| Diabetes Mellitus, Non-Insulin-Dependent
Janumet vs Trulicity
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Janumet vs Trulicity 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 signalsTrulicity has a higher rate of injection site reactions vs Janumet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trulicity but not Janumet, including UnitedHealthcare
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Category
Janumet
Trulicity
At A Glance
Oral
Twice daily
DPP-4 inhibitor / biguanide combination
SC injection
Once weekly
GLP-1 receptor agonist
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 (Adults) Starting dose 0.75 mg SC once weekly; may increase to 1.5 mg after 4 weeks; further increases in 1.5 mg increments after at least 4 weeks on current dose; maximum 4.5 mg SC once weekly.
Diabetes Mellitus, Non-Insulin-Dependent (Pediatric, >=10 years) Starting dose 0.75 mg SC once weekly; if additional glycemic control needed, increase to maximum 1.5 mg SC once weekly after at least 4 weeks.
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
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Serious hypersensitivity reaction to dulaglutide or any product component
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%) Nausea, diarrhea, vomiting, abdominal pain, decreased appetite, dyspepsia, fatigue
Serious Thyroid C-cell tumors, acute pancreatitis, hypoglycemia (with insulin secretagogues or insulin), hypersensitivity reactions, acute kidney injury, severe gastrointestinal reactions, diabetic retinopathy complications, acute gallbladder disease, pulmonary aspiration
Postmarketing Hemorrhagic and necrotizing pancreatitis, ileus, intestinal obstruction, severe constipation, cholecystitis, cholelithiasis, cholestasis, elevated liver enzymes, hepatitis, anaphylactic reactions, angioedema, dysgeusia, dysesthesia, acute renal failure, alopecia
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.
Dulaglutide is a human GLP-1 receptor agonist with 90% amino acid sequence homology to endogenous human GLP-1 (7-37) that activates the GLP-1 receptor in pancreatic beta cells, stimulating glucose-dependent insulin release, decreasing glucagon secretion, and slowing gastric emptying.
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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)
Trulicity
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
UnitedHealthcare
Janumet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Trulicity
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Janumet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Trulicity
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Janumet.
$25/momo
Trulicity Savings CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.