Kazano vs Janumet: Alogliptin or Sitagliptin With Metformin
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[Type 2 diabetes · DPP-4 · Comparison]

Kazano vs Janumet: how do the two DPP-4 and metformin tablets differ?

What is in it · Dose · Kidney limits · Warnings

Short answer: Both pair a DPP-4 inhibitor with metformin, are taken twice daily with food, and carry a boxed warning for lactic acidosis.12 Kazano uses alogliptin and is not recommended with an eGFR of 30 to 59; Janumet uses sitagliptin and is not recommended at 30 to under 45. Kazano adds a liver warning. Neither label reports a trial against the other.

How do Kazano and Janumet compare side by side?

From the US Kazano and Janumet labels. Side-effect rows come from different trials.
KazanoJanumet
Paired with metforminAlogliptin 12.5 mg per tablet1Sitagliptin 50 mg per tablet2
How takenTwice daily with food; tablets not split1Twice daily with meals; tablets not split2
Maximum daily doseAlogliptin 25 mg and metformin 2,000 mg1Sitagliptin 100 mg and metformin 2,000 mg2
Kidney limitsNot used with an eGFR below 30; not recommended at 30 to 591Not used with an eGFR below 30; not recommended at 30 to under 452
Side effects in label trialsPooled trials: upper respiratory infection 8% vs 3% on placebo, stuffy or runny nose 7% vs 2%1Started together: diarrhea 7.5% vs 4.0% on placebo, headache 5.9% vs 2.8%2
Heart failureHospital stays 3.9% on alogliptin vs 3.3% on placebo in EXAMINE1Seen with two other DPP-4 inhibitors2
Missed doseTake when remembered; skip if the next dose is due1Take when remembered; skip if the next dose is due2
Boxed warningWARNING: LACTIC ACIDOSIS1WARNING: LACTIC ACIDOSIS2

Reviewed . Half-life figures are shown only where the value Dose Track uses agrees with the cited source.

How do the warnings differ?

Both list lactic acidosis, pancreatitis, heart failure, allergic reactions, lower vitamin B12, low blood sugar with insulin or a sulfonylurea, severe joint pain and bullous pemphigoid.12 Kazano adds liver effects: fatal and non-fatal liver failure has been reported with alogliptin, and liver tests are checked if symptoms appear.1 Janumet adds acute kidney failure reported after approval.2 Both labels say the fixed tablet is not recommended in some kidney ranges because those people need a lower dose of the DPP-4 part. These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.

Which, if either, fits is for your prescriber. More detail: Kazano side effects, Janumet side effects, the Kazano and Janumet dosing schedules and Januvia vs Janumet: what does adding metformin change?.

Januvia vs Janumet: what does adding metformin change?Sitagliptin alone vs sitagliptin plus metformin Janumet vs Synjardy: how do the two metformin combinations differ?Sitagliptin plus metformin vs empagliflozin plus metformin Glyxambi vs Janumet: how do the two diabetes combination tablets differ?Empagliflozin plus linagliptin vs sitagliptin plus metformin

Frequently asked questions

What is the difference between Kazano and Janumet?+
The DPP-4 inhibitor. Kazano has alogliptin and Janumet has sitagliptin, each with metformin.12
Which one has a liver warning?+
Kazano. Its label warns that fatal and non-fatal liver failure has been reported with alogliptin.1
What if I miss a dose?+
Both Medication Guides say to take it when you remember, or skip it if the next dose is due, and not to take 2 doses at the same time.12
Can Dose Track remind me to take them?+
Yes. You can log each dose and set a reminder.

Sources

  1. Kazano (alogliptin and metformin hydrochloride) tablets prescribing information and Medication Guide, boxed warning and sections 1, 2, 5, 6 and 17. DailyMed, version of August 21, 2026.
  2. Janumet (sitagliptin and metformin hydrochloride) tablets prescribing information and Medication Guide, boxed warning and sections 1, 2, 3, 5 and 6. DailyMed, version of August 27, 2026.

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