| Diabetes Mellitus, Non-Insulin-Dependent
Janumet 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
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.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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Category
Janumet
Xultophy 100/3.6
At A Glance
Oral
Twice daily
DPP-4 inhibitor / biguanide combination
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 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 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, 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, 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, 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
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.
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 (1/12) · Step Therapy (9/12) · Qty limit (11/12)
Xultophy 100/3.6
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (7/12) · Qty limit (9/12)
UnitedHealthcare
Janumet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Xultophy 100/3.6
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Janumet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Xultophy 100/3.6
- 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 Xultophy 100/3.6.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.