As initial therapy in patients with type 2 diabetes mellitus to improve glycemic control when diet and exercise do not provide adequate glycemic control.
As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus inadequately controlled on metformin or sitagliptin alone, or in patients already being treated with the combination of sitagliptin and metformin.
As part of triple combination therapy with a sulfonylurea as an adjunct to diet and exercise in patients with type 2 diabetes mellitus inadequately controlled with any 2 of the 3 agents: Metformin, sitagliptin or a sulfonylurea.
As triple combination therapy with a peroxisome proliferator-activated receptor gamma (PPARγ) agonist (ie, thiazolidinedione) as an adjunct to diet and exercise in patients inadequately controlled on their maximal tolerated dose of metformin and a PPARγ agonist.
Patients Inadequately Controlled on Sitagliptin Monotherapy: If therapy with a combination tablet containing sitagliptin and metformin is considered appropriate for a patient inadequately controlled on sitagliptin alone, the recommended starting dose of Janumet is sitagliptin 50 mg/metformin hydrochloride 500 mg twice daily. Patients with inadequate control on this dose can be titrated up to sitagliptin 50 mg/metformin hydrochloride 1000 mg twice daily.