[etherea]

My insurance has decided to quit paying for my Janumet. I've been on it since I was diagnosed in 2011. Now it will cost $490 a month! Needless to say I can't afford that.
My doctor has switched me to the highest dosage of Metformin ER in its place. The pharmacist was appalled--he said no one goes from Janumet to Metformin! I will be switching when I run out of Janumet in about 10-12 days. All that being said, has anyone gone from Janumet to Metformin? I expect some dietary distress, but otherwise no idea what to expect.

 

[mbuster]

I went from Janumet 50/500 to regular metformin 1000. It was a pain for a while, but that was the regular metformin, I've never taken the extended release version. Not sure what size pills you will get but I've heard 500 mg ERs are a lot less expensive than than the 1000 mg. If it was me, only based upon my starting regular metformin, I would start out taking 1 five hundred a day for a couple of days and then go to 2 a day and split into morning and night. I'd do that a week and add a third pill and do it with my night dose. I'd give that a week and add the 4th pill, 2 in the morning and 2 in the evening.

Be glad your insurance won't continue to pay for it, when I read the warnings about it (Januvia/Janumet DDP-4 inhibitors) I told my doctor to switch me to plain metformin and he did. Never regretted it.

 

[etherea]

I was taking Janumet 50/500 also. I talked to the doctor about changing after I saw the warnings a couple of years ago. He gave me the "I have my mother on this medicine" spiel. I do kind of see it as a blessing in disguise.
I'm glad to hear about your success. The nurse did say I could ease into the Metformin and that the ER was easier on the stomach.
Thanks for the info!

 

[Bunjee]

As an FYI, docs are SUPPOSED to start you on Metformin and save the designer drugs if Metformin doesn't work or not tolerated.

 

[etherea]

As an FYI, docs are SUPPOSED to start you on Metformin and save the designer drugs if Metformin doesn't work or not tolerated.

I know this now, but apparently my doctor didn't and doesn't. I tried to talk to him about it, but he pulled the "I have my mother on this drug" on me.
Back in 2011 I also ate according to the dietician's guidelines--so far off the mark!
I feel like I've come a long way, mostly from being a part of this forum.
:vs_peace:

 

[Bunjee]

The problem with the dieticians is that their certification comes from the ADA so to vary from it would threaten their livelihood. At the same time, I find it frustrating to find out that they know so LITTLE. I have gout and have been able to control it for decades by watching certain things in my diet. I can have any food, but some foods are triggers particularly legumes. I flat out asked a dietician if she even knew what a legume was after I told her that I had to limit legumes because of gout (she was pushing beans, green beans, peas, lentils, etc.). If a dietician is so poorly trained, doctors have no hope since they get no training in nutrition.

Another issue for you to be concerned about is that many doctors have no idea what these drugs cost. They all figure that your insurance pays it. I just looked on GoodRx. If you had to pay out of pocket for Janumet, it's $200/month (1 pill a day) vs. Metformin which is $4-10/month. It isn't his mother who takes it, it's his portfolio that is benefiting from it (am I being cynical?)

 

[etherea]

Just an update on the switch--everything went well. I had a little digestive distress from the increased metformin, but that didn't last long. I did find that I have to be more careful with my carbs (most of my carbs are vegetables) without the Januvia, but I figured that out quickly. I am happy with my numbers, but I'm also trying to lower them. I go for another A1C on December 1 and can't wait to see how it turns out.