Janupil-M 50/500mg Tablet is a combination oral antidiabetic medication containing Sitagliptin 50mg and Metformin 500mg, indicated for the management of type 2 diabetes mellitus. Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, enhances the incretin system by increasing levels of active incretin hormones, which regulate glucose homeostasis by increasing insulin release and decreasing glucagon levels in a glucose-dependent manner. Metformin, a biguanide, primarily acts by reducing hepatic glucose production, improving insulin sensitivity, and enhancing peripheral glucose uptake and utilization. The synergistic action of these agents helps achieve better glycemic control in patients inadequately controlled on diet and exercise alone or on monotherapy. Janupil-M is typically administered orally, with dosage individualized based on patient response and tolerability. Common adverse effects may include gastrointestinal disturbances such as nausea, diarrhea, and abdominal discomfort, primarily attributed to Metformin. Rare but serious adverse reactions include lactic acidosis and pancreatitis. Caution is advised in patients with renal impairment, hepatic dysfunction, or conditions predisposing to hypoxia. Regular monitoring of blood glucose, renal function, and lactic acid levels is recommended during therapy. Janupil-M should be used as part of a comprehensive diabetes management plan including diet, exercise, and weight control.