GlobalRPh Renal Dosing Masterv6.6
Evidence addition

Sitagliptin / metformin immediate-release (Janumet)

Local official-label summaryBase record retrieved 2026-09-05See the evidence for this drug3 sources available - open source summaries, references and comparisons

Janumet / Janumet IR

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Renal guidance at a glance

Cautions / source differences (1)

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Display order is not a clinical ranking. Date of retrieval is not the label revision date. Sources are never merged into one regimen. Other sources and conflicts remain below.

1 additional source qualifications - review before use
JANUMET label versus institutional metformin contrast policy

JANUMET labeling advises interruption for eGFR 30-60 around iodinated contrast. UCSF allows metformin continuation for IV contrast at eGFR at least 30 without AKI. The two also describe arterial procedures differently.

Before applying: Document the institutional policy and contrast route. This disagreement does not override JANUMET suitability or its sitagliptin component. The UCSF page cites an older ACR edition; no latest-edition claim is made.

Also check: JANUMET label versus institutional metformin contrast policy

Official source

Sitagliptin / metformin immediate-release (Janumet) - selected U.S. label sections

Product / population
JANUMET immediate-release combination tablets; not JANUMET XR or separate component tablets.
Renal measure
eGFR in mL/min/1.73 m2

Selected renal sections only, not a complete monograph. Exact product, indication, patient population, renal method and all other contraindications/interactions remain controlling.

Second independent renal reference and clinician adjudication remain pending; no all-indication, dialysis or pediatric dose may be inferred from an omitted field.

Renal restrictions - IR combination

Assess renal function before treatment and periodically. JANUMET is contraindicated below eGFR 30. At 30 to below 45, it is not recommended because the fixed combination cannot provide the lower sitagliptin dosage needed.

Iodinated contrast and renal reassessment

For eGFR 30-60, withhold at or before iodinated contrast. Reassess eGFR after 48 hours and restart only when stable. The label also requires withholding for specified liver disease, alcoholism, heart failure or intra-arterial contrast circumstances.

Source revision: Revision not captured; retrieval date is not the revision date. | Retrieved: 2026-09-05. Retrieval date is not the revision date.

Source: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d19c7ed0-ad5c-426e-b2df-722508f97d67

Scope: Local label summary; independent clinical review pending. Not a two-source validated protocol. GlobalRPh v6.6.

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Evidence sources and renal implications

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Official product label

Sitagliptin / metformin immediate-release (Janumet) - selected U.S. label sections

JANUMET immediate-release combination tablets; not JANUMET XR or separate component tablets.

Renal method: eGFR in mL/min/1.73 m2
Retrieved: 2026-09-05

Read local renal resultOpen original reference
GlobalRPh RX List

GlobalRPh RX List - JANUMET

Restriction or avoidance guidance. Read the specific threshold, age, formulation and dialysis exclusions; do not generalize across products.

Adult sitagliptin/metformin immediate-release fixed combination; not JANUMET XR or either separate ingredient.

Renal method: Indexed eGFR, mL/min/1.73 m2.
Retrieved: 2026-09-07

Read local renal resultOpen original reference
Professional guidance

UCSF Radiology: metformin around iodinated contrast

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Institutional metformin contrast guidance; combination-product restrictions remain separate.

Renal method: eGFR mL/min/1.73 m2 plus AKI and contrast route/procedure
Retrieved: 2026-09-07

Read local renal resultOpen original reference

Source presence is not independent validation. A label mirror is not a second independent source; review the original reference and exact formulation.

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Jump to renal guidanceRead 1 difference / caution notesClinician guide

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Source differences and product cautions

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These are specific issues found during source review, not an automated judgment that one source is universally correct. A label mirror and its original label are not independent evidence.

label vs institutional guidance

JANUMET label versus institutional metformin contrast policy

JANUMET labeling advises interruption for eGFR 30-60 around iodinated contrast. UCSF allows metformin continuation for IV contrast at eGFR at least 30 without AKI. The two also describe arterial procedures differently.

