Sitagliptin/Metformin

1. Introduction to Sitagliptin/Metformin: A Dual Diabetes Therapy

The combination of Sitagliptin (a DPP-4 inhibitor) and Metformin (a biguanide) is a synergistic treatment for type 2 diabetes. This fixed-dose combination (FDC) targets both insulin resistance and insulin secretion, providing comprehensive glycemic control.

Key Benefits:

• Reduces A1C levels more effectively than monotherapy.
• Low risk of hypoglycemia compared to sulfonylureas.
• Available as a single tablet for convenience.

👉 Compare Metformin and Sitagliptin separately.

2. Active Ingredients: Chemistry and Mechanism

• Sitagliptin (化学式: C19H21N5O2S·H3PO4·H2O): Inhibits DPP-4 to boost incretin hormones (GLP-1 and GIP), enhancing insulin secretion.
• Metformin (化学式: C4H11N5·HCl): Reduces liver glucose production and improves insulin sensitivity.

Synergy:

• Sitagliptin addresses post-meal insulin deficiency.
• Metformin targets hepatic glucose overproduction.

🔗 FDA Sitagliptin Monograph

3. Buying Sitagliptin/Metformin in the USA

In the U.S., the combination is available as:

• Brand: Janumet (Merck, founded 1891).
• Generic: Starts at $150/month (varies by dosage).

Steps to Purchase:

1. Obtain a prescription from a healthcare provider.
2. Compare prices via GoodRx or Mint Health .
3. Use 90-day supplies for cost savings.

👉 Explore Glibenclamide/Metformin for sulfonylurea-based alternatives.

4. UK and NHS: Availability and Costs

The NHS covers Sitagliptin/Metformin FDCs. Prices:

• Generic: £120–£180/month .
• Janumet: £200–£300/month .

Important Notes:

• Prescriptions are valid for 2 years.
• Switching between brands may require a new prescription.

🔗 NHS Diabetes Medication Guide

5. Australia: PBS-Subsidized Options

Under Australia’s PBS, the combination costs $6.50/month for generics. Brand versions like Janumet are available but cost more. A prescription is required.

Tip: Use the Medicare Online Script Service for digital prescriptions.

6. Importing from India: Brands and Manufacturers

Indian manufacturers such as Sun Pharma (1983) and Cipla (1935) offer affordable generics. Key options:

Import Rules:

• Limit to personal use (up to 3 months’ supply).
• Declare medications to customs.

7. Dosage and Administration

• Standard Dose:
  • Sitagliptin: 50–100 mg/day.
  • Metformin: 500–2000 mg/day.
• FDC Options: Combined tablets (e.g., 50 mg Sitagliptin + 1000 mg Metformin).
• Side Effects: Nausea, diarrhea, headache.

Storage: Keep at room temperature (15–30°C). Avoid moisture.

🔗 Drugs.com Side Effects

8. Legal Considerations: Prescription Requirements

Sitagliptin/Metformin is prescription-only globally. Purchasing without a prescription may violate regulations. Always consult a doctor before use.

9. Alternatives and Complementary Medications

• For insulin resistance: Pioglitazone (thiazolidinedione).
• For heart health: Atorvastatin (cholesterol control).

👉 Compare Linagliptin for another DPP-4 inhibitor.

10. Global Pricing Comparison

11. Safety Tips and Storage

• Monitor blood sugar levels regularly.
• Avoid alcohol, as it may increase gastrointestinal side effects.
• Store in a cool, dry place.

Conclusion

The Sitagliptin/Metformin combination offers a balanced approach to managing type 2 diabetes, combining DPP-4 inhibition with biguanide action. By understanding regional pricing, legal requirements, and proper use, patients can achieve optimal glycemic control while minimizing risks.

Final Advice: Always verify drug information with WHO Guidelines and consult a healthcare professional.