Januvia vs. Metformin

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS


Januvia and Metformin are two of the treatment options for people who have been diagnosed with type 2 diabetes. Both of these medications have become the most common treatment for people with this condition. These two types of medications have been shown to manage high blood sugar and treat type 2 diabetes.

Januvia and Metformin may be the most popular prescribed medication for type 2 diabetes, but they still might not work for every patient. Doctors look at each individual case to determine which medicine might be best for each patient. It is always important to know the differences between Januvia and Metformin to understand why the doctor prescribed that specific medication for them.

What is Januvia? 

Januvia was approved by the FDA in 2006. This medication has shown significant improvements in hemoglobin A1C. It can be used with other type 2 diabetes medications, but it should not be used to treat type 1 diabetes or diabetic ketoacidosis.

There is no generic medication for Januvia at this time. It is recommended while taking this medication that the individual changes their diet and exercise to help improve blood glucose control.

The medication works by lowering the blood glucose levels by blocking an enzyme known as dipeptidyl peptidase IV, or DPP-4. It helps lower the blood sugar and improves the body’s response to insulin.

Januvia is a pill that is taken once a day with or without food. Januvia can be taken morning or night, but once the individual sets the time of day of taking the medication it should continue to take it the same time every day.

It comes in dosage strengths of 25 mg, 50 mg and 100 mg. The doctor will make sure they work with the patient to prescribe the best strength that will work for them.

Januvia can be taken with other medication as a part of the patient’s treatment plan for type 2 diabetes.

The Side Effects of Januvia 

As with any medication prescribed by a doctor, it is important to understand the potential side effects of Januvia. It is pertinent to tell the doctor if the individual has had heart failure or problems with their kidneys because Januvia might increase the risk of these symptoms.

The most common side effect patients have with Januvia is an upper respiratory infection, stuffy or runny nose, sore throat, and a headache.

There are more serious side effects people need to be made aware of being on medication. If any of the following side effects are experienced, the doctor should be notified immediately.

  • Inflammation of the pancreas
  • Low blood sugar
  • Allergic reactions
  • Joint pain, including serious joint pain
  • Skin reactions such as blisters or breakdown of the outer layer of the skin

If serious side effects occur with the patient, the doctor will find another medication that will be more suitable to treat their condition.

What is Metformin?

Metformin has become the most popular drug in the treatment of type 2 diabetes. It is also used to treat polycystic ovary syndrome (PCOS). Metformin is the generic name and many different manufacturers can sell it under various names, which include:

Before being prescribed Metformin, it is important to know that if the individual has had severe kidney disease, metabolic acidosis, or diabetic ketoacidosis, the patient should not be put on this medication.

It is important to keep the doctor informed of all health conditions while being prescribed Metformin. It is important to mention if the individual has had the following:

  • Heart disease, including congestive heart failure
  • Liver disease
  • Kidney disease
  • Insulin use
  • The use of other medications for type 2 diabetes

Metformin can come in a liquid or pill form and can be used with other diabetes medications. It should be taken with a meal unless the doctor says otherwise. It can be given in different dosages, which can be adjusted throughout the patient’s treatment plan.

The Side Effects of Metformin

Many People experience side effects when taking metformin. This medication can cause a change in blood sugar so it is important to know the symptoms of low and high blood sugar.  Some of the more common side effects of metformin include:

  • Indigestion
  • Bloating
  • Flushing of the skin
  • Metallic taste in the mouth
  • Diarrhea or constipation
  • Headache
  • Flushing of skin

Some more serious side effects can occur which include chest pain and a rash. If these occur, the patient should call the doctor and a different medication may be prescribed.

Januvia Vs. Metformin: Which Medication Works Best for Type 2 Diabetes?

This is the question every patient asks when diagnosed with type 2 diabetes. It is important to understand that patients are all different, and that is why doctors look at the pros and cons when prescribing medication for type 2 diabetes.

What are the Pros and Cons of Januvia?

The pros of taking Januvia for type 2 diabetes include:

  • It does not cause weight gain
  • It uses the hormones naturally produced by the body to affect how the sugar is processed
  • It can be taken in pill form
  • It does not cause stomach side effects like Metformin
  • It does not need to be taken with food

Cons of taking Januvia include:

  • There is no generic form, so the cost can be higher than with Metformin
  • Individuals might experience cold-like symptoms more frequently
  • Lowers AC1 less than 1%
  • More serious side effects of pancreatitis and severe joint pain can occur

What are the Pros and Cons of Metformin?

The pros of taking Metformin include:

  • It rarely causes any concerns with low blood sugar like other medications
  • It will not cause any weight gain
  • It can improve sugar control and lower A1c levels by as much as 2%
  • It is one of the few medications that can lower the risk of death from diabetic-related complications

The cons of taking Metformin include:

  • It can not be used for individuals who have severe kidney problems
  • Individuals who drink alcohol can increase their risk of dangerous side effects
  • It can often cause an upset stomach, diarrhea, nausea, gas, or stomach cramping

In choosing the right medication for a patient, doctors will look at what will give the patient the most benefit in contrast to the risks. This will be done on an individual basis by the doctor.

The Rx Advocates Can Help People Save Money on Their Monthly Januvia Prescriptions

Many doctors will prescribe Januvia to their patients because it does not have as many side effects as other types of diabetes medications. Januvia is not a generic medication, so paying for it can be a challenge. At The Rx Advocates, we help make monthly prescription medications much more affordable for the consumer.

We act on our patients’ behalf with our patient assistance program to get discounts. In the end, you just pay for our services. The benefit is that the medication will be delivered to you at no additional cost.

We have helped many individuals save hundreds of dollars every month on Januvia and other medications. If paying for medicine has been a financial concern for you, we can help. Please contact us today.

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