How to use this: Document the institutional policy and contrast route. This disagreement does not override JANUMET suitability or its sitagliptin component. The UCSF page cites an older ACR edition; no latest-edition claim is made.

GlobalRPh RX List - JANUMETUCSF Radiology: metformin around iodinated contrastSitagliptinSitagliptin / metformin extended-release (Janumet XR)

Source-specific interpretation; independent clinician adjudication pending.

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Renal dosing and precautions

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New source summary - independent clinical review pending. Summaries of the identified label sections are included locally. Source import and numeric transcription checks are not independent two-reference validation. Do not treat this card as an approved institutional dosing protocol.

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Original content / product scopeSitagliptin / metformin immediate-release (Janumet) - selected U.S. label sectionsGlobalRPh RX List - JANUMETUCSF Radiology: metformin around iodinated contrast
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Exact product and population matter. This added page contains locally stored, source-specific clinical summaries. Historical handbook information, when present, is identified separately and may conflict with U.S. labeling. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.
Locally stored source content

Exact product and population

Product identity selected for the separately displayed source protocols below. Reference: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d19c7ed0-ad5c-426e-b2df-722508f97d67

Product and population scope

JANUMET immediate-release combination tablets; not JANUMET XR or separate component tablets.

RDM32-sitagliptin-metformin-janumet-ir-scope · Source section: Editorial scope for the selected U.S. labelRenal section finder
Separate U.S. product-label layer

FDA / DailyMed dosing and renal information

Official

Sitagliptin / metformin immediate-release (Janumet) - selected U.S. label sections

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U.S. product labeling / DailyMed · JANUMET immediate-release combination tablets; not JANUMET XR or separate component tablets.

Renal method: eGFR in mL/min/1.73 m2
Source date: Revision not captured; retrieval date is not the revision date.
Retrieved: 2026-09-05

Local label summary; independent clinical review pending. Not a two-source validated protocol.

Renal restrictions - IR combination

Assess renal function before treatment and periodically. JANUMET is contraindicated below eGFR 30. At 30 to below 45, it is not recommended because the fixed combination cannot provide the lower sitagliptin dosage needed.

RDM32-sitagliptin-metformin-janumet-ir-1 · Source locator: 2.2; 8.6

Iodinated contrast and renal reassessment

For eGFR 30-60, withhold at or before iodinated contrast. Reassess eGFR after 48 hours and restart only when stable. The label also requires withholding for specified liver disease, alcoholism, heart failure or intra-arterial contrast circumstances.

RDM32-sitagliptin-metformin-janumet-ir-2 · Source locator: 2.3; 5.1

Source-specific limits

Selected renal sections only, not a complete monograph. Exact product, indication, patient population, renal method and all other contraindications/interactions remain controlling.

Second independent renal reference and clinician adjudication remain pending; no all-indication, dialysis or pediatric dose may be inferred from an omitted field.

Source identity and provenance
Source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d19c7ed0-ad5c-426e-b2df-722508f97d67
Retrieved
2026-09-05
DailyMed Set ID
d19c7ed0-ad5c-426e-b2df-722508f97d67
Renal-function method
eGFR in mL/min/1.73 m2
Source date/version
Revision not captured; retrieval date is not the revision date.
Hash meaning
SHA-256 identifies this local summary, not original SPL XML or a label PDF.
Local summary SHA-256
133f26f88fb7190c1d131f14130c4ddde21ff4b8b0ff27ba3591cce3e931a21d
Locally imported selected renal sections

GlobalRPh RX List renal information

Rxlist

GlobalRPh RX List - JANUMET

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GlobalRPh-hosted RX List · Adult sitagliptin/metformin immediate-release fixed combination; not JANUMET XR or either separate ingredient.

Renal method: Indexed eGFR, mL/min/1.73 m2.
Source date: Source revision date not established in selected retrieval.
Retrieved: 2026-09-07

Label mirror, not independent corroboration. This is selected locally stored RX List content. Full monograph import and current official-label review are not implied.
Restriction or avoidance guidance. Read the specific threshold, age, formulation and dialysis exclusions; do not generalize across products.

Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.

Renal dosing, restrictions and evidence limits

JANUMET is contraindicated at eGFR below 30 mL/min/1.73 m2 and is not recommended at 30 to below 45 because the fixed combination cannot provide the required lower sitagliptin dose. Check eGFR before therapy and at least annually, more often when renal decline is likely. For iodinated contrast, stop at or before the procedure when eGFR is 30-60, or with hepatic impairment, alcoholism, heart failure, or intra-arterial contrast; recheck renal function after 48 hours and restart only if stable. These combination-product restrictions cannot be replaced by the single-agent sitagliptin schedule. Acute hypoxic illness and restricted food/fluid intake also require the label-specific interruption assessment.

RDM36-rxlist-sitagliptin-metformin-janumet-ir-60d62aea68-C1 · Source locator: Recommendations for renal impairment; iodinated contrast; lactic-acidosis precautions.

Source identity and provenance
Source family
product_label_mirror
Source
https://globalrph.com/rx-list/janumet-drug/
Retrieved
2026-09-07
Renal-function method
Indexed eGFR, mL/min/1.73 m2.
Source date/version
Source revision date not established in selected retrieval.
Hash meaning
SHA-256 of local authored summary only; not original HTML, PDF or SPL bytes.
Local summary SHA-256
4dfa3d34621598eaa4f3d5a5071ca6f067f2fd9d0eeace5f12968dac2508680c
Separate professional-source layer

University and professional protocols

Professional

UCSF Radiology: metformin around iodinated contrast

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UCSF Radiology · Institutional metformin contrast guidance; combination-product restrictions remain separate.

Renal method: eGFR mL/min/1.73 m2 plus AKI and contrast route/procedure
Source date: Page cites ACR Manual version 10.3 (2017); no edition update inferred from retrieval date.
Retrieved: 2026-09-07

Source recheck unresolved. Prior follow-up retrieval/version warning retained; not resolved by v6.0. Read source-review status
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.

Renal dosing, restrictions and evidence limits

UCSF Radiology states that metformin need not be stopped for intravenous iodinated contrast when there is no AKI and eGFR is at least 30 mL/min/1.73 m2; obligatory post-procedure renal testing is not required for that category. With AKI, eGFR below 30, or an arterial catheter procedure that could embolize the renal arteries, withhold at or before the procedure and for 48 hours afterward; restart only after reassessing kidney function and meeting the stated recovery requirement. This addresses the metformin component, not whether JANUMET is otherwise suitable. The page cites ACR Manual version 10.3 (2017); it is not an independently checked 2026 ACR edition.

RDM36-professional-sitagliptin-metformin-janumet-ir-cdc3790063-C1 · Source locator: Contrast administration in patients receiving metformin, Categories I and II.

Source identity and provenance
Source family
professional_guidance
Source
https://radiology.ucsf.edu/patient-care/health-professionals/patient-safety-healthcare-professionals/ct-and-x-ray-contrast-guidelines/info
Retrieved
2026-09-07
Renal-function method
eGFR mL/min/1.73 m2 plus AKI and contrast route/procedure
Source date/version
Page cites ACR Manual version 10.3 (2017); no edition update inferred from retrieval date.
Hash meaning
SHA-256 of local authored summary only; not original HTML, PDF or SPL bytes.
Local summary SHA-256
7bce9ac1802081951f3946b9070c1cad5f736919d746929bdaf3139bc5838f04

Provenance and preservation

Additional summaries stored on this page: 1 official-label, 1 RX List, 1 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d19c7ed0-ad5c-426e-b2df-722508f97d67
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
multisource addition
Local text SHA-256
bcd635529cfbb9aa0c2a8a3bb8c0bc733a8e9127dbc403e89facccb5b43511d7
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

This page is an additional exact-product entry, not a recovered GlobalRPh monograph. Its primary scope text and separately attributed clinical summaries are locally included.

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