Metformin versus Januvia

By Sheryl Latest Reply 2008-08-30 16:25:54 -0500
Started 2008-08-03 14:08:29 -0500

I currently do not take medication, controling through diet and exercise.
I went to my gyno last week for an annual check up and was told that I should ask to be put on Metformim. She said that when in the early stages of this disease it is very effective in keeping the BG down, it has other beneficial effects to health as well.
I was studying Januvia and thought perhaps if I was to go on any medication it would be a good choice as it only works if your BG rises or goes to low.
Both medications boast no weight gain which I am concerned about. I have lost 55 lbs from my all time high, 20 of those lbs most recently.
I see my regular Dr in Sept and plan on discussing this with her.
Can anyone enlighten me on either of these medications? One better then the other? Should they be taken early on?

9 replies

DJ 2008-08-27 00:06:45 -0500 Report

Hi Sheryl, I am on a combination Med called Janumet which is a mix of Metaformin and Januvia..well, I should say I have been on and off of it..I have acid reflux & Gurd so my stomach is very touchy and I get the horrible stomach cramps mentioned above..gets to the point after a week or so that it just burns so bad I have to stop taking it. My Endo says" But everyone takes it!!" and I can't seem to get through to her that I have tried numerous times but the pain gets so bad I can't eat or even move around when I am taking it…and it does require you to eat huge amounts of food…and contrary to what it says about no weight gain…I gained 12 lbs just in the month I have tried to make this med work for me…but this is just me, and it may work just fine for you. Sorry I didn't mean to write a novel here, just wanted to let you know there is a working combo for the Januvia & Metaformin.

Jeanarie 2008-08-19 12:04:41 -0500 Report

I have been on metformin for years and I have friends on Januvia. I think they are both good. Not heard anything bad about either. Januvia is much more expensive than the metformin (the only real difference I know of). Others may know more.

ssmile 2008-08-04 09:20:56 -0500 Report

I was on Metfomin for a couple of weeks and it was so bad I refused to take it anymore. I have a sesitive stomach though and have had problems with acid reflux. It is all on an individual basis. It seems like I've been on a trial and error for the last ten years of my life so don't feel bad. I have been on Gluccotrol XL, Glyberide, Metformin, Gluccophage, Amiryl, Actos. please excuse the spelling. Sometimes its a long road but there is good end results. See a lot of diabetic medications/pills cause the pancreas to sqeeze or constrict in order to secrete insulin. My Endo said he wasn't even sure if mine produced any at all and took me off of any orals. But again every one is so different. Just go with whatever you feel is best for you.

kdroberts 2008-08-04 08:56:23 -0500 Report

They both do similar things as well as different things. Januvia doesn't just work when your blood sugar is high, it works 24/7 as does metformin. The thing the both do in common is to inhibit the amount of sugar the liver stores and releases, especially around meal times. Januvia is interesting, and somewhat similar to byetta. You have a hormone in your body called GLP-1 and that roughly is a communication between your pancreas and liver. It's been shown in diabetics that this hormone is low, not there or obstructed so the process of your liver signaling your pancreas to start producing insulin, your pancreas telling your liver to stop releasing glucose and your liver telling your pancreas to slow down and stop producing insulin doesn't work right. Januvia inhibits the enzyme (DPP-4) that gets in the way of the communication so the process works better (byetta is basically a synthetic version of GLP-1) and that's where the thing about working when you have high blood sugar comes in. It shouldn't be taken now and again, it should be taken every day otherwise you won't get the full effect from it. Currently Januvia is the only DPP-4 inhibitor on the market but at least 3 more are undergoing FDA approval right now. Metformin has been around for a long time, not quite so long in the US but still a significant amount of time. It has been described as an anti death pill for diabetics. The first post here quotes a widely touted post about the benefits of met ( so you can check that out if you like. It's one of those drugs that you have to take for a while for it to become effective, 2-6 weeks is fairly common, and it takes a while for it to stop working which means you can skip a dose here and there and not notice any changes in control. It does have the drawback of stomach cramps and general "GI distress" for many patients. Taking it with food helps with that as does ramping up over a couple of weeks to the therapeutic dose (1500-2550mg). The XR version is also said to cut that dramatically. A lot of people suffer from that side effect, some can live with it but for some it's so bad they have to stop taking it.

Cost will come into play, metformin is cheat ($4/30 day, $10/90 days), Januvia isn't off patent yet and wont be for a while so you will be paying brand pricing for it, cost price was well above $100/30 days last time I checked.

butterfly_8 2008-08-04 09:03:44 -0500 Report

It is expensive but I feel it is worth it. It will be cheaper in the future once there is a generic brand.

kdroberts 2008-08-04 09:10:19 -0500 Report

It will be cheaper when generic is available, unfortunately the initial patent isn't set to expire until 2017 so it will be at least 9 years before you see that generic. It could be longer if they get an extension which is quite common. Unless something drastically changes in the health care system.

Sheryl 2008-08-04 10:29:06 -0500 Report

kd, thanks for all your insight on these two drugs…and the link you provided pretty much summed it up. I should be on it already!
I am going to ask my Dr about it when I see her in Sept. According to the link you sent, the author thinks everyone should be on it and even before diabetes.
I am definately reviewing and fact gathering on the Metformim. My gyno had nothing but good to say about it and it's benefits.
Januvia is also interesting, I like the fact that it only works in the body when the sugars rise or fall, one pill a day.
kd, you sent valuable info and I appreciate that and all the info I can get from others going through this.
But as ssmile pointed out, not everyone is the same or achieves the same results no matter what you do.
Thanks again,

butterfly_8 2008-08-04 01:31:41 -0500 Report

Hi Sheryl,
I take both but they were given to me by my Dr. as everyone on this site will tell you it is an individual thing. What is good for one is not necessarily good for another. I however do not take Januvia daily only when my bs is hiked. I am very pleased with both.