inhibitor/biguanide
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 Individualize starting dosage; take orally twice daily with meals; maximum recommended dosage is 7.5 mg ertugliflozin/1,000 mg metformin HCl per dose (15 mg/2,000 mg daily); not recommended if eGFR <45 mL/min/1.73 m2; contraindicated if eGFR <30 mL/min/1.73 m2, ESRD, or dialysis.
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
- Hypersensitivity to ertugliflozin, metformin, or any excipient in SEGLUROMET
- Severe renal impairment (eGFR less than 30 mL/min/1.73 m2), end stage-renal disease (ESRD), or dialysis
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
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 (>=2%) Female genital mycotic infections, male genital mycotic infections, urinary tract infections, headache, vaginal pruritus, increased urination, nasopharyngitis, back pain, weight decreased, thirst
Most common (>=5%, metformin) Diarrhea, nausea, vomiting, flatulence, abdominal discomfort, indigestion, asthenia, headache
Serious Lactic acidosis, diabetic ketoacidosis, lower limb amputation, volume depletion, urosepsis and pyelonephritis, hypoglycemia, Fournier's Gangrene, vitamin B12 deficiency
Postmarketing Necrotizing fasciitis of the perineum (Fournier's Gangrene), angioedema, rash (ertugliflozin); cholestatic, hepatocellular, and mixed hepatocellular liver injury (metformin)
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.
Ertugliflozin is an SGLT2 inhibitor that reduces renal glucose reabsorption and lowers the renal threshold for glucose, increasing urinary glucose excretion; metformin HCl is a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity.
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Most Common Insurance
Anthem BCBS
Janumet
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (9/12) · Qty limit (11/12)
Segluromet
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Janumet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Segluromet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (1/8)
Humana
Janumet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Segluromet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Janumet.
No savings programs available for Segluromet.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.